Risk Factors For Malaria Research Articles

Pooled prevalence and risk factors of malaria among children aged 6-59 months in 13 sub-Saharan African countries: A multilevel analysis using recent malaria indicator surveys.

Every 75 seconds, a child under five dies of malaria. Mainly children, aged between six months and five years, are at the highest risk for malaria. These children lost maternal immunity and did not yet developed specific immunity to the infection. Under the age of five, children bear the highest burden of malaria in Sub-Saharan Africa (SSA). Many individual and community level factors could contribute to malaria prevalence remaining high among under-five children in the region. Thus, this study aimed to assess the pooled prevalence of malaria among children aged 6-59 months and identify potential factors associated with malaria by using recent Malaria Indicator Surveys in 13 SSA countries. Data for this study were drawn from recent 13 Sub-Saharan African countries Malaria Indicator Surveys (MIS). A total weighted sample of 60,541 children aged 6-59 months was included. STATA version 14.2 was used to clean, code and analyze the data. Multilevel logistic regression was employed to identify factors associated with malaria. Adjusted odds ratio with 95% CI and a P value <0.05 was reported to indicate statistical association. Model fitness and comparison were done using Inter cluster correlation coefficient, Median odds ratio, proportional change in variance, and deviance. The pooled prevalence of malaria among children aged 6-59 months was found to be 27.41% (95% CI: 17.94%-36.88%). It ranges from 5.04% in Senegal to 62.57% in Sierra Leone. Aged 36-47 months (AOR = 3.54, 95% CI 3.21-3.91), and 48-59 months (AOR = 4.32, 95% CI 3.91-4.77), mothers attended primary education (AOR = 0.78, 95% CI 0.73-0.84), richer (AOR = 0.35, 95% CI 0.32-0.39), and richest household (AOR = 0.16, 95% CI 0.14-0.19), number of three and more under-five children (AOR = 1.35, 95% CI 1.26-1.45), improved floor material (AOR = 0.65, 95% CI 0.57-0.73), improved wall material (AOR = 0.73, 95% CI 0.64-0.84), improved roof material (AOR = 0.70, 95% CI 0.51-0.93), insecticide-treated bed net (ITN) use (0.56, 95% CI 0.51-0.62), not anemic (AOR = 0.05, 95% CI 0.04-0.06), rural resident (AOR = 2.16, 95% CI 2.06-2.27), high community ITN use (AOR = 0.40, 95% CI 0.24-0.63) and high community poverty (AOR = 2.66, 95% CI 2.53-2.84) were strongly associated with malaria. Almost 3 out of 10 children were infected by malaria in 13 SSA countries. Malaria infection remains one of the main killers of children aged 6-59 months in the SSA. This study revealed that older under-five children living in large families with low incomes in rural areas are most vulnerable to malaria infection. Our results clearly indicate that ITN utilization and improved housing are promising means to effectively prevent malaria infection among children aged 6-59 months. It is therefore important to note that households with low wealth quintiles and rural residents should be prioritized in any mass distribution of ITNs. This has to be accompanied by education using mass media to enhance community awareness.

A Comparative Study of the Risk Factors of Malaria within Urban and Rural Settings in the Sahelian Region of Cameroon and the Role of Insecticide Resistance in Mosquitoes

Background: Cameroon is among the 11 countries that account for 92 % of malaria infection in sub-Saharan-Africa in 2018, and Maroua III Health District and her environs witnessed a malaria outbreak in 2013 with hundredths of deaths.&#x0D; Aim: To determine the risk factors of malaria in the urban and rural population and to investigate the level of mosquito’s resistance to Deltamethrin and Permethrin.&#x0D; Methods: It was a cross-sectional community-based study carried out in August, September and October 2019, in which questionnaires were administered to 500 participants, to obtain information on demographics, socioeconomics, behavioral, and environmental factors thought to be associated with malaria infection in both rural and urban settings. Blood samples were collected for diagnosis of malaria and bivariate and multivariate regression analysis were used to identify risk factors of malaria. Mosquito resistance to Deltamethrin and Permethrin were determined using the CDC Bottle Bioassay test. &#x0D; Results: Malaria prevalence was 52.2 % which was significantly higher (P = 0.016) in rural areas (57.6%) than urban areas (46.8%). The prevalence of asymptomatic malaria was 43.4% and the geometric mean parasite density was 6333.60 parasites/µL of blood. Malaria infection was significantly (P&lt;0.001) associated with children (64.1%) and teenagers (58.1%). Likewise, the infection was significantly associated with the presence of crops around homes (P=0.031), usage of old LLINs for more than three years and in urban settings, with primary education level (P=0.023). The overall mortality of Anopheles species was 93.57% (91.19% in rural and 95.83% in urban areas) for deltamethrin which was more sensitive than 83.85% (85.24% in rural and 82.46% in urban areas) for permethrin.&#x0D; Conclusion: Relevant data for malaria control in Maroua III health district, a typical Sahelian environment has been generated, and indicates that most of the burden of malaria is borne by children and teenagers.

