Saturated anacardic acid shows promise as adjuvant therapy for preventing severe malaria via attenuation of inflammatory response by modulation of the NF-κB pathway.

Effect of higher dose primaquine for the radical cure of Plasmodium vivax malaria in Indonesia: a systematic review and individual patient data meta-analysis.

A paper-based electrospun nanofibrous membrane of nitrogen sulfur-doped graphene quantum dots for the fluorometric detection of P. vivax malaria

Paracetamol may improve renal function in patients with severe Plasmodium knowlesi malaria, particularly in those with acute kidney injury and hemolysis, via inhibition of cell-free hemoglobin mediated oxidative kidney damage. We developed a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess effects of paracetamol on creatinine, hepatotoxicity, fever clearance, and parasite clearance among Malaysian patients with predominantly non-severe knowlesi malaria using data from the PACKNOW trial (Clinical Trials Registration: NCT03056391). A total of 372 patients were included in the PK/PD analyses (paracetamol: n = 183, control: n = 189). Paracetamol PK was described using a prior PK model published in patients with falciparum malaria. The PK/PD demonstrated that higher paracetamol exposures were associated with a faster decline in both creatinine and fever clearance time, supporting its renoprotective and antipyretic effects. Increased paracetamol exposure was not associated with hepatotoxicity or serious adverse events, despite a weak positive association with liver transaminases over time. No significant relationship was observed between paracetamol exposure and parasite clearance. Overall, these findings highlight an exposure-response relationship for paracetamol and a decline in creatinine, supporting its use as a renoprotective drug in treating Plasmodium knowlesi malaria.

Adherence to radical cure for Plasmodium vivax remains a major challenge for malaria control programmes. Novel regimens, such as 7-day high-dose primaquine regimen and single-dose tafenoquine, may improve treatment adherence and antirelapse effectiveness but can increase the risk of haemolysis in individuals with glucose-6-phosphate dehydrogenase deficiency. Stakeholder (ie, policymakers, providers, patients, etc) perceptions of these risks may significantly influence the acceptability and uptake of these regimens. Understanding these perceptions is essential for policymakers to design effective communication and implementation strategies of novel radical cure strategies. Guided by qualitative methodology and a risk perception lens, this study explored P. vivax malaria stakeholders' experiences and interpretations of novel radical cure regimens. Between February and September 2023, 58 semistructured interviews and 6 focus group discussions were conducted at Arba Minch General Hospital and three health centres and health posts within the Gamo Zone of the South Ethiopia Regional State: Lante, Shecha and Shele. Participants included clinical trial staff and participants, health centre personnel, health extension workers and routine care patients. The 7-day-high-dose primaquine regimen and single-dose tafenoquine were viewed as promising solutions to the adherence challenges of the standard 14-day primaquine regimen; however, participants raised concerns about the effectiveness of the shortened treatment duration and the safety of the increased daily dose of primaquine. A risk perception lens revealed that concerns about effectiveness and safety were influenced by prior public health messaging emphasising completion of the full 14-day regimen alongside fears of overdosing and drug-induced haemolysis. Pill characteristics, including number, shape and colour as well as fears of overdosing and drug-induced haemolysis also contributed to apprehension about the safety of these regimens. Participants' perceptions of shortened radical cure regimens were shaped by concerns about effectiveness and safety, influenced by prior treatment messaging and pill characteristics such as higher dosing and pill burden. A risk perception lens can inform implementation and communication strategies for novel regimens, where addressing user perceptions alongside practical improvements, such as reducing pill burden, is essential for optimising uptake and adherence.

