Plasmodium Falciparum Cases Research Articles

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.

Mapping malaria transmission foci in Northeast Thailand from 2011 to 2021: approaching elimination in a hypoendemic area

BackgroundThailand is approaching local elimination of malaria in the eastern provinces. It has successfully reduced the number of cases over the past decade, but there are persistent transmission hot spots in and around forests. This study aimed to use data from the malaria surveillance system to describe the spatiotemporal trends of malaria in Northeast Thailand and fine-scale patterns in locally transmitted cases between 2011 and 2021.MethodsCase data was stratified based on likely location of infection and parasite species. Annual Parasite Index per 1000 population (API) was calculated for different categories. Time series decomposition was performed to identify trends and seasonal patterns. Statistically significant clusters of high (hot spots) and low (cold spots) API were identified using the Getis-Ord Gi* statistic. The stability of those hot spots and the absolute change in the proportion of API density from baseline were compared by case type.ResultsThe total number of confirmed cases experienced a non-linear decline by 96.6%, from 1061 in 2011 to 36 in 2021. There has been a decline in both Plasmodium vivax and Plasmodium falciparum case numbers, with only four confirmed P. falciparum cases over the last two years—a 98.89% drop from 180 in 2011. API was generally higher in Si Sa Ket province, which had peaks every 2–3 years. There was a large outbreak in Ubon Ratchathani in 2014–2016 which had a high proportion of P. falciparum reported. The proportion of cases classified increased over the study period, and the proportion of cases classed as indigenous to the village of residence increased from 0.2% to 33.3%. There were stable hot spots of indigenous and imported cases in the south of Si Sa Ket and southeast of Ubon Ratchathani. Plasmodium vivax hot spots were observed into recent years, while those of P. falciparum decreased to zero in Ubon in 2020 and emerged in the eastern part in 2021, the same year that P. falciparum hot spots in Si Sa Ket reached zero.ConclusionsThere has been a large, non-linear decline in the number of malaria cases reported and an increasing proportion of cases are classed as indigenous to the patient’s village of residence. Stable hot spots of ongoing transmission in the forested border areas were identified, with transmission likely persisting because of remote location and high-risk forest-going behaviours. Future efforts should include cross-border collaboration and continued targeting of high-risk behaviours to reduce the risk of imported cases seeding local transmission.

Evaluation of Outbreak Preparedness to Prevent the Reintroduction of Malaria in Ramanagara District: A Descriptive Epidemiological Study.

Background Malaria is a vector-borne disease transmitted by female anopheline mosquitoes. It is also a multidimensional disease influenced by social factors such as poor environmental conditions and awareness gaps. India has witnessed a substantial reduction in malaria cases and has declared three regions as malaria-free, with Karnataka being one of the states. However, Karnataka witnesses significant population movement and migration, which influences the spread of malaria. Ramanagara, a district in Karnataka, reported zero indigenous cases over the past three years. Hence, we selected this district to evaluate outbreak preparedness to prevent the reintroduction of malaria. This choice underscores the district's significance as a valuable model for preventing the reintroduction of malaria. Methodology Baseline survey data on malaria cases and vector survey data were evaluated for the period spanning 2018 to 2022. The data were gathered from both the regional office and the Ramanagara district health office. In addition to the documenting system, because there was no regular submission of Form-P and Form-L of the Integrated Disease Surveillance Project and Integrated Health Information Platform from the private sector, to complete the missing data, across-sectional study was conducted among private sector practitioners and pharmacies in Ramanagara from April 2023 to June 2023. Data was collected via interviews using a malaria surveillance assessment toolkit sourced from the National Centre for Vector Borne Diseases Control and World Health Organization protocols to assess six core areas of malaria elimination. Data collected via interviews were compiled in MS Excel and analyzed using SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). Results Malaria control measures in the selected district achieved >80% coverage with notable improvements in the National Health Mission-National Vector Borne Disease Control Programme fund utilization, logistics availability, and physical performance over the past five years. The Annual Parasite Index was <1 at 0.0061 in 2018 and 0.0017 in 2022. The annual blood examination rate was consistently >10 from 22.05 in 2018 to 24.36 in 2022. The primary vectors identified were Anopheles culicifacies and Anopheles stephensi. In 2018, there were six cases of Plasmodium vivax and one case of Plasmodium falciparum reported as imported cases. In 2021 and 2022, two cases of P. vivax were reported. Notably, there were no instances of mixed infections or indigenous cases documented from 2018 to 2022 Conclusions Although the level of outbreak preparedness in the region is satisfactory, the effectiveness of vector control measures appears to be lacking. Increased government funding is needed along with comprehensive training and workshops for healthcare workers. Adequate financial resources and enhanced skills among healthcare workers are crucial to reinforce the existing efforts to control vectors and prevent potential outbreaks effectively.