Imported severe Plasmodium falciparum infection in the first trimester of pregnancy complicated by post-artemisinin delayed hemolysis and intrauterine fetal death, a case report

BackgroundPost-artemisinin delayed hemolysis (PADH) is a serious complication in patients who recover from severe malaria after receiving artemisinin-based combined therapy (ACT), including artemether-lumefantrine. In Japan, among the antimalarial drugs recommended by the World Health Organization (WHO) guideline for severe malaria, intravenous quinine gluconate is available only in 29 designated hospitals, and intravenous artesunate is unavailable. Therefore, oral artemether-lumefantrine is occasionally administered as an alternative, even though it may be a suboptimal treatment. In non-endemic settings like Japan, a lack of knowledge of malaria and the side effects, such as post-artemisinin delayed hemolysis caused by the ACT, can have critical consequences. Like our patient, being a primigravida in the early stages of pregnancy is a serious risk factor for severe malaria and must be carefully monitored.Case presentationThis report describes a severe case of imported Plasmodium falciparum malaria complicated by fetal loss and prolonged anemia, requiring frequent blood transfusions. The patient was a previously healthy pregnant Japanese female in her 30 s. She developed a high fever 2 days after returning from Nigeria. The patient fulfilled the severe malaria criteria by WHO. On arrival, an abdominal ultrasound incidentally revealed a fetus of 5 week gestational age with a heartbeat in the uterus. Given her pregnancy and the severity of the disease, she was administered intravenous quinine 16 mg/kg as a loading dose. However, the second dose of quinine was not administered due to frequent vomiting and QTc prolongation. We initiated treatment with oral artemether-lumefantrine, and clearance of parasitemia was confirmed by microscopic observation on day 4. Miscarriage was noted on day 6 after admission. Moreover, the patient became feverish again up to 39 °C, and from days 14 to 22, the patient required multiple blood transfusions due to PADH. On day 40, follow-up was discontinued as the hemoglobin level exceeded 10 g/dL.ConclusionsIn patients who recover from severe malaria after ACT treatment, monitoring the hemoglobin level for at least a month is strongly recommended for prompt identification of PADH. Travelers to malaria-endemic countries, especially primigravida women, should be provided with adequate information on the risk and prevention of infection.

Women attending antenatal care as a sentinel surveillance population for malaria in Geita region, Tanzania: feasibility and acceptability to women and providers

BackgroundMeasurement of malaria prevalence is conventionally estimated through infrequent cross-sectional household surveys that do not provide continuous information regarding malaria parasitaemia. Recent studies have suggested that malaria parasitaemia prevalence among women attending antenatal care (ANC) correlates with prevalence among children under 5 years old and that pregnant women could be a sentinel population for tracking malaria prevalence. In mainland Tanzania, 97% of women are tested for malaria parasitaemia during first ANC visits. However, acceptability among pregnant women and healthcare providers of collecting malaria risk factor data during ANC visits is limited.MethodsA tablet-based questionnaire including 15 questions on insecticide-treated net ownership and use and care-seeking for febrile children was introduced at 40 healthcare facilities in Geita Region, Tanzania. Facilities were randomly selected from among those with 15–120 first ANC visits per month. To assess perspectives regarding introduction of the questionnaire, 21 semi-structured interviews were held with providers and facility in-charges at 12 facilities. Thirty pregnant and recently delivered women participated in focus group discussions at seven facilities to assess the acceptability of spending additional time answering questions about malaria risk.ResultsAll pregnant women reported that introduction of ANC surveillance and spending 10 more minutes with providers answering questions about their health would be neutral or beneficial. They perceived being asked about their health as standard of care. Providers and in-charges reported that introduction of ANC surveillance was within their scope of practice. Nine of 21 indicated it could potentially benefit women’s health. Six providers expressed concern about staffing shortages and need for reimbursement for extra time and noted that data management occurs after hours.ConclusionsPregnant women and providers generally perceived ANC surveillance for malaria as acceptable and positive. Pregnant and recently delivered women saw this as a reasonable and even helpful intervention. To be seen as a part of standard practice, efforts are needed to ensure providers perceive a benefit for ANC clients and that staffing concerns are addressed. In addition, staff should receive feedback related to data submissions regarding malaria prevalence and risk factors among women at their facility, with actions to take.