In remote areas where access to parenteral treatment for severe malaria or referral is limited, rectal artesunate (RAS) followed by a full course of artemisinin-based combination therapy (ACT) provided by community health workers would be a pragmatic solution. However, concerns remain that its expanded use may select for artemisinin-resistant Plasmodium falciparum strains. This baseline study assessed the presence of molecular markers of resistance to artemisinin and partner drugs and investigated factors associated with Plasmodium falciparum infection prior to RAS implementation. A community-based cross-sectional survey was conducted in remote areas of the Kapolowe health district, Democratic Republic of the Congo, in March-April 2024. Dried blood spot samples were collected from asymptomatic children aged 6-59months. Molecular markers of antimalarial drug resistance in P. falciparum were analyzed using targeted next-generation sequencing, focusing on the Pfkelch13, Pfcoronin, Pfubp1, Pfmdr1, and Pfcrt genes. Among 1242 children screened in 906 households, 656 (53%, 95% CI: 50-55%) were P. falciparum malaria rapid diagnostic test-positive, of which 646 samples were available for analyses. Factors associated with reduced odds of asymptomatic P. falciparum infection included higher household socio-economic status and non-agricultural sources of income, whereas children from households where malaria was perceived as treatable had increased odds of infection. No validated Pfkelch13 mutations associated with artemisinin partial resistance were detected. Several non-synonymous Pfkelch13 mutations were observed more than once, including A578S (7/395, 1.8%). Two Pfubp1 mutations associated with reduced dihydroartemisinin susceptibility, D1525E (88/354, 24.9%) and E1528D (62/354, 17.5%) were observed. No resistance-associated Pfcoronin mutations were detected. The wild-type Pfcrt CVMNK haplotype predominated, while the Pfmdr1 NFSND haplotype (57/379, 15.0%) associated with reduced lumefantrine susceptibility was identified. The absence of Pfkelch13 mutations and a full reversal to wild-type Pfcrt are reassuring for directly guiding the implementation strategies of RAS and continued effectiveness of current ACTs. However, the detection of the Pfmdr1 single mutant NFSND haplotype highlights the need for continued monitoring of lumefantrine susceptibility.

Non-typhoidal Salmonella (NTS) bloodstream infections complicate Plasmodium falciparum (Pf) malaria infections in children under-five, but bacterial co-infections are often missed due to absence of microbiological diagnosis. We compared signs/symptoms and outcome of NTS bloodstream infection, severe Pf malaria and NTS-Pf malaria co-infections. In an area with high, stable Pf malaria transmission (Kongo Central, DR Congo), children (>28 days- <5 years) admitted to hospital with severe febrile illness were enrolled during 18 months (NCT04473768/NCT04850677). Data (in-hospital and 1-month post-discharge) were prospectively collected. NTS bloodstream infections and severe Pf malaria were diagnosed in 12% (331/2682) and 52% (1389/2682) of enrolled children, respectively. NTS-Pf co-infections occurred in 10% (264/2682) of enrolled children, i.e., Pf malaria co-infected 80% (264/330) of NTS bloodstream infections and NTS co-infected 6% (78/1389) of severe Pf malaria. In children with recent Pf malaria (i.e., HRP2-antigen persistence with negative microscopy), NTS occurred in 32% (173/545), making recent malaria a major risk factor for NTS (OR=5.85, p < 0.001). Compared to severe Pf malaria, age under-two (OR=2.19), > 3 days of fever (OR=3.28) and acute malnutrition (OR=2.20-3.48) were risk factors for NTS (p < 0.001) and NTS cases more often had hypoglycemia, grunting, hepato-/splenomegaly, jaundice or altered consciousness, but overall clinical presentation was not discriminative. In-hospital NTS case fatality was high (24% versus 3% in severe Pf malaria), occurred within 2 days of admission in 64% of deaths, and was preceded by general danger/sepsis signs. NTS cases had slower fever resolution, more frequent in-hospital fever recurrence, longer hospital stays, and more post-discharge deaths (n = 4) than severe Pf malaria cases. NTS and Pf malaria frequently co-infected children under-five. Severe Pf malaria and NTS bloodstream infections could not be distinguished clinically, but fatality rates were higher in NTS. Low thresholds for empirical NTS antibiotics and early danger sign recognition triggering sepsis care might improve outcome.

Primaquine is the right drug for the radical cure of malaria. The Ethiopian National malaria guideline recommends a 14-day course of primaquine for vivax and mixed malaria patients. Adherence to the full course of primaquine is crucial to achieve a radical cure. However, the recurrence of malaria is still high. Therefore, this study aimed to assess adherence status and identify factors affecting adherence to primaquine treatment among malaria patients treated at health centers in Yilmana Densa district, Ethiopia. A community-based cross-sectional study was conducted in Yilmana Densa district from December 15, 2024 to January 30, 2025. A total of 594 malaria patients were selected using systematic random sampling. Data were collected through house-to-house visits by using an interviewer-administered questionnaire and observation. Self-report, followed by a pill count, was used to ascertain adherence status. The data were entered with EpiData 4.7 and analyzed using Stata version 17. Binary logistic regression was used. Variables with a P-value < 0.25 in bivariable analysis were entered into multivariable analysis. Variables with a P-value < 0.05 were considered statistically significant. Among the 594 study participants, 545 (91.8%) were interviewed. The overall adherence to primaquine treatment was 282 (51.7%), with a 95% confidence interval (CI) of 47.4% to 56.0%. Female sex (AOR = 1.64, 95%CI = 1.11-2.43), having knowledge that malaria can relapse (AOR = 1.69, 95%CI = 1.11-2.58), and a prior history of malaria infection (AOR = 1.67, 95%CI = 1.14-2.44) were positively associated with probably adherent. Whereas experiencing side effects was negatively associated (AOR = 0.49, 95%CI = 0.33-0.72). The primaquine treatment adherence status is low in the Yilmana Densa district. Being female, having knowledge that malaria can relapse, and having a prior malaria history were positively associated with adherence. Conversely, side effect has negatively associated. Hence, health education focusing on the risk of malaria relapse shall be promoted, giving due attention to males, and counselling about the expected side effects proactively.

