Malaria Status Research Articles

Specific antibody responses to Qβ-displayed Plasmodium falciparum-derived UB05 and MSP3 proteins in mother-neonate couples.

Malaria blood-stage parasite is a critical pathogenic stage responsible for serious adverse outcomes in pregnant women and their neonates. Immunoglobulin G (IgG) antibody responses specific to various asexual blood-stage antigens were well reported in non-pregnant individuals. However, little is still known during placental malaria. To assess the antibody responses specific to Plasmodium falciparum-derived MSP3 and UB05 malaria vaccine candidates in mother-neonate couples, mother's peripheral blood and neonate's cord blood samples were collected at delivery. After malaria diagnostic, plasma levels of IgG and IgG subclass responses specific to UB05, MSP3 and UB05-MSP3 were determined using ELISA. As outcomes, both mothers and neonates had significantly higher IgG responses to UB05 and UB05-MSP3 compared to anti-MSP3 IgG (p < 0.05), irrespective of malaria status. Significant negative correlations were observed between IgG levels specific to the three antigens and parasitaemia (p < 0.01). Anti-UB05 and anti-UB05-MSP3 IgG levels in neonates showed a significant positive correlation with the corresponding mothers' antibodies (rs = 0.25 with p = 0.04; rs = 0.31 with p = 0.01, respectively). UB05MSP3-specific IgG3 and IgG1 subclass responses were significantly higher than the IgG4 subclass (p < 0.01). The neonates IgG1 and IgG3 levels positively correlated with the corresponding antibody subclasses of mothers. These findings suggest an association between UB05 and UB05-MSP3-specific antibody responses and malaria control during pregnancy. Maternal-foetal transfer of MSP3 and UB05-specific IgG occurs during pregnancy, suggesting the interest in the future malaria vaccination strategies in pregnant women to generate early protective immunity in baby against malaria.

Assessment of Malaria, Anemia and Nutrition status of school-going children in the rural area of Charsadda, Pakistan

Malaria, anemia, and malnutrition are global health challenges with significant morbidity and mortality, and higher rates among children particularly in Africa. This study evaluated the prevalence and risk factors of malaria infection, anemia, and malnutrition among school-going children of Charsadda (a city of Khyber, Pakistan). A total of 400 children of aged 5-10 years were included in the study in 2023. Malaria infection was confirmed by rapid diagnostic tests. Hematocrit level was obtained using a centrifuge microhematocrit and converted to hemoglobin using standard conversion. Nutritional status was determined by the anthropometric measurements, and demographic characteristics were obtained by questionnaire. Anemia and malnutrition were defined according to the World Health Organization standards. Logistic regression analysis was used to determine association between the predictor variables and primary outcomes. In current research work 400 children were selected for the assessment of malaria and nutritional status, malaria infection was found more frequent among the students 120(12%). In addition, high prevalence of anemia 105(10.5%), malnutrition 90(9%), and stunting 70(7%) was observed, while wasting 2(0.2%) and underweight 20(2%0 had very low frequency. Malaria infection, anemia, and malnutrition were observed in12%, 10.5% and 9% of the children population, respectively. To the best of our knowledge, this is the first study showing the current health problems among the school-going children of district Charsadda the prevalence of malaria, anemia and malnutrition and their co-existence in children 5-10 years.

Parasite clearance and protection from Plasmodium falciparum infection (PCPI): a three-arm, parallel, double-blinded, placebo-controlled, randomised trial of presumptive sulfadoxine-pyrimethamine versus sulfadoxine-pyrimethamine plus amodiaquine versus artesunate monotherapy among asymptomatic children 3–5 years of age in Cameroon