Livelihood activities, human mobility, and risk of malaria infection in elimination settings: a case–control study

BackgroundLivelihood activities and human movements participate in the epidemiology of vector-borne diseases and influence malaria risk in elimination settings. In Saudi Arabia, where malaria transmission intensity varies geographically, it is vital to understand the components driving transmission within specific areas. In addition, shared social, behavioural, and occupational characteristics within communities may provoke the risk of malaria infection. This study aims to understand the relationship between human mobility, livelihood activities, and the risk of malaria infection in the border region of Jazan to facilitate further strategic malaria interventions. In addition, the study will complement and reinforce the existing efforts to eliminate malaria on the Saudi and Yemen border by providing a deeper understanding of human movement and livelihood activities.MethodsAn unmatched case–control study was conducted. A total of 261 participants were recruited for the study, including 81 cases of confirmed malaria through rapid diagnostic tests (RDTs) and microscopy and 180 controls in the Baish Governorate in Jazan Provinces, Saudi Arabia. Individuals who received malaria tests were interviewed regarding their livelihood activities and recent movement (travel history). A questionnaire was administered, and the data was captured electronically. STATA software version 16 was used to analyse the data. Bivariate and multivariate analyses were conducted to determine if engaging in agricultural activities such as farming and animal husbandry, recent travel history outside of the home village within the last 30 days and participating in spiritual gatherings were related to malaria infection status.ResultsA logistical regression model was used to investigate components associated with malaria infection. After adjusting several confounding factors, individuals who reported travelling away from their home village in the last 30 days OR 11.5 (95% CI 4.43–29.9), and those who attended a seasonal night spiritual gathering OR 3.04 (95% CI 1.10–8.42), involved in animal husbandry OR 2.52 (95% CI 1.10–5.82), and identified as male OR 4.57 (95% CI 1.43–14.7), were more likely to test positive for malaria infection.ConclusionHuman movement and livelihood activities, especially at nighttime, should be considered malaria risk factors in malaria elimination settings, mainly when the targeted area is limited to a confined borderland area.

“A comparative analysis of risk factors of malaria” case study Gisagara and Bugesera District of Rwanda. RDHS 2014/2015. A retrospective study

BackgroundMalaria is a public health concern worldwide. A figure of 3.2 billion people is at risk of malaria a report of World Health Organization in 2013. A proportion of 89 and 91 cases of malaria reported during 2015 were respectively attributed to malaria cases and malaria deaths in Sub-Saharan Africa. Rwanda is among the Sub-Saharan Africa located in East Africa. The several reports indicate that from 2001 to 2011, malaria cases increased considerably especially in Eastern and Southern Province with five million cases. The affected districts included Bugesera in the Eastern and Gisagara in the Southern Province of Rwanda with a share of 41% of the country prevalence in 2014 and during 2017–2018 a figure of 11 deaths was attributed to malaria and both Gisagara and Bugesera Districts were the high burdened.MethodologyThe RDHS 2014–2015 data was used for the study and a cross-sectional survey was used in which two clusters were considered both Gisagara and Bugesera Districts in the Southern and Eastern Province of Rwanda. Bivariate analysis was used to determine the significant predictors with malaria and reduced logistic regression model was used.ResultsThe results of the study show that not having mosquito bed nets for sleeping is 0.264 times less likely of having malaria than those who have mosquito bed nets in Gisagara District. In Bugesera District, living in low altitude is 2.768 times more likely associated with the risk of getting malaria than living in high altitude.ConclusionThe results of the study concluded that environmental and geographical factor such as low altitude is the risk factor associated with malaria than the high altitude in Bugesera District. While not having mosquito bed nets for sleeping is the protective factor for malaria than those who have it in Gisagara District. On the other hand, socio-economic and demographic characteristics do not have any effect with malaria on the results of the study.

Evaluation of the Risk Factors and Prevalence of Cerebral Malaria in Children below 10 Years in Kiryandogo General Hospital.