Awareness of sickle cell disease among nursing undergraduates in Farasan: Its interference with malaria.

The present study was conducted to generate data on awareness and incidence of sickle cell disease (SCD) and also to adduce the widespread myths peddled about SCD. Students studying in the Department of Nursing were recruited. A pretested, self-administered sickle cell assessment questionnaire was distributed electronically through WhatsApp group to collect necessary data. Participants were screened for malaria by thin blood smear analyses, and their hemoglobin (Hb) contents (g/dL) were determined by Sahli's haemoglobinometer. Statistical analyses were done using Origin (version 8.1, USA). A reliability study was performed for the validity of questionnaire data. Study participants had significantly high awareness regarding SCDs (89.9%, P < 0.001). Most participants (96.3%) were aware about government policy regarding premarital screening for genetic disorders and replied that the government has strict health policies backed by equally robust laboratory diagnostics. Moreover, none of the participants had SCDs, although their parents had a consanguineous marriage. Thin blood smear analyses of participants did not reveal any cases of Plasmodium falciparum. However, significant percentages (33.1%) were found to be anemic, probably due to their dietary habits and lifestyles, as has been reflected by questionnaire analyses. Furthermore, a very less number of students had knowledge about genetic variations that might occur in malaria-endemic regions after long exposure to offer protection from malaria. Knowledge about management practices was also lacking among study participants (29%). This research points to the necessity that the nursing study plan should focus on providing specific training on management skills and preventive measures for SCDs, which is of paramount importance.

Deep learning hybrid model for analyzing and predicting the impact of imported malaria cases from Africa on the rise of Plasmodium falciparum in China before and during the COVID-19 pandemic.

Plasmodium falciparum cases are rising in China due to the imported malaria cases from African countries. The main goal of this study is to examine the impact of imported malaria cases in African countries on the rise of P. falciparum cases in China before and during the COVID-19 pandemic. A generalized regression model was used to investigate the association of time trends between imported malaria cases from 45 African countries and P. falciparum cases in 31 provinces of China from 2012 to 2018 before the COVID-19 pandemic and during the COVID-19 pandemic from October 2020 to May 2021. Based on the analysis, we proposed a statistical and deep learning hybrid approach to model the resurgence of malaria in China using monthly data of P. falciparum from 2004 to 2016. This study builds a hybrid model known as the ARIMA-GRU approach for modeling the P. falciparum cases in all provinces of China and the number of malaria deaths in China before and during the COVID-19 pandemic. The analysis showed an emerging link between the rise of imported malaria cases from Africa and P. falciparum cases in many provinces of China. Many imported malaria cases from Africa were P. falciparum cases. The proposed deep learning model achieved a high prediction accuracy score on the testing dataset of 96%. The study provided an analysis of the reduction of P. falciparum cases and deaths caused by imported P. falciparum cases during the COVID-19 pandemic due to the control measures regarding the limitation of international travel in China. The Chinese government has to prepare the imported malaria control measures after the normalization of international travel, to prevent the resurgence of malaria disease in China.

Quantifying climatic and socioeconomic drivers of urban malaria in Surat, India: a statistical spatiotemporal modelling study

