Epidemiology Of Malaria Research Articles

Magnitude of urban malaria and its associated risk factors in Damboya town, Kambata zone, Central Ethiopia.

As Sub-Saharan African country urban malaria is potential catastrophe in Ethiopia, particularly in relation to rapidly growing small towns, which requires updating the epidemiology of malaria. There was lack of information regarding the study area, hence this study was designed to determine the prevalence of malaria and associated risk factors in Damboya town. A Community-based cross-sectional study was carried from March 7 to May 29, 2023 among 422 randomly selected participants. Prevalence of malaria was determined using microscopic examination of thick and thin smear and rapid diagnostic test using kits to standard of the manufacturer. Pretested structured questionnaire was employed to collect socio-demographic data and associated risk factors. Data were entered in Epi data 3.1 and analyzed using SPSS version 25 software. Factors associated with malaria was analyzed using bivariable and multivariable binary logistic regression. The strength of the association was determined by computing Adjusted Odds Ratio (AOR) at Malaria is one of the most vital leading cause of morbidity and mortality in developing countries particularly in Sub Saharan Africa (Bugssa and Tedla, 2020). About 95 % of all malaria cases and 96 % of all malaria deaths in 2021 occurred in Africa (Bugssa and Tedla, 2020). Sub-Saharan Africa accounted for 60 % of global cases and 90 % of global fatalities (WHO, 2022). Over the two peak years of the pandemic (2020-2021), COVID-related setbacks increased malaria cases by around 13 million and fatalities by 63,000 (WHO, 2022). Malaria is thought to directly cost Africa $12 billion annually and reduce GDP growth by 3 %. In addition, it is thought to cause cognitive disorders and school absences, which are barriers to the development of human capital (Monroe et al., 2022). 95% confidence interval (CI) and p-value of <0.05. The prevalence of malaria was 5% (20, 95% CI: 3-7), Plasmodium vivix account for 14 (61.9%) of the infection. Presence of stagnant water (AOR=3.630, 95% CI: 1-13, P<0.049), unavailability of Insecticide-treated bed net (AOR=3.89, 95% CI: 1.08-14.01, P<0.038), living in a house with eaves (AOR=5.06, 95%CI: 1.25-20.58, p<0.023), travel history (AOR=3.58, 95%CI: 1-12.79, p<0.049), low-income (AOR=5.3, 95%CI: 1.09-25.2, P<0.038), were significantly associated with malaria occurrence. Malaria is still a public health concern in Damboya town. Thus, implementing intervention strategies properly and evaluate the access and utilization status of the suburb community and improve accordingly was required to interrupt the transmission in the community of this town.

Extracellular vesicles in malaria: proteomics insights, in vitro and in vivo studies indicate the need for transitioning to natural human infections.

Globally, an estimated 2.1 billion malaria cases and 11.7 million malaria deaths were averted in the period 2000-2022. Noticeably, despite effective control measurements, in 2022 there were an estimated 249 million malaria cases in 85 malaria-endemic countries and an increase of 5 million cases compared with 2021. Further understanding the biology, epidemiology, and pathogenesis of human malaria is therefore essential for achieving malaria elimination. Extracellular vesicles (EVs) are membrane-enclosed nanoparticles pivotal in intercellular communication and secreted by all cell types. Here, we will review what is currently known about EVs in malaria, from biogenesis and cargo to molecular insights of pathophysiology. Of relevance, a meta-analysis of proteomics cargo, and comparisons between in vitro and in vivo human studies revealed striking differences with those few studies reported from patients. Thus, indicating the need for rigor standardization of methodologies and for transitioning to human infections to elucidate their physiological role. We conclude with a focus on translational aspects in diagnosis and vaccine development and highlight key gaps in the knowledge of EVs in malaria research.