This study aimed at determining the prevalence and risk factors of cerebral malaria among children aged 10years and below in Kiryandogo General Hospital. The study was done in Kiryandogo General Hospital with target population of children diagnosed with cerebral malaria between February – December 2017 and constituted a sample size of 100 cases obtained using Kish and Leslie formula. The results were analyzed using descriptive method to calculate frequencies, proportions, means, measures of association and their 95% confidence intervals. Stepwise forward logistic regression was done for all variables that were significantly associated with cerebral malaria at the p=0.25 level on bivariate analysis to determine the independent factors associated with cerebral malaria. The results revealed that out of 100 cases that were enrolled into this study, the majority were male; 58.0% compared to females; 42.0%. the risk factors were found as follows; Caregiver factors associated with cerebral malaria among children were; having at least secondary education, being the mother of the child and female caregiver although not significant. Environmental factors that were significantly associated with Cerebral malaria were; staying in house under construction, staying in a house with open eaves or poorly covered windows, stagnant water within 10 meters from household and having received IRS 12 months preceding child's illness. Household related factors that were significantly protective of cerebral malaria were; sleeping under mosquito net every night and owning at least one ITN in the household. Patient related factors that were significantly associated with Cerebral malaria were; undernutrition and history of malaria illness. Health system factors that were significantly associated with Cerebral malaria among children were; distance between home and nearest health facility &gt;10km, delayed diagnosis and having received antimalarial medicines at initial visit to a health facility. The study also revealed that children who were managed by a VHT were 1.53 times more likely to have cerebral malaria than those who were not. However, this finding was not statistically significant. A Stepwise forward logistic regression analysis revealed that patient related factors that were associated with mortality were; under nutrition and age &lt;5 years. Caregiver healthcare seeking behavioural factors that were associated with mortality due to Cerebral malaria were; duration of child's symptoms before seeking medical care &gt;2 days and first action taken was seeking medical care though not statistically significant. A bivariate analysis revealed the independent risk factors for Cerebral malaria as; distance &gt;10km to the nearest health facility, duration of symptoms before seeking medical care &gt;2 days, staying in a house under construction and duration of illness before receiving antimalarial medicines &gt;24 hours. Owning at least one ITN in the household and having a mother as a caregiver were independent protective factors for cerebral malaria. The prevalence of cerebral malaria was high among children aged 5 years and below with the median age being 3 years. Most of the age group of children affected with cerebral malaria that died was 0-3 years. Keywords: prevalence, risk factors, cerebral malaria, children aged 10 years, under nutrition

Prevalence and Associated Environmental Risk Factors of Malaria: Dansha Town and its Surroundings, Tsegedie District, Ethiopia

Prevalence and Associated Environmental Risk Factors of Malaria: Dansha Town and its Surroundings, Tsegedie District, Ethiopia

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

BackgroundGlobally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria.MethodsThe protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger’s and Begg’s statistical tests.ResultsTwelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria.ConclusionMore than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.

Biochemical characteristics of patients with imported malaria.

This study aimed to investigate the clinical and biochemical profiles of patients with imported malaria infection between 1 January 2011 and 30 April 2022 and admitted to the Fourth People's Hospital of Nanning. This cohort study enrolled 170 patients with conformed imported malaria infection. The clinical and biochemical profiles of these participants were analyzed with malaria parasite clearance, and signs and symptoms related to malaria disappearance were defined as the primary outcome. A multivariable logistic regression model was used to evaluate the odds ratios (ORs) with 95% confidence intervals (CIs) for cerebral malaria. The Cox model was used to estimate the hazard ratios (HRs) with 95% CIs for parasite clearance. Adenosine deaminase and parasitemia were found to be independent risk factors for severe malaria in patients with imported malaria (OR = 1.0088, 95% CI: 1.0010-1.0167, p = 0.0272 and OR = 2.0700, 95% CI: 1.2584-3.4050, p = 0.0042, respectively). A 0.5-standard deviation (SD) increase of variation for urea (HR = 0.6714, 95% CI: 0.4911-0.9180), a 0.5-SD increase of variation for creatinine (HR = 0.4566, 95% CI: 0.2762-0.7548), a 0.25-SD increase of variation for albumin (HR = 0.4947, 95% CI: 0.3197-0.7653), a 0.25-SD increase of variation for hydroxybutyrate dehydrogenase (HR = 0.6129, 95% CI: 0.3995-0.9402), and a 1.0-SD increase of variation for ferritin (HR = 0.5887, 95% CI: 0.3799-0.9125) were associated with a higher risk for increased parasite clearance duration than a low-level change. Aspartate aminotransferase, urea, creatinine, albumin, hydroxybutyrate dehydrogenase, and ferritin are useful biochemical indicators in routine clinical practice to evaluate prognosis for imported malaria.