BackgroundThe World Health Organization 2022 malaria chemoprevention guidelines recommend providing a full course of antimalarial treatment at pre-defined intervals, regardless of malaria status to prevent illness among children resident in moderate to high perennial malaria transmission settings as perennial malaria chemoprevention (PMC) with sulfadoxine-pyrimethamine (SP). The dhps I431V mutation circulating in West Africa has unknown effect on SP protective efficacy.MethodsThis protocol is for a three-arm, parallel, double-blinded, placebo-controlled, randomised trial in Cameroon among children randomly assigned to one of three directly-observed treatment groups: (i) Group 1 (n = 450) receives daily artesunate (AS) placebo on days − 7 to -1, then active SP plus placebo amodiaquine (AQ) on day 0, and placebo AQ on days 1 and 2; (ii) Group 2 (n = 250) receives placebo AS on days − 7 to -1, then active SP and AQ on day 0, and active AQ on days 1 and 2; and (iii) Group 3 (n = 200) receives active AS on days − 7 to -1, then placebo SP on day 0 and placebo AQ on days 0 to 2. On days 0, 2, 5, 7, and thereafter weekly until day 28, children provide blood for thick smear slides. Dried blood spots are collected on the same days and weekly from day 28 to day 63 for quantitative polymerase chain reaction (qPCR) and genotype analyses.DiscussionOur aim is to quantify the chemopreventive efficacy of SP, and SP plus AQ, and measure the effect of the parasite genotypes associated with SP resistance on parasite clearance and protection from infection when exposed to SP chemoprevention. We will report unblinded results including: (i) time-to-parasite clearance among SP and SP plus AQ recipients who were positive on day 0 by qPCR and followed to day 63; (ii) mean duration of SP and SP plus AQ protection against infection, and (iii) mean duration of symptom-free status among SP and SP plus AQ recipients who were parasite free on day 0 by qPCR. Our study is designed to compare the 28-day follow-up of the new WHO malaria chemoprevention efficacy study protocol with extended follow-up to day 63.Trial registrationClinicalTrials.gov NCT06173206; 15/12/2023.

Investigating the association between household exposure to Anopheles stephensi and malaria in Sudan and Ethiopia: A case-control study protocol.

Endemic African malaria vectors are poorly adapted to typical urban ecologies. However, Anopheles stephensi, an urban malaria vector formerly confined to South Asia and the Persian Gulf, was recently detected in Africa and may change the epidemiology of malaria across the continent. Little is known about the public health implications of An. stephensi in Africa. This study is designed to assess the relative importance of household exposure to An. stephensi and endemic malaria vectors for malaria risk in urban Sudan and Ethiopia. Case-control studies will be conducted in 3 urban settings (2 in Sudan, 1 in Ethiopia) to assess the association between presence of An. stephensi in and around households and malaria. Cases, defined as individuals positive for Plasmodium falciparum and/or P. vivax by microscopy/rapid diagnostic test (RDT), and controls, defined as age-matched individuals negative for P. falciparum and/or P. vivax by microscopy/RDT, will be recruited from public health facilities. Both household surveys and entomological surveillance for adult and immature mosquitoes will be conducted at participant homes within 48 hours of enrolment. Adult and immature mosquitoes will be identified by polymerase chain reaction (PCR). Conditional logistic regression will be used to estimate the association between presence of An. stephensi and malaria status, adjusted for co-occurrence of other malaria vectors and participant gender. Findings from this study will provide evidence of the relative importance of An. stephensi for malaria burden in urban African settings, shedding light on the need for future intervention planning and policy development.

Patterns and predictors of malaria among head porters: a mobile population in Ghana