Cerebral malaria is a complication of Plasmodium falciparum infections where the integrity of the blood-brain barrier (BBB) is compromised, frequently leading to persistent neurological sequelae or death. The current treatment for cerebral malaria is based on rapid elimination of the parasite with intravenous anti-malarial drugs, but there is no adjunctive treatment that could address the loss of BBB integrity, potentially decreasing sequelae and improving the survival rate. Prenylation, a cellular process that incorporates isoprenoid lipids to specific protein sites, is known to regulate endothelial barrier integrity. Here we have studied the role of the isoprenoid farnesyl pyrophosphate (farnesyl-PP) and of different inhibitors of the enzymes that perform prenylation in endothelial cells to determine their effect on the endothelial barrier disruption induced by Plasmodium falciparum. An in vitro model using human brain microvascular endothelial cells (HBMECs) incubated with lysates of P. falciparum-infected red blood cells (iRBCs) and a mouse model of cerebral malaria were used to study the role of the two main prenylation enzymes, farnesyltransferase and geranylgeranyltransferase, in the regulation of endothelial barrier integrity in relation to cerebral malaria. Addition of exogenous farnesyl-PP to HBMECs incubated with P. falciparum-iRBCs resulted in increased endothelial barrier disruption. Conversely, treatment with inhibitors of farnesyltransferase, but not of geranylgeranyltransferase, resulted in protection of barrier integrity against disruption induced by P. falciparum-iRBCs. Mice infected with Plasmodium berghei that were treated with the farnesyltransferase inhibitor tipifarnib presented delayed onset of cerebral malaria and higher survival rates. Inhibitors of farnesyltransferase protect human endothelial cell barrier integrity from disruption induced by P. falciparum in vitro and decrease mortality in mice with experimental cerebral malaria, indicating a role for farnesylation in the regulation of barrier integrity during cerebral malaria and identifying a potential drug target for the protection of the endothelium during severe malaria.

Plasmodium vivax malaria is a mosquito-borne disease of significant public health importance. A defining feature of the within-host biology of P. vivax is the accrual of a hypnozoite reservoir, comprising a bank of quiescent parasites in the liver that are capable of causing relapsing blood-stage infections upon activation. Superinfection, characterised by composite blood-stage infections with parasites derived from multiple mosquito inoculation or hypnozoite activation events, is another important attribute. We have previously developed a stochastic epidemic model of P. vivax malaria, formulated as a Markov population process with countably infinitely-many types, that is adjusted for both hypnozoite accrual and blood-stage superinfection. Here, we construct a Markovian branching process with countably infinitely-many types to approximate the early stages of this epidemic model. With denoting the mosquito population size, we consider the limit with the ratio of the mosquito and human populations held fixed. With an arbitrary constant, we use a classical coupling argument to obtain a total variation bound of order that is valid until human-to-mosquito and mosquito-to-human transmission events have occurred. We characterise the probability of global disease extinction under the branching process to approximate the probability of elimination, as opposed to sustained endemic transmission, when the epidemic model is initialised with low-level human and/or mosquito infection. We apply our model to two scenarios of epidemiological interest, namely the re-introduction of P. vivax malaria in a region where elimination has previously been achieved; and a mass drug administration campaign with population-wide depletion of the hypnozoite reservoir.

Epitope mirroring between the malaria surface proteins PfGARP and PIESP2 identifies a knob-associated complex in infected erythrocytes.

