Malarial Control Research Articles

Assessment of hematological parameters in malarial suspected patients: Cross sectional study

BackgroundMalaria is a Zoonotic disease, worldwide in distribution and caused by different species of plasmodium. It is a major cause of sickness and mortality in developing countries including Pakistan. This study was carried with the aim to find out the prevalence of malaria and to aware the people about this disease. MethodsThe study was carried out in district charsadda. 120 blood samples were collected from suspects both male and female, during the period of March 2022 to September 2022 and were analyzed for CBC and for Microscopic examination. ResultsOut of these 120 samples 12(10%) were found positive and 108(90%) were negative. The prevalence of malaria was more in the month of June and July. The infection was high in male (13.3%) as compared to female (6.6%). The prevalence was more in rural areas 8(13.3%) than in urban areas 4(6.6%). ConclusionThe Hemoglobin, Hematocrit, Platelets and Red Blood Cells were found more affected in positive samples as compared to other parameters. The present study will help the malarial control programs to focus on rural areas. The Plasmodium vivax is more common in the study area.

Antimalarial stocking decisions among medicine retailers in Ghana: implications for quality management and control of malaria

Global health efforts such as malarial control require efficient pharmaceutical supply chains to ensure effective delivery of quality-assured medicines to those who need them. However, very little is currently known...

Exosome-derived long noncoding RNAs: Mediators of host-Plasmodium parasite communication.

Overcoming challenges associated with malaria eradication proves to be a formidable task due to the complicated life cycle exhibited by the malaria parasite and the lack of safe and enduring vaccines against malaria. Investigating the interplay between Plasmodium parasites and their mammalian hosts is crucial for the development of novel vaccines. Long noncoding RNAs (lncRNAs) derived from Plasmodium parasites or host cells have emerged as potential signaling molecules involved in the trafficking of proteins, RNA (mRNAs, miRNAs, and ncRNAs), and DNA. These lncRNAs facilitate the interaction between hosts and parasites, impacting normal physiology or pathology in malaria-infected individuals. Moreover, they possess the capacity to regulate immune responses and associated signaling pathways, thus potentially influencing chromatin organization, epigenetic modifications, mRNA processing, splicing, and translation. However, the functional role of exosomal lncRNAs in malaria remains poorly understood. This review offers a comprehensive analysis of lncRNA and exosomal lncRNA profiles during malaria infection. It presents an overview of recent progress in elucidating the involvement of exosomal lncRNAs in host-parasite interactions. Additionally, potential exosomal lncRNAs linked to the domains of innate and adaptive immunity in the context of malaria are proposed. These findings may contribute to the discovery of new diagnostic and therapeutic strategies for malaria. Furthermore, the need for additional research was highlighted that aimed to elucidate the mechanisms underlying lncRNA transportation into host cells and their targeting of specific genes to regulate the host's immune response. This knowledge gap presents an opportunity for future investigations, offering innovative approaches to enhance malarial control. This article is categorized under: RNA Interactions with Proteins and Other Molecules > Small Molecule-RNA Interactions RNA Interactions with Proteins and Other Molecules > Protein-RNA Interactions: Functional Implications RNA in Disease and Development > RNA in Disease.

Comparative Knockdown Efficacy of Locally Made Insecticide ‘Ota Pia-Pia’ and Commercially Available ‘Sniper’ Against Malaria Vectors Using Deltametrin as the Control Standard in Keffi Local Government Area, Nasarawa, Nigeria

Mosquitoes are vectors of the major diseases of public health concern in the World. These include malaria, dengue fever, lymphatic filariasis, yellow fever, chikwungunya and recently zika virus causing morbidity and mortality in tropical and sub-tropical regions of the world. The success of malarial vector control depends on the susceptibility of Anopheles mosquitoes to insecticides. One locally made insecticide (Ota Pia-Pia), and synthetic insecticides Sniper and while Deltamethrin were used as a go standard from WHOPES as the control for the two insecticide to conduct Bioassay test against Anopheles mosquitoes in Keffi Local Government Area, Nasarawa the aim is to compare state of knockdown effects. The test papers included Ota pia-pia impregnated with (0.05%, 0.5% and 1.0%), sniper (0.05%, 0.5% and 1.0%), Deltamethrin (0.05%) as control for the insecticides and a general control using untreated paper impregnated with 0.05% of olive oil. Anopheles mosquito larvae were collected from three locations in Keffi Local Government Area and were returned in plastic bowls to the insectary laboratory of the Department of Zoology, Nasarawa State University, Keffi and reared to adults. One hundred (100) female Anopheles mosquitoes were fed with glucose for 3 – 5 days used in the Bioassay per treatment and replicated four times. The post-exposure one hour knockdown and 24hours mortality was assessed. It was observed that at 1%, 0.5% and 0.05% concentrations in sniper had the highest knockdown effect, 96%, 90% and 88% respectively while Deltamethrin had the least knockdown effect of 25%, 28% and 29% in August, September and October respectively. The results indicated that the mosquito populations in the locality were more resistant to Deltamethrin than sniper. A regular monitoring of resistance status is essential to help control mosquitoes in our communities.