BackgroundHead porters popularly known as ‘Kayayeis in Ghana, face challenges in accessing essential health care services due to the mobile nature of their trade, low formal education, poor settlements, low-income among others. Kayayeis are predominantly females and form part of the mobile population who are at increased risk of malaria infection. Despite their increased risk of malaria, mobile populations are difficult to target for malaria interventions, hence serving as potential drivers of transmission even if malaria in the general population is controlled. The study, therefore, assessed the patterns and predictors of malaria among the Kayayei population in Ghana to inform policy decisions.MethodsA mixed methods study was conducted among Head-porters and their leaders in the three main hubs of Head-porters in Ghana; namely Accra, Kumasi, and Tamale. Blood samples were collected from participants and tested for malaria parasites using Rapid Diagnostic Test (RDT). Additionally, data including socio-demographics, malaria knowledge, attitude and practice were collected using a semi-structured questionnaire. Associations between malaria status and participants characteristics were determined by logistic regression (p < 0.05). Thematic analysis was used to analyse transcripts from the key informant interviews.ResultsOut of 754 head porters studied, 10.48% (79) tested positive for malaria. The majority 43.10% (325/754) of the head porters were twenty years and below, and most 67.11% (506/754) had no formal education. Nearly half (50.4%) were not on any health insurance. Receiving malaria education in the past 6 months [AOR = 0.48, (0.26–0.88), p-value 0.02], and having poor knowledge of malaria [AOR = 2.23, (1.26–4.27), p < 0.02], were the factors significantly associated with malaria infection.ConclusionThe prevalence of malaria among ‘Kayayei’s was estimated at 10.46%. A majority of them sleeps outside and in structures without mosquito screens. Receiving malaria education in the past 6 months reduced the odds of malaria infection whilst poor knowledge of malaria increased the odds of malaria infection among the porters. The authors recommend that the National Malaria Elimination Programme and partners should provide long-lasting insecticidal nets (LLIN) and other outdoor interventions for use by this special group. Designated state institutions should arrange free National Health Insurance Scheme (NHIS) registration for ‘Kayayeis’ to narrow the health access gap.

Association between asymptomatic Plasmodium falciparum malaria infection, anaemia and mean corpuscular volume of school children in the Volta Region of Ghana.

Although, several studies have reported abnormal Mean Corpuscular Volume (MCV) values and anaemia associated with malaria infections with a focus on Plasmodium falciparum among patients with complicated and uncomplicated malaria, none has looked at the association with asymptomatic malaria. This study aimed to assess this association. We conducted a cross-sectional study using 3 mL of blood samples from 549 children aged 5-17 years attending 5 schools selected in the Volta Region. Semi-structured questionnaires were administered to the children to obtain demographic data. Blood samples were collected to estimate the children's full blood count (FBC) and malaria status. Data obtained wereanalysed using STATA 15 software. P-values of less than 0.05 were considered statistically significant. Most of the children inthis study (49.9%) had normal MCV (81.3-91.3 fL) with an overall malaria prevalence of 55.6%(95% CI: 51.3-59.8) and anaemia prevalence of 48.6% (95% CI 44.4-52.9). Most anaemic children had normal MCV (81.3-91.3 fL) (49.8, 95% CI 43.7-56.0). The predicted probability of malaria was highly likely among children with normal MCV (81.3-91.3 fL) but with high variability and uncertainty among those with low MCV (<81.3 fL) and high MCV (>91.3 fL). This study shows a reduced predicted probability of malaria among children with low and high MCV, playing a protective function against malaria. Further studies are required to elucidate the interaction.

Molecular speciation of Plasmodium and multiplicity of P. falciparum infection in the Central region of Ghana.

Malaria is endemic in the Central region of Ghana, however, the ecological and the seasonal variations of Plasmodium population structure and the intensity of malaria transmission in multiple sites in the region have not been explored. In this cross-sectional study, five districts in the region were involved. The districts were Agona Swedru, Assin Central and Gomoa East (representing the forest zone) and Abura-Asebu-Kwamankese and Cape Coast representing the coastal zone. Systematically, blood samples were collected from patients with malaria. The malaria status was screened with a rapid diagnostic test (RDT) kit (CareStart manufactured by Access Bio in Somerset, USA) and the positive ones confirmed microscopically. Approximately, 200 μL of blood was used to prepare four dried blood spots of 50μL from each microscopy positive sample. The Plasmodium genome was sequenced at the Malaria Genome Laboratory (MGL) of Wellcome Sanger Institute (WSI), Hinxton, UK. The single nucleotide polymorphisms (SNPs) in the parasite mitochondria (PfMIT:270) core genome aided the species identification of Plasmodium. Subsequently, the complexity of infection (COI) was determined using the complexity of infection likelihood (COIL) computational analysis. In all, 566 microscopy positive samples were sequenced. Of this number, Plasmodium genome was detected in 522 (92.2%). However, whole genome sequencing was successful in 409/522 (72.3%) samples. In total, 516/522 (98.8%) of the samples contained P. falciparum mono-infection while the rest (1.2%) were either P. falciparum/P. ovale (Pf/Po) (n = 4, 0.8%) or P. falciparum/P. malariae/P. vivax (Pf/Pm/Pv) mixed-infection (n = 2, 0.4%). All the four Pf/Po infections were identified in samples from the Assin Central municipality whilst the two Pf/Pm/Pv triple infections were identified in Abura-Asebu-Kwamankese district and Cape Coast metropolis. Analysis of the 409 successfully sequenced genome yielded between 1-6 P. falciparum clones per individual infection. The overall mean COI was 1.78±0.92 (95% CI: 1.55-2.00). Among the study districts, the differences in the mean COI between ecological zones (p = 0.0681) and seasons (p = 0.8034) were not significant. However, regression analysis indicated that the transmission of malaria was more than twice among study participants aged 15-19 years (OR = 2.16, p = 0.017) and almost twice among participants aged over 60 years (OR = 1.91, p = 0.021) compared to participants between 20-59 years. Between genders, mean COI was similar except in Gomoa East where females recorded higher values. In conclusion, the study reported, for the first time, P. vivax in Ghana. Additionally, intense malaria transmission was found to be higher in the 15-19 and > 60 years, compared to other age groups. Therefore, active surveillance for P. vivax in Ghana and enhanced malaria control measures in the 15-19 year group years and those over 60 years are recommended.