There is limited evidence regarding the association between weather and Plasmodium vivax (Pv), particulary in Latin America where Pv is the predominant malaria species and key challenge for countries to achieve malaria elimination. We analyzed the association between weather and Pv malaria incidence from 2017 to 2024 in 136 communities in the Peruvian Amazon. Monthly community-level incidence was calculated using Pv case data from Notiweb, the national epidemiological surveillance system, and population census data. Predictors included weekly minimum and maximum temperature and total weekly precipitation and were calculated using hourly weather from the climate dataset ERA5. Non-linear distributed lag models were fit using a lookback period of 2-16weeks. Temperature models were adjusted for total precipitation; precipitation models were adjusted for maximum temperature. Sub-group analyses were conducted by community type (adjacent to river versus highway) and El Niño Southern Oscillation (ENSO) period. Minimum temperature at the 90th percentile (23.7°C) was associated with 10% (95% CI 5-14%) higher malaria incidence compared to the 5th percentile (20.5°C) at a 7-week lag. Maximum temperature at the 90th percentile (33.7°C) was associated with 10% (95% CI 8-13%) higher malaria incidence compared to the 5th percentile (29.6°C) at a 9-week lag. Total weekly precipitation at the 90th percentile (1000mm) was associated with 29% (95% CI 24-33%) higher malaria incidence compared to weeks with the 5th percentile (57mm) at an 11-week lag. Incidence was higher and associations were stronger in communities adjacent to rivers versus highways. Malaria incidence was lower during El Niño periods, and there was evidence of interaction on the multiplicative scale for the association between incidence, all weather predictors, and ENSO period. Pv malaria incidence was positively associated with higher temperatures and precipitation in an elimination setting in Peru, particularly in riverine communities during non-El Niño years, with longer lag periods than previously reported for such associations. These findings can inform malaria elimination interventions to combat the long-lasting effects of weather on Pv transmission.

Malaria remains a major public health challenge in Ethiopia, with Plasmodium falciparum and Plasmodium vivax accounting for most malaria cases. Continuous monitoring of antimalarial drug efficacy and safety is essential to ensure effective case management and to detect early signs of emerging drug resistance. In addition, understanding gametocyte clearance following treatment is important because persistent gametocytaemia can sustain malaria transmission. This study assessed the therapeutic efficacy, safety, and gametocyte clearance following antimalarial treatment among patients with uncomplicated P. falciparum and P. vivax malaria in Northeast Ethiopia. A prospective observational study was conducted from November 2024 to January 2026 among 159 patients with uncomplicated malaria, including 81 P. falciparum and 78 P. vivax infections. Patients received treatment according to national guidelines, with artemether-lumefantrine for P. falciparum and chloroquine for P. vivax, while a subset also received a single low dose of primaquine. Participants were followed for 28 days to assess therapeutic outcomes, fever clearance, asexual parasite clearance, haemoglobin recovery, gametocyte clearance and adverse events. Data were analysed using SPSS version 26.0. Kaplan-Meier survival analysis was used to evaluate fever, parasite, and gametocyte clearance. Statistical significance was considered at p < 0.05. Therapeutic efficacy was high in both species, with adequate clinical and parasitological response rates of 88.9% among P. falciparum patients and 97.4% among P. vivax patients. Fever and asexual parasite clearance occurred more rapidly in P. vivax than in P. falciparum, with median fever clearance times of 2 and 3 days and median parasite clearance times of 2 and 4 days, respectively. Haemoglobin levels improved throughout follow-up in both groups, although P. falciparum infections were associated with lower baseline haemoglobin levels. Antimalarial treatments were generally well tolerated, with most adverse events being mild and no treatment discontinuations recorded. A transient increase in gametocyte carriage on day 3 was observed more frequently among participants who did not receive primaquine. Primaquine significantly accelerated gametocyte clearance, reducing the median clearance time from 11 to 7 days in P. falciparum and from 7 to 4 days in P. vivax. Higher baseline gametocyte density was associated with slower gametocyte clearance, particularly among P. falciparum patients. First-line antimalarial treatments remain highly effective and well tolerated for the management of uncomplicated P. falciparum and P. vivax malaria in Northeast Ethiopia. However, post-treatment gametocyte persistence may contribute to ongoing transmission, particularly in P. falciparum infections. The addition of low-dose primaquine significantly enhanced gametocyte clearance in both species, highlighting its potential role in reducing transmission and supporting malaria elimination efforts.