Assessment of health staff's proficiency and quality of key malaria indicators in rural district of Ghana.

Routine Health Information Systems (RHIS) are important for not just sure enough control of malaria, but its elimination as well. If these systems are working, they can extensively provide accurate data on reported malaria cases instead of presenting modelled approximations of malaria burden. Queries are raised on both the quality and use of generated malaria data. Some issues of concern include inaccurate reporting of malaria cases as well as treatment plans, wrongly categorizing malaria cases in registers used to collate data and misplacing data or registers for reporting. This study analyses data quality concerning health staff's proficiency, timeliness, availability and data accuracy in the Sissala East Municipal Health Directorate (MHD). A cross-sectional design was used to collect data from 15 facilities and 50 health staff members who offered clinical related care for malaria cases in the Sissala East MHD from 24th August 2020 to 17th September 2020. Fifteen health facilities were randomly selected from the 56 health facilities in the municipality that were implementing the malarial control programme, and they were included in the study. On the question of when did staff receive any training on malaria-related health information management in the past six months prior to the survey, as minimal as 13 out of 50(26%) claimed to have been trained, whereas the majority 37 out of 50 (74%) had no training. In terms of proficiency in malaria indicators (MI), the majority (68% - 82%) of the respondents could not demonstrate the correct calculations of the indicators. Nevertheless, the MHD recorded monthly average timeliness of the 5th day [range: 4.7-5.7] within the reporting year. However, the MHD had a worse average performance of 5.4th and 5.7th days in July and September respectively. Furthermore, results indicated that 14 out of 15(93.3%) facilities exceeded the target to accomplish report availability (> = 90%) and data completeness (> = 90%). However, the verification factor (VF) of the overall malaria indicator showed that the MHD neither over-reported nor under-reported actual cases, with the corresponding level of data quality as Good (+/-5%). The Majority of staff had not received any training on malaria-related RHIS. Some staff members did not know the correct definitions of some of MI used in the malaria programme, while the majority of them could not demonstrate the correct calculations of MI. Timeliness of reporting was below the target, nevertheless, copies of data that were submitted were available and completed. There should be training, supervision and monitoring to enhance staff proficiency and improve the quality of MI.

Reducing maternal mortality: a 10-year experience at Mpilo Central Hospital, Bulawayo, Zimbabwe.

Maternal mortality is one of the major Sustainable Development Goals (SDGs) of the global health community. The aim of the SDG 3.1 is to reduce global maternal mortality ratio considerably by 2030. The objective of this study was to document the epidemiological trends in maternal mortality for Mpilo Central Hospital. This was a 10year retrospective study using readily available data from the maternity registers. The International Classification of Diseases-Maternal Mortality (ICD-MM) coding system for maternal deaths was used. The maternal mortality ratio (MMR) declined from 655 per 100,000 live births in 2011 to 203 per 100,000 live births by 2020. The commonest groups of maternal mortality during the period 2011-2020 were hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, and pregnancies with abortive outcomes. There were 273 maternal deaths recorded in the period 2011-2015, and 168 maternal deaths in the period 2016-2020. There was also a decline in maternal deaths due to obstetric haemorrhage (53 vs. 34). Maternal deaths due to pregnancy-related infection also declined (46 vs. 22), as well as pregnancies with abortive outcomes (40 vs. 26). There was a 69% decline in the MMR over the 10year period. The introduction of government interventions such as malarial control, the adoption of life-long Option B+ antiretroviral treatment for the pregnant women, the training courses of staff, and the introduction of strong clinical leadership and accountability were all associated with a significant decline in the causes of maternal deaths.