Dietary diversity in primary schoolchildren of south-central Côte d’Ivoire and risk factors for non-communicable diseases

BackgroundA balanced nutrition is important for children’s physical and cognitive development; yet, remains a challenge in many parts of low- and middle-income countries (LMICs). Early detection of nutritional deficiency and metabolic syndrome in school-aged children is necessary to prevent non-communicable diseases (NCDs) in later life. This study aimed at obtaining baseline data on health, nutritional status, and metabolic markers of NCDs among primary schoolchildren in Côte d’Ivoire.MethodsA cross-sectional survey was conducted among 620 children from 8 public primary schools located in the south-central part of Côte d’Ivoire. Underweight and overweight were defined as a body mass index (BMI; kg/m2) < 5th and 85th up to 95th percentile for sex and age, respectively. Dietary diversity of children was calculated based on a 24-hour recall conducted with the primary caretaker according to the guideline of Food and Agriculture Organization. Anaemia, malaria, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose levels (HbA1c) were assessed, using capillary blood samples. Logistic models were performed to identify risk factors associated with overweight, HDL-C, LDL-C, and HbA1c.ResultsAmong the 620 children (330 girls, 290 boys; Mage 8.0 (± 1.7) years), 530 children attended school in a semi-urban and 90 in a rural area. Around 60% of children had a medium dietary diversity score (DDS). Children in peri-urban areas consumed more cereals (80.2% vs. 63.3%, p < 0.05). Most children were normal weight (n = 496), whereas 3.9% of children classified as prediabetic, 5% were underweight, and 15% overweight. LDL-C and HDL-C levels of children were associated with age, high DDS, and moderate anaemia. A significant association was found between prediabetes and malaria infection, as well as medium and high DDS. Overweight was associated with malaria infection and moderate anaemia.ConclusionOverweight, prediabetes, low HDL-C, malaria, and anaemia are the main concerns of children’s health in Taabo. Our findings highlight interactions between infectious diseases, particularly malaria, and NCD risk factors. Monitoring NCD risk and infectious disease comorbidity in LMIC paediatric populations simultaneously is essential to better understand the dual diseases burden and apply early prevention measures.

Prevalence of malaria and its risk factors in Lake Tana and surrounding areas, northwest Ethiopia

BackgroundIn Ethiopia, malaria is a major concern to the health, and socio-economic development of the country because of its occurrence at the peak agricultural activities. Factors such as environmental, human host, parasite, and vector determine malaria transmission. Therefore, the present study was conducted to determine the prevalence and associated factors of malaria among febrile patients who visited selected health centres.MethodsInstitutional-based cross-sectional study was conducted between October 2020 to July 2021 in eight selected health centres located in Lake Tana and its surrounding areas. A simple random sampling technique was used to select febrile patients. Thick and thin blood films were prepared and processed according to the WHO guidelines. Socio-demographic and malaria risk factors were collected from study participants who could read and write using a self-administered questionnaire, whereas face-to-face interview was used to collect information from those participants who could not write and read. The strength of association between risk factors and malaria was assessed using univariate and multivariate logistic regression models.ResultsOf the total (531) febrile patients, 75.3% were malaria negative and 24.7% (overall prevalence) were malaria confirmed cases. Most of the infections were caused by Plasmodium falciparum (72.5%) followed by Plasmodium vivax (23.7%) and mixed-species (3.8%). The highest prevalence was recorded in Kidist Hana (51.5%) followed by Robit (34.8%), Gorgora (30.3%), and Wusha Tiris (25%) health centres. In terms of months, the highest prevalence (37.5%) was detected in October whereas the lowest (14%) was in March. Logistic regression analysis revealed that gender (p = 0.023), educational level (p = 0.025), study month (p = 0.036), presence of eave in the house (p = 0.002) and wall openings (p = 0.041), not using bed nets (p = 0.001), sleeping in the same house with cattle (p = 0.031) and the distance between mosquito-breeding site and living house (p = 0.020) were explanatory risk factors significantly associated with malaria among studied participants.ConclusionsIn this study, we confirmed that the occurrence of malaria prevalence was high and continued against the Ethiopian malaria elimination plan of 2021–2025. Therefore, to meet the goals of this plan, the current prevention and control efforts should be stepped up even better in the coming years.

Assessing seroprevalence and associated risk factors for multiple infectious diseases in Sabah, Malaysia using serological multiplex bead assays.