Malaria and diabetes are two major health challenges in Nigeria, with malaria being a leading cause of morbidity and mortality, and diabetes rapidly emerging as a significant non-communicable disease. The coexistence of these two conditions presents a complex healthcare challenge, especially in malaria-endemic regions like Nigeria. This review explores the immunological interactions between malaria infection and diabetes, focusing on how diabetes influences the immune response, clinical progression, and outcomes of malaria. Diabetes, particularly when poorly managed, impairs immune function, increasing susceptibility to malaria and exacerbating its severity. Diabetic patients with malaria often experience prolonged illness, severe complications, and poorer clinical outcomes, such as cerebral malaria, organ failure, and hypoglycemia. Furthermore, the treatment of malaria in diabetic patients is complicated by potential drug interactions and the need for synchronized management of both diseases. This review highlights the importance of integrated care approaches, early detection, and the need for further research to better understand the dual burden of these diseases. Effective management strategies are essential to mitigate the health risks posed by the intersection of malaria and diabetes in Nigeria. Keywords: Malaria, Diabetes, Immunological Interactions, Clinical Outcomes, Nigeria, Malaria Severity.

Evaluation of immunogenicity and efficacy of a Plasmodium vivax nanoparticle vaccine in mice.

Plasmodium falciparum malaria remains a major cause of morbidity and mortality in endemic regions, with outcomes influenced by host genetic factors. The ABO blood group system has been linked to clinical severity, though findings differ regarding blood groups and severe malaria susceptibility. This analysis aims to synthesise evidence on ABO blood group's role in severe P. falciparum malaria (SM) through meta-analysis and trial sequential analysis. A search was conducted across PubMed, Scopus, Embase, Web of Science and Science Direct databases on August 31, 2025, to identify case-control studies reporting ABO blood groups in SM and uncomplicated malaria (UM). All Statistical analysis was performed with CMAv4. Twenty-three studies comprising 3553 SM and 6112 UM cases were analysed. Results showed higher SM risk in blood groups A (OR:1.98; p = 0.00), B (OR:1.87; p = 0.00), AB (OR:1.91; p = 0.00) and non-O (OR:1.88; p = 0.00) versus group O. These associations were confirmed in African and South Asian populations, while Melanesians showed different patterns. Non-O groups showed increased risk in adults and children. Group A was linked to severe malarial anaemia (OR:1.75, p = 0.004), while group B showed protective effects (OR:0.75, p = 0.00). SM patients had lower haemoglobin (MD = -2.23; p = 0.00), with parasite density showing no correlation with severity. TSA confirmed evidence linking ABO groups with SM and haemoglobin levels. This meta-analysis and TSA confirm non-O blood groups as a susceptible factor for SM across ethnicities and ages. While ABO blood group is an inexpensive and widely available genetic marker, its clinical utility should be viewed as complementary rather than deterministic. However, at present, evidence does not support population-wide screening solely for malaria risk prediction. These findings improve understanding of host genetic susceptibility and may inform future research into targeted risk stratification.

Background & Purpose: Experimental cerebral malaria (ECM) is associated with abnormalities in cerebral perfusion, yet the mechanisms underlying vascular dysfunction remain incompletely defined. Experimental Approach: Ex vivo pressure myography of middle cerebral arteries (MCAs) was used to assess intrinsic arterial function in control and ECM mice. Mesenteric arteries were used to compare intraluminal perfusion versus abluminal superfusion with healthy plasma or serotonin (5-HT). Wire myography of aortic rings as a biosensor for plasma-derived vasoactive factors was used to investigate circulating modulators of vascular tone. Key Results: MCAs from ECM animals showed preserved constriction to 5-HT, preserved endothelium-dependent relaxation to methacholine (MCh), and intact responses to nitroprusside. MCh relaxation was inhibited by L-NAME, indicating preserved endothelial NO signaling. In aortic rings, ECM plasma produced concentration-dependent vasoconstriction, enhanced by NOS inhibition. Blockade of 5-HT₂A receptors with ketanserin abolished >80% of this constriction in a sex-independent manner, demonstrating that plasma 5-HT is the predominant circulating vasoconstrictor. Plasma or 5-HT induced robust vasoconstriction when applied abluminally, but not intraluminally. Conclusion & Implications: ECM does not cause intrinsic endothelial or smooth muscle dysfunction of the MCA. Vasoconstrictive responses to plasma from ECM or control mice were similar, suggesting no major differences in plasma vasoregulatory molecules. Plasma serotonin exerts a vasoconstrictive effect in the setting of NOS inhibition when plasma contacts the adventitial, but not the luminal, aspect of an artery. Based on these findings, we propose that normal circulating levels of serotonin could potentially have vasoconstrictive effects in disease conditions that compromise vascular barrier integrity.