Plants screening and laboratory investigation of Ageratina adenophora methanol extract against Anopheles stephensi

Laboratory investigation of Ageratinaadenophora methanol leaf extract fractions (A. adenophora-MLEFr) was controlled and using GC-MS analysis, highlights of the main components on malarial vector, Anopheles stephensi(An. stephensi). In phytochemical, characterized by GC-MS analysis was carried out to be eligible for the constituents of the MLE. Maximum mortality was exerted by Fr-1 was showed EH/ENH% ovicidal activity of 15.7/37.2% at 10 ppm and 100% mortality at 20, 30, 40 50 and 60 ppm, against An. stephensi. The repellent activity of Fr-1 was the highest, showing 100% protection up to 240 min at 0.75 mg/cm2. In GC-MS analyzes, a total of 21 compounds were identified in the A. adenophora-MLE, and the main component was 5-isopropyl-2-methylphenol. The reports revealed the 5-isopropyl-2-methylphenol was the main constituent provides malarial control for the vector mosquito from A. adenophora-MLEFr

Knowledge, attitude, and practice of the National Guidelines for Diagnosis and Treatment of Malaria among medical doctors in Ebonyi state, Nigeria: A cross-sectional survey

The Guidelines for Diagnosis and Treatment of Malaria are meant to guide medical practitioners to enhance optimal management of patients suspected of having malaria which is vital to malarial control and elimination. Medical doctors have the main responsibility for treating patients with malaria so there was need to evaluate the extent to which the medical doctors in Ebonyi state, Nigeria, knew, viewed, and practiced the 2015 National Guidelines for Diagnosis and Treatment of Malaria. A cross-sectional survey was carried out in May, 2019 among medical doctors who were involved in the management of malaria patients and selected via convenience sampling. Data was collected using a structured self-administered questionnaire. Each respondent was categorized as having poor, fair, or good knowledge, attitude, and practice respectively based on knowledge, attitude, and practice scores of <50%, 50-75%, and >75%. Associated factors were evaluated through bivariate and multivariate binomial logistic regressions at 5% probability of type one error and the overall test for the effect of each independent factor on practice level was done using the "postestimation test" command in Stata. A total of 156 medical doctors were surveyed. Most, 138 (88.5%) were aware there was a national guideline for diagnosis and treatment of malaria. Among the medical doctors, 19 (12.2%) had good knowledge, 110 (70.5%) had fair knowledge, and 27 (17.3%) had poor knowledge; 38 (24.4%) had good attitude, 74 (47.4%) had fair attitude, and 44 (28.2%) had poor attitude; and 59 (37.8%) had good practice, 90 (57.7%) had fair practice, and 7 (4.5%) had poor practice. The attitude level of the medical doctors toward the 2015 National Guidelines for Diagnosis and Treatment of Malaria was a predictor of good practice (adjusted p-value of overall effect = 0.0003). Although most of the medical doctors in Ebonyi state, Nigeria, were aware of the existence of a national guideline, only just over a third of them had good practice of the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Policy interventions should focus on improving the attitude of the medical doctors toward the National Guidelines through training and re-training.

Knowledge and Practice of Malaria Control Measures among Women Attending Antenatal Clinics in Abakaliki, Nigeria

Background: Pregnant women, children and immune-compromised persons are highly vulnerable to malaria morbidity and mortality. Malaria accounts for about 50% of all clinic attendance in Nigeria and contributes significantly to anaemia in pregnancy, low birth weight, preterm births, still births and perinatal mortality. It is therefore imperative that these highly susceptible groups of people are adequately informed and supported for prevention of malaria at all times. This study assessed the knowledge and practice of malaria control measures among Antenatal Care attendees in Abakaliki.&#x0D; Methods: A descriptive cross-sectional study was conducted in the two biggest hospitals in Abakiliki, among 400 Antenatal Care attendees selected using systematic sampling technique. Data was collected using interviewer administered questionnaire and analyzed using Statistical Package for Social Sciences version 22. Chi-square was used to test for associations between independent and dependent variables. The significance level was set at p&lt; 0.05.&#x0D; Results: The mean age of respondents was 29.2 ± 4.1 years. Majority correctly identified methods of diagnosis of malaria in pregnancy. Although 375(93.7%) of the women constantly owned a long-lasting insecticide treated net, only 187(49.9%) of them always slept under it. While 363(90.7%) of the respondents cleared their surrounding bushes, only 130 (32.5) regularly used in-door insecticide spray and 153(38.3%) always used anti-malaria prophylaxis in the index pregnancy.&#x0D; Conclusion: Knowledge about malarial control measures was high but use of Long-Lasting Insecticide Treated Net with drug prophylaxis was suboptimal. It is therefore recommended that health education on malaria prevention practice be intensified during Antenatal clinic visits.