Infectious diseases continue to burden populations in Malaysia, especially among rural communities where resources are limited and access to health care is difficult. Current epidemiological trends of several neglected tropical diseases in these populations are at present absent due to the lack of habitual and efficient surveillance. To date, various studies have explored the utility of serological multiplex beads to monitor numerous diseases simultaneously. We therefore applied this platform to assess population level exposure to six infectious diseases in Sabah, Malaysia. Furthermore, we concurrently investigated demographic and spatial risk factors that may be associated with exposure for each disease. This study was conducted in four districts of Northern Sabah in Malaysian Borneo, using an environmentally stratified, population-based cross-sectional serological survey targeted to determine risk factors for malaria. Samples were collected between September to December 2015, from 919 villages totaling 10,100 persons. IgG responses to twelve antigens of six diseases (lymphatic filariasis- Bm33, Bm14, BmR1, Wb123; strongyloides- NIE; toxoplasmosis-SAG2A; yaws- Rp17 and TmpA; trachoma- Pgp3, Ct694; and giardiasis- VSP3, VSP5) were measured using serological multiplex bead assays. Eight demographic risk factors and twelve environmental covariates were included in this study to better understand transmission in this community. Seroprevalence of LF antigens included Bm33 (10.9%), Bm14+ BmR1 (3.5%), and Wb123 (1.7%). Seroprevalence of Strongyloides antigen NIE was 16.8%, for Toxoplasma antigen SAG2A was 29.9%, and Giardia antigens GVSP3 + GVSP5 was 23.2%. Seroprevalence estimates for yaws Rp17 was 4.91%, for TmpA was 4.81%, and for combined seropositivity to both antigens was 1.2%. Seroprevalence estimates for trachoma Pgp3 + Ct694 were 4.5%. Age was a significant risk factors consistent among all antigens assessed, while other risk factors varied among the different antigens. Spatial heterogeneity of seroprevalence was observed more prominently in lymphatic filariasis and toxoplasmosis. Multiplex bead assays can be used to assess serological responses to numerous pathogens simultaneously to support infectious disease surveillance in rural communities, especially where prevalences estimates are lacking for neglected tropical diseases. Demographic and spatial data collected alongside serosurveys can prove useful in identifying risk factors associated with exposure and geographic distribution of transmission.

Malaria Control, Elimination, and Prevention as Components of Health Security: A Review.

International travel, a major risk factor for imported malaria, has emerged as an important challenge in sustaining malaria elimination and prevention of its reestablishment. To make travel and trade safe, the WHO adopted the International Health Regulations (IHR) which provides a legal framework for the prevention, detection, and containment of public health risks at source. We conducted a systematic review to assess the relevance and the extent of implementation of IHR practices that can play a role in reducing malaria transmission. Selected studies addressed control, elimination, and prevention of reestablishment of malaria. Study themes focused on appraisal of surveillance and response, updating national policies to facilitate malaria control and elimination, travel as a risk factor for malaria and risk mitigation methods, vector control, transfusion malaria, competing interests, malaria in border areas, and other challenges posed by emerging communicable diseases on malaria control and elimination efforts. Review results indicate that malaria has not been prioritized as part of the IHR nor has the IHR focused on vector-borne diseases such as malaria. The IHR framework in its current format can be applied to malaria and other vector-borne diseases to strengthen surveillance and response, overcome challenges at borders, and improve data sharing-especially among countries moving toward elimination-but additional guidelines are required. Application of the IHR in countries in the malaria control phase may not be effective until the disease burden is brought down to elimination levels. Considering existing global elimination goals, the application of IHR for malaria should be urgently reviewed and included as part of the IHR.

Risk factors associated with malaria infection along China–Myanmar border: a case–control study

BackgroundThe World Health Organization (WHO) has certificated China malaria free, but imported malaria is a continuous challenge in preventing reintroduction of malaria in the border area of China. Understanding risk factors of malaria along China–Myanmar border is benefit for preventing reintroduction of malaria in China and achieving the WHO’s malaria elimination goal in the Greater Mekong Subregion (GMS).MethodsThis is a case–control study with one malaria case matched to two controls, in which cases were microscopy-confirmed malaria patients and controls were feverish people with microscopy-excluded malaria. A matched logistic regression analysis (LRA) was used to identify risk factors associated with malaria infection.ResultsFrom May 2016 through October 2017, the study recruited 223 malaria cases (152 in China and 71 in Myanmar) and 446 controls (304 in China and 142 in Myanmar). All the 152 cases recruited in China were imported malaria. Independent factors associated with malaria infection were overnight out of home in one month prior to attendance of health facilities (adjusted odd ratio [AOR] 13.37, 95% confidence interval [CI]: 6.32–28.28, P < 0.0001), staying overnight in rural lowland and foothill (AOR 2.73, 95% CI: 1.45–5.14, P = 0.0019), staying overnight at altitude < 500 m (AOR 5.66, 95% CI: 3.01–10.71, P < 0.0001) and streamlets ≤ 100 m (AOR9.98, 95% CI: 4.96–20.09, P < 0.0001) in the border areas of Myanmar; and people lacking of knowledge of malaria transmission (AOR 2.17, 95% CI: 1.42–3.32, P = 0.0004).ConclusionsMalaria transmission is highly focalized in lowland and foothill in the border areas of Myanmar. The risk factors associated with malaria infection are overnight staying out of home, at low altitude areas, proximity to streamlets and lack of knowledge of malaria transmission. To prevent reintroduction of malaria transmission in China and achieve the WHO goal of malaria elimination in the GMS, cross-border collaboration is continuously necessary, and health education is sorely needed for people in China to maintain their malaria knowledge and vigilance, and in Myanmar to improve their ability of personal protection.