The epidemiology of malaria in four districts in southern Mozambique receiving indoor residual spray as part of a cross-border initiative

BackgroundImported malaria from southern Mozambique drives low levels of disease transmission in KwaZulu-Natal, South Africa. Therefore, the South African Department of Health funded implementation of indoor residual spraying (IRS) in Mozambiquan districts identified as sources of malaria infection for border communities in KwaZulu-Natal. IRS was initiated in districts of Guija, Inharrime, Panda and Zavala. To determine impact of spraying on malaria transmission in these districts, data relating to incidence and prevalence was collected before spraying (2018) and before the second round of spraying was completed (2023). Implementation of IRS was also monitored to ensure optimal spray coverage was achieved.MethodsThe study was a cross-sectional survey conducted in 6 sentinel sites in each of the four afore-mentioned districts, focusing on children 6 months to < 15 years from selected households. There was a baseline and an endline cross-sectional survey. Baseline prevalence took place during March–April 2022 whereas the endline surveys occurred during February–March 2023. One hundred and twenty children from each sentinel site were tested for malaria using rapid diagnostic tests. Monthly malaria cases were obtained from health facilities in each study district. Spray data was obtained from LSDI2 initiative who implemented IRS in the targeted districts.ResultsThe study showed a definite impact of IRS on malaria prevalence in the targeted districts. Prevalence for sentinel sites in Guija district indicated that the prevalence of malaria increased slightly from baseline to endline in all sentinel sites in Guija. Overall, there was no significant change in prevalence in Zavala, from baseline to endline (p-value = 0.611). Panda’s overall malaria prevalence decreased from 19.20% to 10.82% (p-value < 0.001) whereas overall prevalence in Inharrime, decreased from 27.68% to 19.50% (p-value < 0.001). Malaria prevalence in children younger than 5 years decreased significantly in all four districts. In Panda there was a decrease in numbers of males and females being infected between surveys (p < 0.001), whereas for Inharrime the decrease was significant in females (p < 0.001). High coverage with IRS (> 95%) resulted in greater population protection.ConclusionThe study revealed that IRS implementation decreased malaria prevalence in Inharrime and Panda but not in Guija and Zavala. To ensure that cross-border movement of people does not result in increased malaria transmission, targeting areas identified as source of infection in travelers is paramount to reaching elimination.

Prevalence and associated factors of malaria among the displaced population in refugee camps in Africa: a systematic review and meta-analysis

BackgroundThe increased occurrence of malaria among Africa’s displaced communities poses a new humanitarian problem. Understanding malaria epidemiology among the displaced population in African refugee camps is a vital step for implementing effective malaria control and elimination measures. As a result, this study aimed to generate comprehensive and conclusive data from diverse investigations undertaken in Africa.MethodsThis review adhered to PRISMA standards, involving searches across electronic data bases such as Google Scholar, PubMed, Web of Science, Scopus, and Science Direct. In addition, grey literature was retrieved from several professional associations. The quality of selected studies was evaluated using the Newcastle–Ottawa Quality Assessment Scale. Data extraction was executed using Microsoft Excel, and the meta-analysis was performed with STATA 14 software. A random-effects model was used to estimate the pooled prevalence and associated factors of malaria. Meta-regression and subgroup analysis were used to identify heterogeneity, while funnel plots and Egger’s statistical tests assessed the publication bias. Furthermore, a sensitivity analysis was performed.ResultsThe overall random-effects pooled prevalence of malaria infection (comprising symptomatic and asymptomatic cases) across all included studies was 35.93% (95% CI 24.71–47.15). This study showed a high level of heterogeneity between studies (I2 = 97.1; P < 0.001). Of the identified Plasmodium species, Plasmodium falciparum constituted 99.3%. The frost plot indicated that the overall prevalence of P. falciparum was 34.94% (95% CI 24.34–45.53). Subgroup analysis revealed significant variation (P < 0.001) in malaria prevalence between asymptomatic and symptomatic cases, with a prevalence of 4.39% (95% CI 2.57–6.21) and 45.10% (95% CI 27.28–62.92), respectively. Lack of insecticide-treated mosquito net utilization (AOR 2.43; 95% CI 1.01–5.88) and living near mosquito breeding sites (AOR 2.76, 95% CI 1.56–4.87) were risk factors of malaria.ConclusionThis study determined that the pooled prevalence of malaria among displaced individuals in refugee camps was high and exhibited variations across different population groups. This signifying there is still a need to improve and recheck existing malaria prevention and control strategies to establish an effective malaria control and elimination programme in Africa.