Association between asymptomatic Plasmodium falciparum malaria infection, anemia and mean corpuscular volume of school children in the Volta Region of Ghana

Abstract Introduction/Objective Although several studies have reported abnormal MCV values and anemia associated with malaria infections with a focus on P. falciparum among patients with complicated and uncomplicated malaria. This study assessed the association between asymptomatic P. falciparum malaria infection, anemia, and the MCV values of school children in Ghana. Methods/Case Report We conducted a cross-sectional study using 3 ml of blood samples from 549 children aged 5- 17 years attending 5 schools selected in the Volta Region. Semi-structured questionnaires were administered to the children to obtain demographic data. Blood samples were collected into a K2EDTA tube and then used to estimate the children’s automated full blood count (FBC) and malaria status using microscopy. MCV was classified into low, normal, and high. Data obtained were analyzed using STATA 15 software. P-values less than 0.05 were considered statistically significant. Results (if a Case Study enter NA) Most of the children in this study (49.9%) had normal MCV (81.3-91.3 fL) with an overall malaria prevalence of 55.6 % (95% CI: 51.3-59.8) and anemia prevalence of 48.6% (95% CI 44.4-52.9). The majority of the anemic children had normal MCV (81.3-91.3 fL) (49.8, 95% CI 43.7-56.0). The predicted probability of malaria was highly likely among children whose MCV fell within the first and third quartiles. Conclusion This study shows a reduced predicted probability of malaria among children with low and high MCV, playing a protective function against malaria. Further studies are required to elucidate the association and interaction between MCV, anemia, and asymptomatic Plasmodium falciparum infection.

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

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

Malaria, HIV, and Intestinal Coccidian Parasites Mixed-Infections in Adult Patients in the Fundong Health District, Northwest Region, Cameroon