Cities are becoming increasingly important habitats for mosquito vectors of disease. The pronounced heterogeneity of urban landscapes challenges our understanding of the effects of climate and socioeconomic factors on mosquito-borne disease dynamics at different spatiotemporal scales. Here, we quantify the impact of climatic and socioeconomic factors on urban malaria risk, using an extensive dataset in both space and time for reported Plasmodium falciparum cases in the city of Surat, northwest India. We analysed 10 years of monthly P falciparum cases resolved at three nested spatial resolutions (seven zones, 32 units, and 478 worker units) with a Bayesian hierarchical mixed model that incorporates the effects of population density, poverty, relative humidity, and temperature, in addition to random effects (structured and unstructured). To reduce dimensionality and avoid correlation of covariates, socioeconomic variables from survey data were summarised into main axes of variation using principal component analysis. With model selection, we identified the main drivers of spatiotemporal variation in malaria incidence rates at each of the three spatial resolutions. We also compared observations to model-fitted cases by quantifying the percentage of predictions within five discrete levels of malaria risk. The spatial variation of urban malaria cases was stationary over time, whereby locations with high and low yearly cases remained largely consistent across years. Local socioeconomic variation could be summarised with three principal components accounting for approximately 80% of the variance. The model that incorporated local temperature and relative humidity together with two of these principal components, largely representing population density and poverty, best explained monthly malaria patterns in models formulated at the three different spatial scales. As model resolution increased, the effect size of humidity decreased, whereas those of temperature and the principal component associated with population density increased. Model predictions accurately captured aggregated total monthly cases for the city; in space-time, they more closely matched observations at the intermediate scale, with around 57% of units estimated to fall in the observed category on average across years. The mean absolute error was lower at the intermediate level, showing that this is the best aggregation level to predict the space-time dynamics of malaria incidence rates across the city with the selected model. This statistical modelling framework provides a basis for development of a climate-driven early warning system for urban malaria for the units of Surat, including spatially explicit prediction of malaria risk several weeks to months in advance. Results indicate environmental and socioeconomic covariates for which further measurement at high resolution should lead to model improvement. Advanced warning combined with local surveillance and knowledge of disease hotspots within the city could inform targeted intervention as part of urban malaria elimination efforts. US National Institutes of Health.

Evaluation of performance for malaria diagnosis in health facilities by five provincial reference laboratories of China.

The provincial malaria diagnosis reference laboratories review and assess malaria cases diagnosed in health facilities for supporting the malaria elimination efforts and preventing re-transmission of imported malaria. The study aimed to evaluate the detection capability of malaria diagnosis in China from 2014 to 2021. Data on malaria cases reported in the provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, Guangxi, and Zhejiang from 2014 to 2021 were collected and analyzed. In total, 5,770 malaria cases were reported from 2014 to 2021, and 99.05% (5,715/5,770) were submitted to the provincial malaria diagnosis reference laboratories. The median time between malaria cases being reported and the samples being received by reference laboratories was 6 days (Interquartile range, IQR:3-12 days) from 2017 to 2021. Diagnosis of 5,680 samples in the laboratory were confirmed by provincial reference laboratories, including 3,970 cases of Plasmodium falciparum, 414 of P. vivax, 1,055 of P. ovale, 158 of P. malariae, 1 of P. knowlesi, and 82 of mixed infections. Plasmodium species of 5,141 confirmed cases were consistent with the initial diagnosis, with a species accuracy rate of 90.53% (5,141/5,679). The accuracy of P. falciparum diagnosis in health facilities was higher than that of non-falciparum species. The inconsistency between microscopy and nested polymerase chain reaction (nPCR) results of confirmatory diagnosis was mainly in malaria-positive versus malaria-negative cases, as well as in mixed versus single infection cases. The provincial malaria diagnosis reference laboratories have played an important role in ensuring the accuracy and reliability of Plasmodium diagnosis in health facilities. However, the results of this study imply that capacity training for the identification of Plasmodium species in health facilities is warranted.

Polymorphism analysis of drug resistance markers in Plasmodium falciparum isolates from Benin