Prevalence and Risk Factors of Malaria among Pregnant Women receiving Antenatal Care in a Health Facility in Delta State, Southern Nigeria

Background: Malaria is one of the major causes of morbidity and mortality in developing countries including Nigeria. Malaria in pregnancy is estimated to cause about 15% of maternal deaths globally, accounting for over 10,000 maternal and 200,000 neonatal deaths annually. This study determined the prevalence and risk factors of malaria infection among pregnant women receiving antenatal care in a health facility in Delta State. Methods: This was a facility-based cross-sectional study carried out among 418 pregnant women who were selected by systematic sampling technique. Clinical malaria was confirmed using microscopy method (Giemsa staining technique) while a pre-tested, structured, interviewer administered questionnaire was used to collect information on soscio-demographic characteristics and obstetrics history of the respondents. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 and the level of statistical significance was set at p&lt; 0.05. Results: The mean age of the participants was 29.9 ± 5.7 years. Two hundred and sixty three (62.9%) pregnant women tested positive for malaria. Respondents who were pregnant for the second time (AOR = 0.521, 95% CI: 0.28 – 0.99, p = 0.045) and those from a family size of 1-6 (AOR = 2.123, 95% CI: 1.12 – 4.04, p = 0.022) were more likely to test positive to malaria parasite. Conclusion: In this study, the prevalence of malaria in pregnant women was high and the significant predictors were; family size of 1–6, skill level 1, first trimester and multigravidae. The Delta State Ministry of Health should ensure increasing access to IPT, ITNs/LLIN and health education on malaria in all hospitals rendering ANC services.

Distribution and Risk Factors of Malaria in the Greater Accra Region in Ghana.

Malaria remains a serious public health challenge in Ghana including the Greater Accra Region. This study aimed to quantify the spatial, temporal and spatio-temporal patterns of malaria in the Greater Accra Region to inform targeted allocation of health resources. Malaria cases data from 2015 to 2019 were obtained from the Ghanaian District Health Information and Management System and aggregated at a district and monthly level. Spatial analysis was conducted using the Global Moran’s I, Getis-Ord Gi*, and local indicators of spatial autocorrelation. Kulldorff’s space–time scan statistics were used to investigate space–time clustering. A negative binomial regression was used to find correlations between climatic factors and sociodemographic characteristics and the incidence of malaria. A total of 1,105,370 malaria cases were reported between 2015 and 2019. Significant seasonal variation was observed, with June and July being the peak months of reported malaria cases. The hotspots districts were Kpone-Katamanso Municipal District, Ashaiman Municipal Districts, Tema Municipal District, and La-Nkwantanang-Madina Municipal District. While La-Nkwantanang-Madina Municipal District was high-high cluster. The Spatio-temporal clusters occurred between February 2015 and July 2017 in the districts of Ningo-Prampram, Shai-Osudoku, Ashaiman Municipal, and Kpone-Katamanso Municipal with a radius of 26.63 km and an relative risk of 4.66 (p < 0.001). Malaria cases were positively associated with monthly rainfall (adjusted odds ratio [AOR] = 1.01; 95% confidence interval [CI] = 1.005, 1.016) and the previous month’s cases (AOR = 1.064; 95% CI 1.062, 1.065) and negatively correlated with minimum temperature (AOR = 0.86, 95% CI = 0.823, 0.899) and population density (AOR = 0.996, 95% CI = 0.994, 0.998). Malaria control and prevention should be strengthened in hotspot districts in the appropriate months to improve program effectiveness.

Assessment of malaria prevalence in Boset District, East Shawa Zone, Oromia Regional State, Ethiopia: a retrospective study

ObjectiveIn this study, we aimed to assess the epidemiological profile and associated risk factors of malaria in Boset District using clinical records from the Boset District Health Office Central Surveillance Unit, East Shawa Zone, Oromia, Ethiopia.MethodsThis health facility-based retrospective cross-sectional study included clinical malaria data for 5 years (2016–2020) recorded at all public and private health facilities in the district.ResultsThe present study revealed an overall malaria slide positivity rate of 12.4% (21,059/169,986), ranging from 23.3% to 5.3% during 2016–2020 in Boset District. Malaria cases were recorded in all age groups, but individuals aged 15 years and above accounted for a higher (56.2%) average proportion of malaria cases. Concerning the relative proportion of malaria parasite species, Plasmodium falciparum was slightly predominant (58%) over P. vivax (42%).ConclusionThe present study revealed a declining trend in malaria cases over the 5-year study period in Boset District. Scaling up the available malaria prevention strategies and control measures is recommended to achieve malaria pre-elimination.