Background: Malaria and intestinal coccidian parasites are both protozoan and their interaction in co-infected patients is still not clear. Patients infected with both malaria and coccidian parasites experience diarrhoea, gastro-intestinal and health problems that maybe life threating. We studied opportunistic intestinal coccidian parasites (OIPs) and the human immunodeficiency virus (HIV) in adult patients with malaria in Fundong Health District, Northwest of Cameroon. The objectives was to determine prevalence, and distribution of the diseases in adult population. &#x0D; Methods: A prospective cross-sectional study carried out between April and December 2022. Malaria patients were identified by the presence of the Plasmodium parasite in Giemsa blood-stained films. HIV status was determined using the rapid diagnostic test (RDT). Stool samples were subjected to wet preparation and formol-ether concentration technique to detect intestinal coccidian parasites. Pearson’s Chi-Square (χ2) and binary logistic regression were performed as part of the statistical analysis. Statistical significance was set a P-value&lt;0.05.&#x0D; Results: Three hundred and thirty (330) adult patients all infected with malaria took part in the study, 115(35%) males and 215 females (65%). The adult were of age 21 years and above. The mean age of participant was 37.02(±15.235) years. Malaria co-infection with coccidian parasites was observed in 19.4%. Malaria co-infection with other gastro-intestinal intestinal parasite capable causing pathological conditions in patients was 5.5%. The study showed the prevalence of malaria co-infections with HIV was 8.2%. The mixed infections observed were domestically acquired (57.8%) as well as travel related (46.2%). Fever was most reported in severe malaria 315/330 (95%), followed by those who reported abdominal pains 85/330 (26%), while diarrhoea was reported in 35/330 (11%) of the study participants. Fever, and abdominal pain significantly associated with malaria status (simple or severe malaria) p-value=, P-value= respectively (5.915) 0.015, P-value= (8.3) 0.004, as well as the HIV status P-value= (11.798) 0.003. The odds of developing severe malaria from fever was 3.533(CI: 1.204-10.366) times higher compared to those who did not have fever. The odds of developing severe malaria from abdominal pain was 0.420(CI: 0.230-0.767) less. Results showed living with child&lt;2 years, water treatment methods, material use in hand washing, predicted the probability of coccidian infection in the final logistic regression model accounting for 23.6% of the variance in the coccidian infections was explained by the model.&#x0D; Conclusion: Prevalence of malaria, and opportunistic intestinal coccidian infections in adult patients was significantly influenced by migration, seasonal variation and the individual’s immune status. Routine clinical practice have often ignore the investigation of possible mixed infections especially in persons with compromised immunity including HIV. Screening patients suspected of malaria should include investigation for opportunistic intestinal coccidian parasites especially for HIV and other vulnerable populations. An integrated prevention and control strategy need to be considered.

IMPLEMENTATION OF BINARY LOGISTIC ANALYSIS ON DETERMINANTS OF MALARIA STATUS

Malaria is a disease transmitted through mosquitoes; malaria is still one of the endemic diseases in Eastern Indonesia. This study aims to determine the factors that affect malaria status. The independent variables used were region, gender, insect repellent, sowing larvicide powder, draining the bathtub, and mosquito nets. The data comes from the Basic Health Research Report (Riskesdas) 2018. The analysis method used is binomial regression / binary logistics. Based on research states that together all independent variables have a significant effect on a person's malaria status. Partially, the chances of rural status, male sex, not using insect repellent, not using larvicide powder, not draining bathtubs, and not wearing mosquito nets are greater than other categories of malaria status. Therefore, self-awareness of individuals and communities is needed in striving for cleanliness and personal health

ANALISIS DAN SIMULASI MODEL SUSCEPTIBLE INFECTIVE TREATMENT RECOVERY PADA PENYEBARAN PENYAKIT MALARIA DI KOTA MEDAN

Malaria is an infectious disease caused by plasmodium, which is a single-celled living creature belonging to the group of protozoan parasites, malaria is transmitted through the bite of a female Anopheles mosquito containing plasmodium in it. Plasmodium carried through mosquito bites will live and reproduce in human red blood cells. This disease attacks all age groups, both men and women. People who are exposed to malaria will have symptoms of fever, chills, sweats, headaches, nausea or vomiting. Patients who show clinical symptoms must undergo laboratory tests to confirm their positive malaria status. The purpose of this study was to determine the model of the spread of Malaria and to analyze the stability of the model of Malaria. This study uses the SITR mathematical model which involves 4 population compartments, namely Susceptible (S), Invective (I), Treatment (T), Recovery (R). The data used is secondary data obtained from the Medan City Health Office through the Medan City Health Office. From this study, the SITR mathematical model was obtained, two equilibrium points, namely the point of disease and endemic from the SITR model with a basic Reproductive value of = 0, 2693449588 or &lt; 1. The greater the basic reproduction number, the more likely it is that malaria will spread, but the more the smaller the basic reproduction number, the smaller the chance for malaria to spread and will gradually disappear

Private sector antimalarial sales a decade after "test and treat": A cross-sectional study of drug shop clients in rural Uganda.