A Household-Based Cross-Sectional Survey of Knowledge, Awareness and Practice Regarding Malaria in Western Area Rural District, Sierra Leone.

Sierra Leone is a highly endemic area for malaria, and the implementation of the National Malaria Strategic Plan (2016–2020) has reached its midpoint in 2018. To provide more specific guidance for interventions in the future, a household-based cross-sectional survey was conducted to elucidate the knowledge, awareness and practices regarding malaria and malarial control measures among the general public. Three communities (Grafton, Jui, and Kossoh) in the Western Area Rural District that were in close proximity to Sierra Leone's capital city of Freetown were included. Households were randomly selected and interviewed with a structured questionnaire covering malaria infection, diagnosis, treatment and prevention, as well as knowledge of malaria prevention. As a result, a total of 262 qualified questionnaires were included. The average cost for meals per day is ~30,000 Leones in each household. The rate of awareness, indicated by reporting having heard of malaria, was 98.1% (257/262), and 86.6% (227/262) of the respondents knew that mosquito bites are the main route of transmission. In addition, 80.9% (212/262) of the respondents sought health advice or treatment for the illness, and a similar percentage of respondents had been tested for malaria, mostly with rapid diagnostic tests (RDTs). A high demand for long-lasting insecticidal nets (72.1%) matched the serious shortage (61.8%, 162/262), and of the households that reported a lack of nets, 66 had children younger than 5 years old. In conclusion, public awareness of malaria prevention is high, based on this survey, although there was a limited use of preventive measures in these three communities and the malaria burden was still high. Therefore, the public's knowledge of malaria should be sustained and reinforced, and the distribution and use of malaria prevention measures should be promoted to supprt the achievement of the planned objectives.

Potentiation Effects of Ficus sycomorus Active Fraction Against Permethrin-Resistant Field-Population of Anopheles coluzzii (Diptera: Culicidae).

Insecticide resistance in mosquitoes is increasing amidst growing cases of global malaria, leading to high fatality in mostly Africa. To overcome the resistance as well as environmental effects of the synthetic insecticides, preliminary insecticidal and botanical potentiating effects of sub-lethal concentration (LC25) Ficus sycomorus active fraction (AFFS) and its synergistic potential with standard insecticide permethrin were evaluated against malarial vector Anopheles coluzzii (Coetzee & Wilkerson) populations. The glutathione-S-transferase (GST) inhibitory activity of the AFFS was also investigated compared to standard GST inhibitor, diethyl meleate (DEM). The WHO standard protocol for adult bioassay was used to expose the adult mosquitoes with sub-lethal concentration (LD25=0.49 mg/ml) of the plants' active fraction and permethrin (0.75%). The permethrin susceptibility screening result showed high level of resistance to permethrin in the field populations of A. coluzzii from Kano with 50.29 ± 2.14% average mortality after exposure to WHO diagnostic dose 0.75% permethrin. Post hoc Fisher's exact test showed that combination of sub-lethal concentration of AFFS with permethrin (mortality=73.02±12.10%; p=0.00352; RR=0.6923 and 95% CI = 0.5358-0.8946) was statistically significant, while the combination of sub-lethal concentration of AFFS with DEM showed no statistical difference (mortality=63.22±5.03; p=1; RR=0.6667 and 95% CI=0.4470-0.8438). This potentiation effect was signified to be additive effects with co-toxicity factor (CTF) of - 12.66. There was significant reduction of GST activities in the AFFS- and permethrin -exposed groups compared to unexposed populations of A. coluzzii (p < 0.05). The AFFS additively potentiate the permethrin activities by inhibiting GSTs, bio-transformational enzymes implicated in pyrethroids resistance. This study finding generally signifies the potential for bio-rational insecticide approach for malarial vector control.