Epidemiology of malaria and hematological analysis in district Dir (lower), Pakistan

Background: Malaria is considered as a tropical disease, in developing countries. Among all parasitic infections malaria is most widespread and devastating disease. According to WHO malaria is endemic in 24 countries. Methods: This cross-sectional study was conducted at Department of Medical Laboratory Technology University of Haripur. Total 995 samples were collected at District Head Quarter Hospital (DHQ), Tehsils Hospitals (THQs), and other private laboratories in District Dir (Lower). These samples were processed to observe the shape of RBCs as well as plasmodium species in the smear microscopically, and for hemoglobin estimation. Data was analyzed through SPSS version-21. Results: Highest percentage of malaria was recorded in Munda (35.17%) followed by Timergara (19.59%) whereas the lowest number of cases were found in Khall (5.02%). Prevalence of P. vivax was (98.0 %) and P. falciparum was (2 %) in district Dir Lower. Mean red blood cell count (RBCs) was 4.2±0.64 mm3 while mean Hb was 11.0±1.99g/dl. Based on different age categories, the highest RBCs and Hb levels were found in age group 41-50 years, whereas the lowest RBCs were found in age group 11-20 years while the lowest Hb levels were recorded in group 1-10 years. In associated diseases, the upper respiratory tract infections (URTIs) were the most frequent (20%) followed by diarrhea (18%). Mean Hb of males was 11.8±1.53 g/dl while the mean Hb of female was 11.5±5.384 g/dl. Hb in both males and females were low as compared to the standard. However, as compared to females, Hb of males were significantly lower with p-value &lt;0.001. Conclusion: We concluded that males are more commonly infected from malaria as compared to females. Males and children were found to have low Hb as compared to females and higher age group patients. URTIs and diarrhea were the most common associated illness.

Climate Change and Malaria: A Call for Robust Analytics.

Mosquito ecology and behavior and malaria parasite development display marked sensitivity to weather, in particular to temperature and precipitation. Therefore, climate change is expected to profoundly affect malaria epidemiology in its transmission, spatiotemporal distribution and consequent disease burden. However, malaria transmission is also complicated by other factors (e.g. urbanization, socioeconomic development, genetics, drug resistance) which together constitute a highly complex, dynamical system, where the influence of any single factor can be masked by others. In this study, we therefore aim to re-evaluate the evidence underlying the widespread belief that climate change will increase worldwide malaria transmission. We review two broad types of study that have contributed to this evidence-base: i) studies that project changes in transmission due to inferred relationships between environmental and mosquito entomology, and ii) regression-based studies that look for associations between environmental variables and malaria prevalence. We then employ a simple statistical model to show that environmental variables alone do not account for the observed spatiotemporal variation in malaria prevalence. Our review raises several concerns about the robustness of the analyses used for advocacy around climate change and malaria. We find that, while climate change's effect on malaria is highly plausible, empirical evidence is much less certain. Future research on climate change and malaria must become integrated into malaria control programs, and understood in context as one factor among many. Our work outlines gaps in modelling that we believe are priorities for future research.

Subclinical Plasmodium spp. Infections in a Community Setting in Bangui, Central African Republic.

Malaria is a major public health problem in the Central African Republic (CAR). Data on malaria epidemiology are often derived from confirmed cases of symptomatic malaria using passive detection approaches, with very limited knowledge of the extent of subclinical and submicroscopic infections. A community-based cross-sectional study was conducted in Bangui, the capital of the CAR, to assess the prevalence of subclinical malaria parasitaemia. Proportions of positive tests for malaria parasites were determined by combining the results of antigen-based malaria rapid diagnostic test (mRDT), thick blood smear microscopy, and polymerase chain reaction (PCR). A total of 638 participants (mean age, 26.44 years (range, [1-75] years) with a sex ratio (M/F) of 1.22) were tested for malaria using all three detection methods. Proportions of positives were 32.45% by PCR, 27.59% by mRDT, and 23.51% by Giemsa-based thick blood smear microscopy, representing the burden of subclinical malaria. In addition, a 9.56% prevalence of submicroscopic infections was observed. Subclinical malaria was more common in individuals aged 15-49 years, and microspatial heterogeneity in positivity was observed, with the majority of cases occurring in semi-urban areas by mRDT and microscopy, respectively. Approximately, 80% of microscopy-positive subjects had a low parasite density (<1000 parasites/µL whole blood). Although P. falciparum was the most common species (98.55%), the transmission of P. ovale appears to be well-established in the area, occurring either as mono-infection (1.45%) or co-infection (1.93%) with P. falciparum. This study of community malaria in Bangui highlights the high burden of subclinical malaria in the community and provides essential baseline data to guide future research on malaria parasites in the CAR, particularly regarding the circulating parasite species. The high prevalence of community malaria demonstrates its persistence as a major public health challenge in the country, highlighting the need to intensify its ongoing control using new tools such as the upcoming malaria vaccine.