The World Health Organization has promoted "test and treat" guidelines for malaria since 2010, recommending all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment with antimalarial medications. However, many fevers at private drug shops in Uganda continue to be treated presumptively as malaria without diagnostic testing. The purpose of this study was to document private sector malaria case management in rural Uganda through a cross-sectional survey of drug shop clients in Bugoye sub-county. Drug shop vendors (n = 46) recorded information about sales interactions with clients reporting fever or requesting antimalarials and collected capillary blood samples from clients who purchased medications without an RDT. We estimated the proportion of clients who purchased an RDT, adhered to the RDT result, and received antimalarials without having laboratory-confirmed malaria. Most drug shops were unlicensed (96%) and sold RDTs (98%). Of 934 clients with suspected malaria who visited study drug shops during the data collection period, only 25% bought an RDT. Since some clients reported previous RDTs from the public sector, 40% of clients were aware of their malaria status at the drug shop. Among those with negative tests, 36% still purchased antimalarials. Sixty-five percent of clients who purchased an antimalarial without an RDT subsequently tested negative. Despite national guidelines, drug shop clients who purchase antimalarials from drug shops in Bugoye are often not tested to confirm a malaria diagnosis prior to treatment. Most clients treated presumptively with antimalarials did not have malaria. Interventions are needed to improve malaria case management and rational drug use in the private sector.

Impact of Sub-patent Malaria During Pregnancy on Birth-Weight in Odisha, India: Time-to-Event Analysis of Prospective Longitudinal Follow-Up of a Survey

ObjectiveThe current study aimed to estimate prevalence of malaria infection, especially sub-patent infection, in pregnant women residing in high malaria-endemic, hard-to-reach pockets of the Indian state of Odisha; and also measure its impact on birth-weight of their new-borns.MethodA time-to-event analysis of prospective longitudinal follow-up study nested within a cross-sectional survey of people residing in high malaria-endemic six districts of Odisha was conducted during July–November 2019. Malaria status in pregnant mothers was categorized as malaria free; sub-patent, and patent. Hazards Ratio (HR) of low birth-weight (LBW; birth-weight < 2500 gms) was estimated in these three categories (n = 308) adjusted for residence (block), gravida, caste, age and gestational age at testing.Results50.3% pregnant women had sub-patent malaria infection, 3.9% had patent infection. In fully adjusted model, hazards ratio of LBW was 3.76 (95% CI 1.12, 12.64, p = 0.032) in pregnant women with patent infection and 1.82 (95% CI 0.87, 3.81, p = 0.109) in women with sub-patent infection when compared to no malaria group.ConclusionThe study showed that half of the pregnant women in high-endemic pockets had sub-patent infection which posed deleterious influence on birth-weight of their new-borns. The study thereby flags the prevalence of sub-patent infection as a public health concern, because sub-patent infection in pregnant mothers may persist as a “silent” reservoir, with the potential to derail the malaria control program, especially when the country plans malaria elimination by 2030.

Clinical and laboratory presentation of first-time antenatal care visits of pregnant women in Ghana, a hospital-based study.