Malaria and Associated Risk Factors among Pregnant Women attending Antenatal Care in Awka, Anambra State, Nigeria

Malaria in pregnancy is a major public health problem in endemic areas of sub-Saharan Africa. It is a major contributor to adverse maternal and perinatal outcome. This work was carried out to determine the prevalence and associated risk factors of malaria among pregnant women attending antenatal clinics in Awka. Microscopy was used to determine the prevalence of malaria among the pregnant women, while structure questionnaire was used to determine the knowledge and use of IPTp and LLINs among thepregnant women. Out of the 300 pregnant women screened for malaria, 184 (61.3%) were positive for malaria parasite.of 184 positive for malaria, 130(47.1%) had mild malaria, 49(27.0%) moderate infection, while 5(2.7%) had severe malaria. Of the 184 pregnant women positive for malaria parasite, those less than 20 years (70.0%) were more infected with malaria parasite, followed by 21-30 years (65.4%), while 41 years and above (20.0%) years were the least infected. Those in their first trimester had the highest prevalence of malaria (76.2%). Primigravidae (64.5%) were more infected than multigravidae (56.1%) Pregnant women with non formal education were most infected (95.0%), followed by primary education (27.3%), while secondary education showed the lowest rate of malaria in pregnancy (92.9%). Farmers reported the highest cases(86.3%) of malaria in pregnancy, while civil servants reported the least (27.3%). Married women showed the highest cases of malaria in pregnancy (65.1%), while single reported the least (51.0%).the knowledge and compliance of IPTp among the pregnant women studied were 84.7% and 52.7% respectively, while knowledge of LLINs was 51.7%. intensified health education is needed to reducethe burden of malaria among pregnant womenin Awka.

Seroepidemiological surveillance, community perceptions and associated risk factors of malaria exposure among forest-goers in Northeastern Thailand.

Malaria remains a major public health challenge in Thailand. Continuous assessment and understanding of the behavior and perceptions related to malaria exposure in the high-risk group are necessary to achieve the elimination goal. This study aimed to investigate the parasite prevalence, seroprevalence rate, knowledge, attitudes, and practices (KAP), and malaria risk factors in rural communities living close to a forested area in the northeastern part of Thailand. A community-based cross-sectional survey was conducted in three forest-goer communities (i.e., Ban Khok, Ban Koh, and Dong Yang) located in Khamcha-i district, Mukdahan Province, Thailand, from July to August 2019. Demographic, socioeconomic information and KAP data were collected using a structured questionnaire. Parasite prevalence was determined by microscopy. Seroprevalence was determined via ELISA using two Plasmodium falciparum (PfAMA-1 and PfMSP-119) and two Plasmodium vivax (PvAMA-1 and PvMSP-119) antigens. Age-adjusted antibody responses were analyzed using a reversible catalytic model to calculate seroconversion rate (SCR). Malaria parasite was not detected in any of the 345 participants. The overall malaria seroprevalence was 72.2% for PfAMA-1, 18.8% for PfMSP-119, 32.5% for PvAMA-1, and 4.4% for PvMSP-119. The proportion of seroprevalence for P. falciparum and P. vivax antigens was significantly highest in Ban Koh (35.1%, P < 0.001) and Don Yang (18.8%, P < 0.001), respectively. For all parasite antigens except PvMSP-119, the proportion of seropositive individuals significantly increased with age (P < 0.001). Based on the SCRs, there was a higher level of P. falciparum transmission than P. vivax. Regarding KAP, almost all respondents showed adequate knowledge and awareness about malaria. Nevertheless, significant effort is needed to improve positive attitudes and practices concerning malaria prevention measures. Multivariate regression analyses showed that living in Ban Koh was associated with both P. falciparum (adjusted odds ratio [aOR] 12.87, P < 0.001) and P. vivax (aOR 9.78, P < 0.001) seropositivities. We also found significant associations between age and seropositivity against P. falciparum and P. vivax antigens. The data suggest that seroepidemiological surveillance using AMA-1 and MSP-119 antigens may provide further evidence to reconstruct malaria exposure history. The absence of weak evidence of recent malaria transmission in Mukdahan Province is promising in the context of the disease elimination program.