Malaria among febrile patients suspected of Yellow fever during an outbreak in Ghana.

Introduction Between October 2021 and February 2022, there was an outbreak of Yellow fever that spread within several districts in the northern part of Ghana. Febrile illnesses such as Yellow fever are often misdiagnosed as malaria and vice versa, which delays appropriate management and treatment. Hence, the true burden of Yellow fever and malaria are mostly underestimated. This study investigated the epidemiology of malaria in febrile patients suspected of Yellow fever in and around the epicenter of a Yellow fever outbreak in Ghana. Methods The study was a cross-sectional study conducted in two outbreak sites (Wenchi and Damongo) and two non-outbreak sites (Kumbungu and Tamale). A total of 498 febrile patients from healthcare facilities were recruited in the rainy and dry seasons. A structured questionnaire was administered to collect patients' demographic information. Venous blood was collected from consented study participants for malaria parasite detection via microscopy and PCR. Total RNA was extracted from serum samples for the detection of yellow fever virus using Reverse Transcriptase PCR. Results None of the patients tested positive for Yellow fever virus. Out of the 498 participants tested for plasmodium parasites, 98 (19.7%) were microscopy positive while 92 (29.7%) were PCR positive. Plasmodium prevalence via microscopy was significantly higher in the dry season, 42 (18.67%) compared to the rainy season, 12 (4.4%) ( P < 0.001). However, the difference in malaria prevalence via PCR in the rainy and dry seasons was not significant ( P > 0.05). Kumbungu had the highest parasite prevalence by PCR during the dry (78.38%) and rainy (27.18%) seasons. Higher Plasmodium falciparum prevalence was observed using PCR compared to microscopy across all age groups. The age groups with the highest prevalence of P. falciparum were under five years (34.69%) and 5 to 9 years (35.56%). The differences in P. falciparum prevalence across the age groups were significant ( P < 0.05). Conclusion High malaria prevalence was found in the study sites, affecting preschool and the school-aged children the most. Although Yellow fever was not detected, its overlap with malaria in Ghana, suggests the importance of enhancing surveillance for both diseases to better prevent and control.

Pan African Vivax and Ovale Network (PAVON) Malaria Diagnostic Competency Training: Offering Training Opportunities to Impact Malaria Elimination Strategies in Sub-Saharan Africa.

PAVON has developed a malaria microscopy competency training scheme to augment competency in malaria microscopy. Here, data accrued from training activities between 2020 and 2023 in Botswana are presented. Three trainings were done for 37 central and peripheral level technicians for a two-week period. The scheme consisted of basic theory on Plasmodium parasites, malaria epidemiology and diagnosis. The practicals focused on standard slide preparation, staining, parasite detection, speciation and counting. Scores were assessed by the Wilcoxon signed rank test. Participants who excelled joined the WHO External Competency Assessment for Malaria Microscopy (ECAMM). The median competency scores for the three trainings were detection: 100 (IQR = 94-100), 100 (IQR = 94-100) and 92 (IQR = 92-100), respectively, from pre-test scores of 40 (IQR = 27-54), 44 (IQR = 32-52) and 20 (IQR = 10-40) (z = 2.937, p < 0.003, z = 3.110, p = 0.002 and (z = 2.251, p = 0.024), respectively. Speciation: 93 (IQR = 86-96), 81 (IQR = 73-96) and 88, (IQR = 88-100) from pre-test scores of 50 (IQR = 30-50), 36 (IQR = 20-45) and 17 (IQR = 17-50) (z = 2.936, p < 0.003, z = 3.152, p = 0.002 and z = 3.237, p = 0.001). The competency scores achieved in the ECAMM were 98/98 and 97/98 for sensitivity and specificity pre- and post-tests detection. The training was effective in raising the competency skills of participants and is open to NMPs (National Malaria Programs) for critical capacity building.

The fight against malaria in Edo-North, Edo State, Nigeria: identifying risk factors for effective control.