Artemether and artesunate are effective antimalarial drugs in rescue therapies of Plasmodium berghei ANKA (PbA)-infected mice with experimental cerebral malaria (ECM), with a superiority for artemether among the single daily dosing schemes. The present study aimed to optimize the efficacy of artesunate treatment protocols using two daily dosing or slow continuous delivery schemes. PbA-infected mice were treated with four different artesunate protocols on day 5 post-infection (5 dpi). Protocol G4 (single intraperitoneal (IP) loading dose of 20 mg/kg followed by continuous delivery for 3 days with osmotic pumps) was superior to the other artesunate groups, with a 97.2% ± 0.86 reduction of parasitemia in 24 h, but recrudescence ensued in 50% of treated animals. Protocol G1 (loading dose of 40 mg/kg followed by 20 mg/kg twice a day for 5 days) led to a 90.5% ±5.39 decrease in parasitemia 24 h after the first dose without recrudescence. A variant of the G1 protocol, with two doses of 40 mg/kg in the first day, resulted in a survival rate of 42% in ECM-rescuing experiments, with ~30% decreases in hematocrit, hemoglobin, and red blood cell count 24 h after the first dose. Infected mice on 5 dpi showed severe thrombocytopenia (196 ± 118.3 platelets/μL; uninfected controls: 1,291 ± 256.4 platelets/μL), and artesunate treatment had little impact on these numbers 24 h after the first dose. In conclusion, two daily doses IP or via slow continuous delivery improve the efficacy of artesunate treatments compared to single-daily dose schemes and are suitable for ECM adjunctive therapy studies.

SUMMARYPlasmodium vivax remains a major barrier to global malaria elimination due to dormant liver-stage hypnozoites that drive relapse and sustain transmission even in low-endemic settings. India accounts for nearly half of the global P. vivax burden, placing it at the center of elimination efforts. This review synthesizes current evidence on the epidemiology, biology, and control of P. vivax in India. Despite progress, early gametocytogenesis, hypnozoites, low parasitemia, and immune evasion complicate diagnosis and treatment. Recent single-cell and multi-omics studies are elucidating vir gene regulation, epigenetic control of hypnozoite dormancy, and quiescent liver-stage biology. Diagnostic gaps persist because microscopy and rapid diagnostic tests poorly detect asymptomatic infections, and molecular surveillance cannot map relapse without hypnozoite biomarkers. Standard radical cure with chloroquine and 14-day primaquine is limited by poor adherence and restricted glucose-6-phosphate dehydrogenase testing, while single-dose tafenoquine awaits wider implementation. Urban malaria, largely driven by P. vivax and Anopheles stephensi, is increasing as a consequence of rapid urbanization and vector adaptation. National initiatives such as the Integrated Health Information Platform, Tribal Malaria Action Plans, and Urban Malaria Schemes are critical but face constraints in surveillance integration, private sector reporting, and cross-border coordination. We highlight emerging experimental liver models, single-cell technologies, and systems biology frameworks as essential tools for addressing key knowledge gaps in relapse biology. Sustained investment and interdisciplinary collaboration will be required for India to lead P. vivax elimination and translate national progress into global impact.

Accurate and species-specific diagnosis of Plasmodium vivax malaria remains a significant challenge in malaria management due to the insufficient sensitivity and selectivity of existing rapid antigen tests. In this study, a highly sensitive and selective lateral flow immunoassay (LFIA) platform was developed utilizing blue-colored cellulose nanobeads (CNBs) as high-contrast colorimetric reporters for the detection of P. vivax lactate dehydrogenase (PvLDH). Six novel monoclonal antibodies with sub-nanomolar dissociation constants and exceptional specificity toward PvLDH were generated and characterized. Systematic screening identified an optimal antibody pair-clone #6 for detection (probe) and clone #4 for capture-which was subsequently incorporated into the CNB-based LFIA. The developed assay achieved limit of detection values of 5 ng/mL in buffer and 10 ng/mL in blood sample, representing a 50- to 100-fold improvement in sensitivity compared with conventional gold nanoparticle-based commercial RDTs. Notably, the distinct blue signal produced by the CNBs provided superior visual contrast against the red background of the blood sample, enabling clear, instrument-free interpretation. The assay exhibited no cross-reactivity with P. falciparum LDH or human LDH, thereby ensuring robust species-specific discrimination. Given its high sensitivity, portability, and strong performance in complex biological matrices, this CNB-based LFIA represents a promising next-generation point-of-care diagnostic tool for effective P. vivax malaria detection in endemic settings.