Widespread Contamination of Polychlorinated Biphenyls in South Carolina and North Carolina (USA): A Legacy of Malarial Eradication and Mosquito Control

The South Carolina Department of Health and Environmental Control (SCDHEC) has been conducting fish tissue monitoring for Polychlorinated Biphenyls (PCBs) since 1974 and, based on the results, restrictive fish consumption advice has been in place at two reservoirs in South Carolina for several decades. But in 2009, widespread contamination was reported in fish from the Catawba-Wateree and Yadkin-Pee Dee River Basins. Therefore, beginning in 2010, additional monitoring of fish tissue for PCBs in the rivers and reservoirs of these two basins was initiated. Results from a spatial analysis, combined with evidence from historic literature, suggests that the source of the PCB contamination, in part, is from past direct application of used transformer oil on reservoirs located along the two rivers, the origins of which were hydroelectric projects in both basins. The use of used motor oil for mosquito control and malaria eradication was widespread in the first half of the twentieth century, and results suggest that for some utility operations, PCB oil was utilized to augment these programs. The global ramifications of these findings are not yet known, but they should encourage reconsideration of origin, transport, and fate of PCBs in other regions, particularly where a known source of environmental contamination is not obvious.

Implications of COVID-19 Pandemic on Evolution of Diabetes in Malaria-Endemic African Region.

The coronavirus disease 2019 (COVID-19) pandemic continues to cause havoc to many countries of the globe, with no end in sight, due to nonavailability of a given vaccine or treatment regimen. The pandemic has so far had a relatively limited impact on the African continent, which contributes more than 93% of global malaria burden. However, the limited burden of COVID-19 pandemic on the African region could have long-term implications on the health and wellbeing of affected inhabitants due to its malaria-endemic status. Malaria causes recurrent insulin resistance with episodes of infection at relatively low parasitaemia. Angiotensin-converting enzyme 2 (ACE2) which is widely distributed in the human body is implicated in the pathogenesis of malaria, type 2 diabetes mellitus (T2DM), and COVID-19. Use of ACE2 by the COVID-19 virus induces inflammation and oxidative stress, which can lead to insulin resistance. Although COVID-19 patients in malaria-endemic African region may not exhibit severe signs and symptoms of the disease, their risk of exhibiting heightened insulin resistance and possible future development of T2DM is high due to their prior exposure to malaria. African governments must double efforts at containing the continued spread of the virus without neglecting existing malarial control measures if the region is to avert the plausible long-term impact of the pandemic in terms of future development of T2DM.

Co-infection with malaria and coronavirus disease-2019

Sir, Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is an ongoing global pandemic. Among the plethora of knowledge being garnered about the virus, the occurrence of co-infections and superinfections is also being reported.[1] Although SARS-CoV-2 is the first culprit to be suspected in symptomatic cases, it is important not to lose sight of the burden India faces with other infectious diseases. We report a case of malaria and COVID-19 co-infection. A 67-year-old male, a known case of type 2 diabetes mellitus and heart disease, presented with complaints of fever and progressive exertional breathlessness for 4 days in the 1st week of May. He had no history of travel or contact with a COVID-19-confirmed case. On examination, his oxygen saturation was 96% on room air. Complete blood count revealed moderate thrombocytopenia of 71.0 × 109/L with normal hemoglobin and white blood cell counts. On peripheral blood examination, ring forms and trophozoites of Plasmodium vivax were seen, along with reactive lymphocytes [Figure 1]. Chest X-ray (anteroposterior view) showed haziness in both lung fields. The patient was started on intravenous injection artesunate, followed by artemether and lumefantrine, per oral. He responded well to the antimalarial treatment with symptomatic relief.Figure 1: Peripheral blood smear showing ring form (red arrow) and trophozoite (white arrow) of Plasmodium vivax. A reactive lymphocyte is also seen (black arrow) (Leishman stain, ×400)Although his first nasopharyngeal swab for SARS-CoV-2 real-time reverse transcription–polymerase chain reaction test indicated the absence of the virus, repeat swabs sent on day 3 revealed positivity for the same. In the coming week, his platelet counts improved to normal levels, and he became clinically asymptomatic and stable. Co-infections of COVID-19 are thought to be very common, as high as 80%, most commonly with seasonal respiratory pathogens.[1] With overlapping symptoms and travel history (significant for COVID-19 and malaria), co-infection diagnosis may be challenging. India witnesses a temporal rise in water-borne and water-related diseases, including malaria, in the monsoon season, annually. With the ongoing pandemic, one can expect an increase in the rate of co-infections with COVID-19. It is important to investigate thoroughly in order to correctly identify a treatable infection as well as the presence of co-infections. While many clinical trials are ongoing for COVID-19 with no approved treatment regimen yet, there are already established antimalarial, antiviral, and antibiotic schemes for known infections. At present, the entire population, globally, is at very high risk of COVID-19. In 2018, it was reported that nearly half of the world population was at risk of malaria.[2] A single case of COVID-19 can potentially be infective to 3.58 susceptible individuals.[3] Likewise, an untreated case of malaria can lead to community spread. Furthermore, due to lockdowns and restricted mobility, there have been interruptions to health-care access and national malarial control programs. The World Health Organization is urging countries to ensure the continuity of malaria services in the context of the COVID-19 pandemic.[4] It is advisable that health-care professionals screen for malaria while they test for COVID-19.[5] This would help in timely identification of two infectious diseases having significant global impacts and reduce unnecessary morbidity and mortality. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Adherence to antimalarial drug policy among doctors in Delta State, Nigeria: implications for malaria control.