This study investigated malaria epidemiology in Edo-North, Nigeria; a region within the equatorial rainforest belt that has lacked prior research on malaria prevalence. This research sought to investigate the prevalence of malaria and identify potential risk factors in Edo-North, Nigeria. Additionally, the study aimed to analyze trends in malaria cases to inform the development of effective malaria control measures. A cross-sectional study was conducted in six local government areas of Edo-North, Nigeria, between June and August 2023. Using systematic sampling, study zones, local governments, towns, villages, and households were selected. Data on sociodemographics and environmental risk factors were collected from 605 participants through questionnaires and blood samples. Blood smears were microscopically examined, binary and multivariate logistic regression was used for data analysis. Malaria disease rate trends were also analyzed from health records. Statistical analyses were performed using R software, with p-values less than 0.05 considered statistically significant. The overall malaria prevalence in the study area was 15.54%, with males more likely to be infected than females. Prevalence varied across localities, with Akoko-Edo having the highest rate. Children had the highest prevalence. Rural residents were more likely to have malaria than urban residents. Binary logistic regression identified several risk factors, including age, location, local government area, education, occupation, marital status, housing type, household size, water source, sanitation, surrounding environment, window net use, ceiling type, water storage, and parasite density. The multivariate logistic regression analysis identified several significant risk factors for malaria in the study population. Children, residents of Owan-East, individuals using pit latrines, and those not sleeping under LLINs were at significantly increased risk. Environmental factors such as proximity to bushes, streams/rivers, and storing water in open containers were also associated with higher malaria prevalence. History of malaria treatment at pharmacies and use of Chloroquine/Quinine medication were linked to recurrent infections. The study found a high average parasite density (5,146 parasites/μL) and low consistent LLIN use despite widespread ownership. Trend analysis from malaria records revealed a decline in malaria prevalence from 2020 to 2023. The study identified several demographic, environmental and behavioural factors associated with malaria risk in Edo North. Males, children, urban dwellers, those living in mud houses and those in large households, proximity to natural features such as bushes, rivers and streams and low LLIN were more likely to contract malaria. These findings highlight the importance of implementing targeted interventions to address these risk factors and reduce the burden of malaria.

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

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

Implementation of reactive case detection strategy recommendations towards malaria elimination in the Shai Osudoku district of Ghana

Ghana has refocused its national malaria programme to align with an agenda of malaria elimination. The key interventions in the strategic plan include enhancing epidemiological surveillance for reactive case detection (RACD). Identifying asymptomatic infections using index cases can help understand the epidemiology of malaria and guide its elimination. The study determined asymptomatic carriage in index cases household members and neighbours living near index cases and the suitability of diagnostic accuracy to inform RACD. A cross-sectional health centre and community-based studies were conducted in the Shai Osudoku district. Passive surveillance involved 19 index cases that triggered RACD in 67 index cases household members and 414 neighbours. Malaria was diagnosed using rapid diagnostic test (RDT) kits, microscopy and quantitative polymerase chain reaction (qPCR). Overall malaria prevalence was 8.00% [CI95: 5.78–10.73] by RDT, 10.00% [CI95: 7.51–12.97] by microscopy and 12.60% [CI95: 9.82–15.83] by qPCR. Index cases household members were 2 times more likely of having malaria compared to their neighbours. Across cohorts, significant difference [p = 0.012] was observed between index cases household members and neighbours by qPCR. The mean distribution of Plasmodium spp. parasite densities among positive outcomes of the RDT test in study participants was 162 [IQR: 77.75–3919] parasite/µL of blood, and 96.00 [IQR: 48.00–181.30] parasite/µL of blood in RDT negative outcomes. The mean parasite densities associated with RDT positive results differed significantly from that of the RDT negative results [p = 0.026]. Index cases household members were more likely of having malaria compared to their neighbours. RACD is needed to identify asymptomatic malaria infections and complement efforts that target individuals in low transmission and elimination areas.