Like most countries in sub-Saharan African countries, Benin continues to bear a heavy malaria burden. In 2014, the National Malaria Control Programme (NMCP) changed its treatment policy, and recommended the use of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated Plasmodium falciparum cases. The study presented here was conducted to investigate the impact of current antimalarial drug resistance on the country. Molecular surveillance targeting the Pfcrt, Pfmdr1, Pfkelch13, dhfr, and dhps genes was carried out on samples from patients positive for P. falciparum malaria by microscopy, LAMP and PCR diagnostic test. Molecular analysis was performed using targeted amplicon deep sequencing (TADS). In addition, the frequency of parasites with dual deletion of the histidine-rich protein 2 and 3 genes (pfhrp2 and pfhrp3), known to be responsible of the performance of HRP-based malaria rapid diagnostic tests (HRP-RDT), was estimated. Fifty-three falciparum samples collected at the Saint Jean de Dieu hospital in Tanguiéta, Benin, were tested. No Pfkelch13 validated or candidate artemisinin partial resistant variants were identified. A marked prevalence of Asn51Ile (N51I), Cys59Arg (C59R), and Ser108Asn (S108N) mutant alleles was found in the dhfr gene, representing the most frequent genotype (64%). Five-point mutations were detected in dhps, Ile431Val (I431V), Ser436Ala (S436A), Ala437Gly (A437G), Ala581Gly (A581G), Ala613Ser (A613S) of which the third was the most common (92%). No mutation was identified in dhps Lys540Glu (K540E). The quintuple mutant genotype resulting from the combination of the dhfr triple mutant (51I/59R/108N) with the dhps double mutant 436A/437G was detected at a frequency of 30%. Low levels of mutations in Pfcrt and no mutation at codon 86 in the Pfmdr1 DNA fragment were observed, whereas a high level of Tyr184Phe (Y184F) polymorphism in the Pfmdr1 gene was found. These results could be indicative, over a decade after the implementation of ACT therapy, of the return of chloroquine-sensitive but artemether-lumefantrine resistant falciparum genotypes in Benin. There was no evidence of HRP2 and HRP3 deletions. Data from the present study support the need for routine monitoring of molecular markers of antimalarial drug resistance as part of surveillance activities aimed to make informed treatment policy decisions at the national level.

Artemisinin-based combination therapy successfully treated two hyperparasitaemic Plasmodium falciparum cases.

Hyperparasitaemia is an important event in the cascade of Plasmodium falciparum severe malaria (SM), and may also lead to SM associated complications and death, if left untreated. Here, we report two hyperparasitaemic patients with no life-threatening complications. Malaria diagnosis was performed using thick and thin blood smears and immunochromatographic-based rapid diagnostic tests (RDTs) purchased from three different manufacturers. Parasitaemia was calculated following the World Health Organization (WHO) guidelines. Haematological and biochemical investigations were also performed. Weekly follow-up of blood smear examination, blood pressure and temperature were recorded up to day 63. The first patient had 42% parasitaemia (100% asexual parasites). The second patient had 9.5% parasitaemia, comprising 46% asexual and 54% sexual stages, with a 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference values. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine on day 1. Weekly follow-up did not show any parasite suggesting successful treatment with ACT without any side effects. The presence of hypergametocytaemia may hinder malaria elimination efforts, if not treated immediately.

A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK Emergency Departments.

Microscopy is the gold standard for malaria diagnosis but is dependent on trained personnel. Rapid diagnostic tests (RDTs) form the mainstay of diagnosis in endemic areas without access to high-quality microscopy. We aimed to evaluate whether RDT alone could rule out imported malaria in children presenting to UK emergency departments (EDs). UK-based, multi-center, retrospective, diagnostic accuracy study. Included: any child <16 years presenting to ED with history of fever and travel to a malaria-endemic country, between 01/01/2016 and 31/12/2017. Diagnosis: microscopy for malarial parasites (clinical reference standard) and RDT (index test). UK Health Research Authority approval: 20/HRA/1341. There were 47 cases of malaria out of 1,414 eligible cases (prevalence 3.3%) in a cohort of children whose median age was 4 years (IQR 2-9), of whom 43% were female. Cases of Plasmodium falciparum totaled 36 (77%, prevalence 2.5%). The sensitivity of RDT alone to detect malaria infection due to any Plasmodium species was 93.6% (95% CI 82.5-98.7%), specificity 99.4% (95% CI 98.9-99.7%), positive predictive value 84.6% (95% CI 71.9-93.1%) and negative predictive value 99.8% (95% CI 99.4-100.0%). Sensitivity of RDT to detect P. falciparum infection was 100% (90.3-100%), specificity 98.8% (98.1-99.3%), positive predictive value 69.2% (54.9-81.2%, n = 46/52) and negative predictive value 100% (99.7-100%, n = 1,362/1,362). RDTs were 100% sensitive in detecting P. falciparum malaria. However, lower sensitivity for other malaria species and the rise of pfhrp2 and pfhrp3 (pfhrp2/3) gene deletions in the P. falciparum parasite mandate the continued use of microscopy for diagnosing malaria.