The WHO recommends pregnant women attend antenatal clinic at least three times during pregnancy; during the first, second and third trimesters. During these visits, an array of clinical and laboratory tests is conducted. The information obtained plays an important role not only in the management and care of pregnancy, but also guides policies targeted at addressing pregnancy-induced health challenges. This study therefore presents laboratory and clinical information of pregnant women at their first antenatal visits. The study was cross-sectional in design which retrospectively reviewed laboratory and clinical data of pregnant women attending their first antenatal clinic (ANC) at the Comboni Hospital, Volta region, Ghana. The data reviewed included information on hemoglobin level, hemoglobin phenotype, malaria diagnostics, Human Immunodeficiency Virus test (HIV), glucose-6-phosphate dehydrogenase (G6PD) deficiency, Hepatitis C Virus (HCV) test, Hepatitis B Virus (HBV) test, Syphilis test, blood pressure, age, urine glucose, and urine protein. The hemoglobin level was assayed with a hemoglobinometer. Qualitative lateral flow chromatographic immunoassay techniques were used to diagnose the HIV, HCV, HBV, syphilis, and malaria status of the pregnant women. Urine dipstick was used assay for the urine protein and urine glucose, whilst the methemoglobin test was used for the G6PD deficiency and alkaline hemoglobin electrophoresis for hemoglobin phenotype. Data on demographic, anthropometric and vital signs such as age, weight and blood pressure were also collected. Descriptive statistics were performed. Frequency and percentages were used to describe the categorical variables and means and standard deviations used to describe the continuous variables. Hemoglobin S(Hb S) was found in 12.8% of the women with 73.4% having hemoglobin levels below 11.5g/dl. On G6PD deficiency, 1.6% and 0.8% were partially and fully defective respectively. Also, urine protein (1.2%) and glucose (0.4%) were detected. The prevalence of HBV, HCV and malaria were 4.4%, 3.6% and 2.4%, respectively. Anemia in pregnancy was high among the study sample. Malaria and hepatitis infections were observed in the study sample. Policies on maternal health should be targeted at providing better nutritional options, that can enhance the hemoglobin level during pregnancy. Pregnant women should benefit from enhanced surveillance for HIV, HBV, HCV, and syphilis.

Bayesian joint spatial modelling of anemia and malaria in Guinea

&lt;abstract&gt;&lt;p&gt;In sub-Saharan Africa, anemia and malaria are the leading causes of morbidity and mortality among children under the age of five years. Guinea is one of the countries where the two diseases have devastating effects. Both of these diseases have been studied separately, but the two diseases exhibit inherent dependence between them, therefore, modelling them in isolation negates practical reality. This study aims at jointly estimating the spatial linear correlation between anemia and malaria, as well as to investigate the differences in contextual, socioeconomic and demographic factors affecting morbidity among children under five years in Guinea. Statistical approaches are used to handle modelling of binary outcomes with allowance for spatial components and joint responses. In particular, a latent model approach is proposed in the methodology to investigate the linear correlation between anemia and malaria allowing for spatial and non-spatial effects. All the parameters are estimated using Bayesian approach based on Markov chain Monte Carlo (MCMC) technique. According to the findings, 76.15% of children under the age of five years in Guinea were anemic, and 14.31% had malaria. Furthermore, the results showed that the child's malaria status is significantly associated with the place of residence, his/her age and ownership of television as an indicator of well being. In terms of anemia in children, there was a significant association with age, mother's education level and ethnicity group of the household head. The Nzerekore region, had both high malaria and anemia prevalences in children under five years. The latent model results showed that there was weak positive correlation between anemia and malaria in Nzerekore and Boke regions. Based on the shared component model, there was a significant unobserved risk factor that both diseases share.&lt;/p&gt;&lt;/abstract&gt;

Left ventricular function by strain in uncomplicated malaria: a prospective study from the Brazilian Amazon.

We hypothesized that adults with uncomplicated malaria have lower left ventricular contractile function compared to the general population and that this improves after antimalarial treatment. We examined uncomplicated malaria and the general population from the Western part of the Brazilian Amazon Basin. All persons underwent an echocardiographic examination and peripheral blood smears. Left ventricular function was assessed by speckle tracking analysis of global longitudinal strain (GLS). Logistic regression models were used to assess the association between malaria status (yes/no) and GLS and improvement in GLS by follow-upwas assessed using a paired T-test. We enrolled 99 adults with uncomplicated malaria (mean age 40 years, 46% female) of whom 75 had Plasmodium vivax, 22 Plasmodium falciparum and two had both species [median 1595 (528 to 6585) parasites/mm3]. Seventy adults completed a follow-up examination after standard malaria treatment (median 31 days). We examined 486 from the general population (mean age 41 years, 63% female). In persons with malaria at baseline, GLS was lower compared to the general population (18.7% vs. 19.4%, P = 0.002) and GLS improved at follow-up (19.2%, P = 0.032). In multivariable models adjusted for clinical, socioeconomic and echocardiographic confounders, baseline GLS remained significantly associated with malaria status [odds ratio 2.45 (95%CI 1.00 to 7.25), P = 0.023 per 1% increase]. Parasite density was associated with worsening in GLS [+ 16% (+ 0% to + 34%), P = 0.047 per 1 unit increase in GLS]. Adults with uncomplicated malaria had lower GLS compared to the general population and this improved after completed antimalarial treatment. Our results suggest that malaria infection may affect left ventricular contractile function, however, further studies are needed to fully elucidate such a relationship.