Malaria notifications in Legal Amazon, Brazil (2003-2022): A Comprehensive Dataset for research &amp; surveillance

Malaria, a life-threatening disease, is preventable and curable. However, the World Health Organization reported alarming statistics for the year 2021, estimating 247 million cases of malaria worldwide, resulting in 619,000 deaths. In Brazil, cases of malaria are concentrated in the region of the Amazon rainforest, known as the Legal Amazon. In response to calls for more research to adapt malaria mitigation and eradication strategies to local conditions, this article presents a dataset based on data collected from the Malaria Epidemiological Surveillance Information System (SIVEP-Malaria) for the period from January 2003 to December 2022 on patients diagnosed with malaria. The pre-processed data set is composed of 1,251,309 records of confirmed malaria cases and included four attributes (Date, Municipality, Test results, and Notifications), attributes considered essential for the development and application of series modeling techniques temporal. By making this dataset available, it is intended to provide researchers with the necessary tools to develop effective strategies for mitigating and eradicating malaria in the region.

Malaria Epidemiology in Rask City and Surrounding Areas (2020 - 2023), Southeast Iran

Background: Malaria, a disease caused by Plasmodium parasites and transmitted by Anopheles mosquitoes, remains a major global health challenge, causing widespread illness and mortality. Objectives: This study provides an in-depth analysis of malaria trends in Rask, Southeast Iran, from 2018 to 2023, assessing malaria prevalence, transmission factors, and impacts on the local population and healthcare system. Methods: Blood samples were collected from individuals suspected of having malaria at health centers in Rask. For each positive case, demographic information was recorded in a questionnaire. Data analysis was performed using SPSS 26, with t-tests applied to compare variables. Results: Findings indicate a peak in malaria cases in 2022, with an annual incidence rate of 2.49%. The most common species identified was Plasmodium vivax, affecting primarily males over the age of 12, with the highest number of cases reported in September. Conclusions: The results underscore the urgent need to enhance malaria prevention and control measures. The study emphasizes the value of targeted interventions, including improvements to prevention and treatment programs, reinforcement of healthcare systems, and advancement of health infrastructure. These strategies should consider climatic patterns and rainfall rates to effectively address malaria transmission dynamics.

Malaria in the Republic of Ireland; A retrospective review of the clinical epidemiology of malaria between 2016 and 2020

ObjectivesMalaria is a parasitic infection that continues to present significant morbidity and mortality figures throughout the world. In the Republic of Ireland (Ireland), malaria is an imported infection linked most frequently to travel routes from West Africa. There is a paucity of data on the clinical epidemiology and hospital service utilization of malaria in non-endemic setting to inform physician practice. This study aims to fill that gap, providing a clinical context to the national picture of both adult and pediatric cases. MethodsA retrospective review of data from all public Irish hospitals was performed from 2016 to 2020, inclusive. Ethical approval was granted following review by the Social Research Ethics Committee (SREC) of University College Cork. Results and ConclusionsDuring the study period, there were 337 cases of malaria presenting to Irish hospitals, 15.1% (51/337) in the pediatric age category. Presentations occurred nationwide with a predictable seasonality. The majority (77.45%; 261/337) were Plasmodium falciparum and 6% (20/337) required critical care admission. Interestingly, females had a higher likelihood of admission to critical care (odds ratio 2.75, 95% confidence interval 1.1-6.86). The COVID-19 pandemic saw a 78% reduction in malaria presentations in 2020. A total of 1,166 bed days were utilized by cases of malaria.

Influence of Altitudinal Gradient on Human Malaria Prevalence in Plateau State, Central Nigeria: A Longitudinal Study

Study’s Excerpt The relationship between altitude and malaria transmission dynamics in Plateau State, North-Central Nigeria, is assessed. The highest malaria prevalence was observed at lower altitudes and vice-versa. Environmental factors (altitude) have an influence on malaria epidemiology in the region. Full Abstract This longitudinal study assessed the prevalence of human malaria infection across different altitudinal zones in Plateau State, North-Central Nigeria, aiming to identify the impact of altitude on malaria transmission dynamics. Malaria is a potentially lethal disease caused by protozoan parasites called Plasmodium. Abiotic factors are known to be the main factors influencing the epidemiology of the disease. In 2018 and 2019, blood samples were taken and examined for the presence of Plasmodium falciparum malaria using the SD-PAN Ag mRDT. After that, blood film slides were created in order to calculate the parasite density for each of the four seasons' worth of positive samples. The prevalence rates of malaria in the three locations vary significantly, with the highest rates observed at lower altitudes (Pangwasa 211m) above sea level and the lowest at the highest altitude (Vwang 1330m) above sea level. Vwang has the lowest malaria prevalence of 16.25%, Jing (663m) has a higher prevalence of 40.0%, and Pangwasa has the highest prevalence at 46.9.