The impact of sustained malaria control in the Loreto region of Peru: a retrospective, observational, spatially-varying interrupted time series analysis of the PAMAFRO program

Although malaria control investments worldwide have resulted in dramatic declines in transmission since 2000, progress has stalled. In the Amazon, malaria resurgence has followed withdrawal of Global Fund support of the Project for Malaria Control in Andean Border Areas (PAMAFRO). We estimate intervention-specific and spatially-explicit effects of the PAMAFRO program on malaria incidence across the Loreto region of Peru, and consider the influence of the environmental risk factors in the presence of interventions. We conducted a retrospective, observational, spatial interrupted time series analysis of malaria incidence rates among people reporting to health posts across Loreto, Peru between the first epidemiological week of January 2001 and the last epidemiological week of December 2016. Model inference is at the smallest administrative unit (district), where the weekly number of diagnosed cases of Plasmodium vivax and Plasmodium falciparum were determined by microscopy. Census data provided population at risk. We include as covariates weekly estimates of minimum temperature and cumulative precipitation in each district, as well as spatially- and temporally-lagged malaria incidence rates. Environmental data were derived from a hydrometeorological model designed for the Amazon. We used Bayesian spatiotemporal modeling techniques to estimate the impact of the PAMAFRO program, variability in environmental effects, and the role of climate anomalies on transmission after PAMAFRO withdrawal. During the PAMAFRO program, incidence of P.vivax declined from 42.8 to 10.1 cases/1000 people/year. Incidence for P.falciparum declined from 14.3 to 2.5 cases/1000 people/year over this same period. The effects of PAMAFRO-supported interventions varied both by geography and species of malaria. Interventions were only effective in districts where interventions were also deployed in surrounding districts. Further, interventions diminished the effects of other prevailing demographic and environmental risk factors. Withdrawal of the program led to a resurgence in transmission. Increasing minimum temperatures and variability and intensity of rainfall events from 2011 onward and accompanying population displacements contributed to this resurgence. Malaria control programs must consider the climate and environmental scope of interventions to maximize effectiveness. They must also ensure financial sustainability to maintain local progress and commitment to malaria prevention and elimination efforts, as well as to offset the effects of environmental change that increase transmission risk. National Aeronautics and Space Administration, National Institutes of Health, Bill and Melinda Gates Foundation.

The malaria transmission in Anhui province China.

Plasmodium vivax and Plasmodium falciparum cases have opposite trends in Anhui China in the past decade. Long term and seasonal trends in the transmission rate of P. falciparum in Africa has been well studied, however that of P. vivax transmitted by Anopheles sinensis in China has not been investigated. There is a lot of work on the relationship between P. vivax cases and climatic factors in China, with sometimes contradicting results. However, how climatic factors affect transmission rate of P. vivax in China is unknown. We used Anhui province as an example to analyze the recent transmission dynamics where two types of malaria have been reported with differing etiologies. We examined breakpoints of the P. vivax and P. falciparum malaria long term dynamics in the recent decade. For locally transmitted P. vivax malaria, we analyzed the transmission rate and its seasonality using the combined human and mosquitos SIR-SI model with time-varied mosquito biting rate. We identified the effects of meteorological factors on the seasonality in transmission rate using a GAM model. For the imported P. falciparum malaria, we analyzed the potential reason for the observed increase in cases. The breakpoints of P. vivax and P. falciparum dynamics happened in a same year, 2010. The seasonality in the transmission rate of P. vivax malaria was high (42.4%) and was linearly associated with temperature and nonlinearly with rainfall. The abrupt increase in imported P. falciparum cases after the breakpoint was significantly related to the increased annual Chinese investment in Africa. Under the conditions of the existing vectors of malaria, long-term trends in climatic factors, and increasing trend in migration to/from endemic areas and imported malaria cases, we should be cautious of the possibility of the reestablishment of malaria in regions where it has been eliminated or the establishment of other vector-borne diseases.

Dengue and falciparum malaria co-infection in travelers returning from Burkina Faso: Report of two cases in Northeastern Italy

Rationale: Malaria and dengue are the most prevalent vector-borne diseases in tropical countries. Plasmodium parasite and dengue virus (DENV) concurrent infection is possible and often under-recognized in geographical areas where these infections are both endemic.Patients concern and diagnosis: We describe the first two cases of Plasmodium falciparum and DENV-3 co-infection in travelers returning to northeastern Italy from Burkina Faso during 2013-2014.Interventions: Malaria infection in both patients was treated with mefloquine. Due to the persistence of symptoms despite of the antimalaria treatment, dengue was also investigated; the treatment of dengue was symptomatic.Outcomes: The patients were discharged in good general condition.Lessons: The need for surveillance of potential malaria and dengue co-infection in travelers returning to Europe from endemic areas is highlighted, as infection with Plasmodium does not exclude arboviral co-infection.