Malaria is a public health problem compounded with a widespread emergence of drug-resistant Plasmodium falciparum which necessitated the formulation of a new antimalarial drug policy (AMP). This study was designed to assess adherence to the policy among physicians in health facilities in Delta state, Nigeria. Cross-sectional, analytic study. Data were collected with a semi-structured questionnaire. Two secondary and one tertiary health facilities in Delta State, Nigeria. Physicians selected with a simple random technique from the facilities. Prescribing pattern of antimalarial drugs and adherence to WHO treatment guideline among doctors. Majority (90.8%) of respondents believed the antimalarial policy (AMP) should be strictly adhered to, although three-fifth (61.0%) of them rated its performance as poor. The level of adherence to the national antimalarial drug policy was high (78.5%) as most doctors prescribed Arthemeter-Lumefantrine, AL for uncomplicated malaria however barely two-fifth (35.4%) adhered to prescribing injectable Artesunate for complicated malaria. AL, (71.9%) was the most prescribed antimalarial drug for uncomplicated malaria The most prescribed antimalarial drugs for complicated malaria was artesunate (40.0%) followed by quinine (27.6%) and artemether (26.7%); although, chloroquine was also prescribed. The level of adherence to AMP among doctors was sub-optimal. Continuous education of doctors on the new AMP is needed to achieve malarial control. No funding was received for this study.

Genetic diversity and allele frequencies of Plasmodium falciparum msp1 and msp2 in parasite isolates from Bioko Island, Equatorial Guinea

BackgroundMalaria is still a serious public health problem on Bioko Island (Equatorial Guinea), although the number of annual cases has been greatly reduced since 2004 through the Bioko Island Malaria Control Project (BIMCP). A better understanding of malaria parasite population diversity and transmission dynamics is critical for assessing the effectiveness of malaria control measures. The objective of this study is to investigate the genetic diversity of Plasmodium falciparum populations and multiplicity of infection (MOI) on Bioko Island 7 years after BIMCP.MethodsA total of 181 patients with uncomplicated P. falciparum malaria diagnosed with microscopy were collected from Bioko Island from January 2011 to December 2014. Parasite DNA was extracted using chelex-100 and species were identified using a real-time PCR followed by high-resolution melting. Plasmodium falciparum msp1 and msp2 allelic families were determined using nested PCR.ResultsThree msp1 alleles (K1, MAD20, and RO33) and two msp2 alleles (FC27 and 3D7) were analysed in all samples. In msp1, the MAD20 allelic family was predominant with 96.69% (175/178) followed respectively by the K1 allelic family with 96.07% (171/178) and R033 allelic family with 70.78% (126/178). In msp2, the FC27 allelic family was the most frequently detected with 97.69% (169/173) compared to 3D7 with 72.25% (125/173). Twenty-six different alleles were observed in msp1 with 9 alleles for K1, 9 alleles for MAD20 and 8 alleles for R033. In msp2, 25 individual alleles were detected with 5 alleles for FC27 and 20 alleles for 3D7. The overall MOI was 5.51 with respectively 3.5 and 2.01 for msp1 and msp2. A significant increase in overall MOI was correlated with the age group of the patients (P = 0.026) or parasite densities (P = 0.04).ConclusionsThe present data showed high genetic diversity and MOI values among the P. falciparum population in the study, reflecting both the high endemic level and malaria transmission on Bioko Island. These data provide valuable information for surveillance of P. falciparum infection and for assessing the appropriateness of the current malarial control strategies in the endemic area.