Molecular survey of pfmdr-1, pfcrt, and pfk13 gene mutations among patients returning from Plasmodium falciparum endemic areas to Turkey

BackgroundIn recent years, there has been an increasing trend in the number of imported Plasmodium falciparum cases in Turkey. To improve treatment success and to better understand malaria epidemiology among imported cases, it is necessary to determine anti-malarial drug resistance. This study aimed to survey polymorphisms of resistance genes in imported P. falciparum patients using archived thin smear preparations and EDTA blood samples.MethodsA total of 100 imported P. falciparum patients admitted to Bakırköy Dr. Sadi Konuk Research and Training Hospital between 2017 and 2022 were included in this study. DNA extraction was performed using an archived slide and EDTA blood samples that were microscopically diagnosed. After confirming the samples by real-time PCR, the pfmdr1, pfcrt, and pfk13 genes were amplified and sequenced. Single nucleotide polymorphisms (SNPs) were screened using Geneious R9 software, with the reference P. falciparum clone 3D7 isolate.ResultsAll studied samples were confirmed to be P. falciparum using real-time PCR. Nested PCR was conducted and the pfcrt (92 samples), pfmdr1 (91 samples), and pfk13 (93 samples) genes were successfully amplified. Sequence analysis revealed the highest mutation rate in the pfmdr1 (74.5%) gene, with the identification of five haplotypes: NYSND (wild-type, 23%), NFSND (56%), NYSDD (2.2%), NFSDD (15.4%), and YFSND (3.4%)]. The pfcrt mutation was identified in 11 samples (12.2%), whereas the pfk13 mutation was found in only two samples.ConclusionThis study is the first molecular survey of anti-malarial drug resistance genes in Turkey. With the increasing number of imported Plasmodium malaria cases and recent reports of sporadic indigenous P. falciparum cases, malaria is becoming a growing concern in Turkey. Although molecular screening for resistance markers in P. falciparum malaria is not routinely conducted, the data from this study will enhance treatment success rates and contribute to global malaria elimination.

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.

The Burden of Malaria in East Africa: Epidemiology and Health Impact

Malaria remains a significant public health challenge in East Africa, disproportionately affecting the region due to diverse ecological conditions, socioeconomic factors, and variable healthcare infrastructure. This review provides an overview of the epidemiological landscape and health impact of malaria in East African countries, including Kenya, Tanzania, Uganda, Rwanda, Burundi, and Ethiopia. The prevalence and distribution of malaria vary widely, with high transmission rates in specific regions and vulnerable groups, particularly children under five and pregnant women. The disease’s health impacts are profound, contributing to high morbidity and mortality, economic loss, and educational deficits, while placing a substantial burden on healthcare systems. Despite progress in malaria control efforts, challenges such as drug resistance, inadequate healthcare infrastructure, and the need for sustained funding persist. The methodology for this review involved a comprehensive analysis of existing literature and epidemiological data on malaria in East Africa. Addressing these challenges requires a multifaceted approach that includes improved surveillance, targeted interventions, and community engagement to reduce the burden of malaria and improve health outcomes in the region. Keywords: Malaria Epidemiology, East Africa, Health Impact, Socioeconomic Burden, Malaria Control Strategies.

Lower Microscopy Sensitivity with Decreasing Malaria Prevalence in the Urban Amazon Region, Brazil, 2018-2021.

Malaria is increasingly diagnosed in urban centers across the Amazon Basin. In this study, we combined repeated prevalence surveys over a 4-year period of a household-based random sample of 2,774 persons with parasite genotyping to investigate the epidemiology of malaria in Mâncio Lima, the main urban transmission hotspot in Amazonian Brazil. We found that most malarial infections were asymptomatic and undetected by point-of-care microscopy. Our findings indicate that as malaria transmission decreases, the detection threshold of microscopy rises, resulting in more missed infections despite similar parasite densities estimated by molecular methods. We identified genetically highly diverse populations of Plasmodium vivax and P. falciparum in the region; occasional shared lineages between urban and rural residents suggest cross-boundary propagation. The prevalence of low-density and asymptomatic infections poses a significant challenge for routine surveillance and the effectiveness of malaria control and elimination strategies in urbanized areas with readily accessible laboratory facilities.