Impact of exposure to malaria and nutritional status on responses to the experimental malaria vaccine ChAd63 MVA ME-TRAP in 5-17 month-old children in Burkina Faso.

Pactr.org, identifier PACTR201208000404131; ClinicalTrials.gov, identifier NCT01635647.

Nigeria at 62: Quagmire of malaria and the urgent need for deliberate and concerted control strategy

BackgroundSub-Saharan Africa (SSA) has disproportionately contributed the majority (95%) of all malaria cases and deaths for more than a decade (2010-2021) and Nigeria contributes the highest in global malaria cases and deaths in the last decade.Main bodyDespite several malaria control initiatives, why is Nigeria still the most endemic malaria country? Published reports have underlined possible reasons for the sustenance of malaria transmission. Malaria transmission pattern in the country is largely and remarkably heterogeneous, hence control measures must take this uniqueness into consideration when designing intervention strategies. Nigeria became 62 years post-independence on the 1st of October, 2022, therefore making positive impacts on all aspects of the country, especially in the health sector becomes imperative more than ever before. To achieve a pre-elimination malaria status, we propose the implementation of focused and calculated research strategies. Such strategies would be consciously geared towards understanding vectorial capacity, susceptibility to approved insecticides, identifying malaria hotspots, and deciphering the genetic structure and architecture of P. falciparum within and between groups and regions. This will provide insight into delineating the inter/intra-regional migration of parasite populations, amongst others.ConclusionWith regard to malaria elimination, Nigeria still has a long way to go. There is a need for dedicated prioritization of research efforts that would provide a basic understanding of the Plasmodium parasite in circulation. Such information will support the implementation of policies that will drive down malaria transmission in Nigeria.

Microscopic and submicroscopic infection by Plasmodium falciparum: Immunoglobulin M and A profiles as markers of intensity and exposure.

Assessment of serological Plasmodium falciparum–specific antibodies in highly endemic areas provides valuable information about malaria status and parasite exposure in the population. Although serological evidence of Plasmodium exposure is commonly determined by Plasmodium-specific immunoglobulin G (IgG) levels; IgM and IgA are likely markers of malaria status that remain relatively unexplored. Previous studies on IgM and IgA responses have been based on their affinity for single antigens with shortage of immune responses analysis against the whole Plasmodium proteome. Here, we provide evidence of how P. falciparum infection triggers the production of specific IgM and IgA in plasma and its relationship with parasite density and changes in hematological parameters. A total of 201 individuals attending a hospital in Breman Asikuma, Ghana, were recruited into this study. Total and P. falciparum–specific IgM, IgA, and IgG were assessed by ELISA and examined in relation to age (0–5, 14–49, and ≥50 age ranges); infection (submicroscopic vs. microscopic malaria); pregnancy and hematological parameters. Well-known IgG response was used as baseline control. P. falciparum–specific IgM and IgA levels increased in the population with the age, similarly to IgG. These data confirm that acquired humoral immunity develops by repeated infections through the years endorsing IgM and IgA as exposure markers in endemic malaria regions. High levels of specific IgA and IgM in children were associated with microscopic malaria and worse prognosis, because most of them showed severe anemia. This new finding shows that IgM and IgA may be used as diagnostic markers in this age group. We also found an extremely high prevalence of submicroscopic malaria (46.27% on average) accompanied by IgM and IgA levels indistinguishable from those of uninfected individuals. These data, together with the observed lack of sensitivity of rapid diagnostic tests (RDTs) compared to PCR, invoke the urgent need to implement diagnostic markers for submicroscopic malaria. Overall, this study opens the potential use of P. falciparum–specific IgM and IgA as new serological markers to predict malaria status in children and parasite exposure in endemic populations. The difficulties in finding markers of submicroscopic malaria are highlighted, emphasizing the need to explore this field in depth.