Factors affecting control and eradication of malaria in Cape Coast, Ghana

The Global Malarial Action Plan (GMAP) addresses different measures towards achieving complete elimination of malaria, the most dangerous vector-borne disease. Present efforts for prevention and treatment of malaria in Cape Coast, a small town in southern Ghana, has achieved significant improvement from the past in controlling both the morbidity and mortality rates through various approaches. However, the current efforts and methodology in proceeding towards elimination of malaria presents many unanswered questions in terms of its level of sustainability. This report provides an overview of the current strategies implemented and addresses multifactorial issues that impede the control and eradication of malaria in Cape Coast. In addition, the effectiveness and sustainability of these strategies to achieve such intended goals have been evaluated. This study was conducted within Cape Coast, Ghana among 2 rural villages, Cape Coast Teaching Hospital and the general populous. Data collection involved face-to-face interviews of 55 individuals residing in Cape Coast, as well as, the use of hospital records on malaria. The paper concludes by indicating that more funding in infrastructure, as well as, serious advancement in public action is essential for improved malarial control and complete elimination of the disease.Keywords: DDT: Dichlorodiphenyltrichloroethane, GMAP: Global Malaria Action Plan, IRS: Indoor residual spraying (insecticide), ITN: Insecticide-treated nets, LBW: Low birth weight, LLIN: Long-lasting insecticide-treated nets, LSM: Larval Source Management, NHIS: National Health Insurance Scheme, Pf: Plasmodium Falciparum, WHO: World Health Organization

Temporal changes in genetic diversity of msp-1, msp-2, and msp-3 in Plasmodium falciparum isolates from Grande Comore Island after introduction of ACT.

BackgroundMalaria is still one of the serious public health problems in Grande Comore Island, although the number of annual cases has been greatly reduced in recent years. A better understanding of malaria parasite population diversity and transmission dynamics is critical for assessing the effectiveness of malaria control measures. The objective of this study is to investigate temporal changes in genetic diversity of Plasmodium falciparum populations and multiplicity of infection (MOI) in Grande Comore 10 years after introduction of ACT.MethodsA total of 232 P. falciparum clinical isolates were collected from the Grande Comore Island during two sampling periods (118 for 2006‒2007 group, and 114 for 2013‒2016 group). Parasite isolates were characterized for genetic diversity and complexity of infection by genotyping polymorphic regions in merozoite surface protein gene 1 (msp-1), msp-2, and msp-3 using nested PCR and DNA sequencing.ResultsThree msp-1 alleles (K1, MAD20, and RO33), two msp-2 alleles (FC27 and 3D7), and two msp-3 alleles (K1 and 3D7) were detected in parasites of both sampling periods. The RO33 allele of msp-1 (84.8%), 3D7 allele of msp-2 (90.8%), and K1 allele of msp-3 (66.7%) were the predominant allelic types in isolates from 2006–2007 group. In contrast, the RO33 allele of msp-1 (63.4%), FC27 allele of msp-2 (91.1%), and 3D7 allele of msp-3 (53.5%) were the most prevalent among isolates from the 2013–2016 group. Compared with the 2006‒2007 group, polyclonal infection rates of msp-1 (from 76.7 to 29.1%, P < 0.01) and msp-2 (from 62.4 to 28.3%, P < 0.01) allelic types were significantly decreased in those from 2013‒2016 group. Similarly, the MOIs for both msp-1 and msp-2 were higher in P. falciparum isolates in the 2006–2007 group than those in 2013–2016 group (MOI = 3.11 vs 1.63 for msp-1; MOI = 2.75 vs 1.35 for msp-2). DNA sequencing analyses also revealed reduced numbers of distinct sequence variants in the three genes from 2006‒2007 to 2013‒2016: msp-1, from 32 to 23 (about 28% decline); msp-2 from 29 to 21 (about 28% decline), and msp-3 from 11 to 3 (about 72% decline).ConclusionsThe present data showed dramatic reduction in genetic diversity and MOI among Grande Comore P. falciparum populations over the course of the study, suggesting a trend of decreasing malaria transmission intensity and genetic diversity in Grande Comore Island. These data provide valuable information for surveillance of P. falciparum infection and for assessing the appropriateness of the current malarial control strategies in the endemic area.

Persistent organic pollutant emission via dust deposition throughout Pakistan: Spatial patterns, regional cycling and their implication for human health risks

In the current study, Persistent Organic Pollutants (POPs) in outdoor dustfall was monitored for the first time along the Indus river system of Pakistan. Among the studied OCPs (ng/g, dry weight), DDTs (0.16–62) were the predominant contaminants identified in deposited dust followed by HCHs (0.1–10.2), HCB (0.09–7.4) and chlordanes (0.1–2.8). The indicative diagnostic ratio for DDTs and HCHs suggested recent emission of DDTs as well as historical emission of both chemicals in regions where they were used for crop protection and malarial control. The levels of ∑31PCBs (ng/g, dry weight) in dust ranged from 0.95–125, and compositional profiles suggested arochlor-1248, -1254 commercial mixtures as source. A few exceptions were samples from urban areas that reflected the use of aroclor-1260, and-1262 and/or unintentional leakage from several industrial processes. The WHO05-TEQ values for dioxin-like PCBs (with major contributions of PCB-126) were found to be 0.07–34.5 (median; 1.87) pg TEQg−1dw for all the studied samples. Correlation analysis identified that DDTs, HCHs, HCB and PCBs were significantly associated (r=90; p<0.01) with dusts collected in proximity to urban centers with widespread anthropogenic activities in these areas. A few cases where high levels of POPs from remote mountain highlands were detected, point to the potential for long range transport of these chemicals. Human risk assessment analysis of contaminated dust showed that DDTs and PCBs are major constituent chemicals of concern with regard to the development of cancer in children, with ingestion being the main route of exposure of dust-borne DDTs (0.12–1.03×10−6) and PCBs (0.86–12.43×10−6).

Transcriptomic Analysis of Chloroquine-Sensitive and Chloroquine-Resistant Strains of Plasmodium falciparum: Toward Malaria Diagnostics and Therapeutics for Global Health.

Increasing drug resistance in Plasmodium falciparum is an important global health burden because it reverses the malarial control achieved so far. Hence, understanding the molecular mechanisms of drug resistance is the epicenter of the development agenda for novel diagnostic and therapeutic (drugs/vaccines) targets for malaria. In this study, we report global comparative transcriptome profiling (RNA-Seq) to characterize the difference in the transcriptome between 48-h intraerythrocytic stage of chloroquine-sensitive and chloroquine-resistant P. falciparum (3D7 and Dd2) strains. The two P. falciparum 3D7 and Dd2 strains have distant geographical origin, the Netherlands and Indochina, respectively. The strains were cultured by an in vitro method and harvested at the 48-h intraerythrocytic stage having 5% parasitemia. The whole transcriptome sequencing was performed using Illumina HiSeq 2500 platform with paired-end reads. The reads were aligned with the reference P. falciparum genome. The alignment percentages for 3D7, Dd2, and Dd2 w/CQ strains were 85.40%, 89.13%, and 84%, respectively. Nearly 40% of the transcripts had known gene function, whereas the remaining genes (about 60%) had unknown function. The genes involved in immune evasion showed a significant difference between the strains. The differential gene expression between the sensitive and resistant strains was measured using the cuffdiff program with the p-value cutoff ≤0.05. Collectively, this study identified differentially expressed genes between 3D7 and Dd2 strains, where we found 89 genes to be upregulated and 227 to be downregulated. On the contrary, for 3D7 and Dd2 w/CQ strains, 45 genes were upregulated and 409 were downregulated. These differentially regulated genes code, by and large, for surface antigens involved in invasion, pathogenesis, and host-parasite interactions, among others. The exhibition of transcriptional differences between these strains of P. falciparum contributes to our understanding of the attendant, drug-sensitivity phenotypes, and by extension, the current efforts in maintaining global health by developing novel diagnostics and therapeutics for malaria.