Clinical profile and severity of Plasmodium vivax and falciparum malaria in hospitalized children from North India.

Malaria is the most common parasitic infection in children and the most common cause of mortality by vector-borne disease in tropical countries. In these endemic countries there is limited published literature on the clinical profile and severity of Plasmodium vivax malaria in children. We highlight the clinical presentations and severity of malaria in children belonging to Uttar Pradesh, North India Methods: This observational study was conducted in a tertiary care hospital, in Moradabad, western Uttar Pradesh, India. Children (aged 6 months-18 years) hospitalized from June 2019 to May 2020 with a clinical picture consistent with malaria along with a positive rapid malaria antigen test (RMAT) and/or positive peripheral blood smear for malaria were enrolled. All data about the clinical profile and laboratory features were recorded. Results were analyzed for significance using appropriate statistical tests for continuous and categorical data. One hundred children were enrolled in this study; 59 cases had Plasmodium vivax (PV) malaria, 33 cases had Plasmodium falciparum (PF) malaria, and 8 cases had mixed infections (both PV and PF). Among 59 children with P V malaria, 44 (74%) had severe malaria and 15 (26%) had uncomplicated malaria. Severe malarial anaemia (43.2%), followed by jaundice (36.4%), impaired renal function (21.6%), significant bleeding (18.9%), shock (18.9%), and prostration (16.2%), were the main severity parameters of malaria among these hospitalised children. Impaired renal function (P-value = 0.01) and unconsciousness (P-value = 0.02) were more frequent in Plasmodium falciparum cases. Other severity parameters were not significant between the vivax and falciparum species. We conclude that a significant proportion of severe malaria was caused by Plasmodium vivax in this region, where both species coexist. Plasmodium vivax malaria is no longer the benign entity it was around ten years ago in hospitalised children. Severe malarial anaemia was the most common severity parameter found in both Plasmodium vivax and P. falciparum species. The clinical presentation and a change in the severity parameters in vivax malaria indicate a recent shift in the disease severity from benign to fatal.

A Retrospective Analysis of Malaria Trends in Leka Dulecha Health Center over the Last Ten Years (2013-2022), Western Oromia, East Wollega Zone.

Malaria is a serious public health concern in the world, and it causes a major socioeconomic problem in Ethiopia. Malaria data trend analysis of health facilities is useful to understand the prevalence and incidence of malaria cases and implementing evidence-based malaria control strategies. Hence, the main objective of this study was to investigate the malaria trends over the last ten years (2013-2022) at Leka Dulecha Health Center, East Wollega Zone, Western Oromia. Methodology. A retrospective study was conducted at Leka Dulecha Health Center to determine the trends of malaria prevalence by considering the malaria registration laboratory logbook for the last ten years from 2013 to 2022. Hence, to do this, sociodemographic data, years, months, and malaria prevalence were collected using a predesigned data collection sheet recorded from perspective between years. In the last ten years, a total of 30,576.00 suspected malaria cases were examined at Leka Dulecha Health Center, and out of these, 7,413.00 (24.24%) confirmed malaria cases were reported. In this health center, malaria cases were reported among both sexes and all age categories, but male (3,951.00, 54%) and age groups ≥ 15 years (3,994, 54%) were the most affected. The highest peak of malaria cases was reported during the autumn season (September, October, and November) followed by the spring season (March, April, and May) in the years of 2013 and 2007. In this study, the prevalence of malaria species was identified as Plasmodium falciparum, Plasmodium vivax, and mixed cases, with 5,014 (68%), 1,123 (15%), and 1,848 (25%), while Plasmodium falciparum was reported as the highest recorded cases. Males and above 15 years old were more affected than the others. The highest peak malaria prevalence appeared from September to December of 2017 and 2013 years. Therefore, proper planning, implementation, and monitor of malaria prevention and control activities should be strengthened at all levels.

ЛАБОРАТОРНЫЕ ИССЛЕДОВАНИЯ НА МАЛЯРИЮ И ДИРОФИЛЯРИОЗ В ЦЕЛЯХ ЭПИДЕМИОЛОГИЧЕСКОГО МОНИТОРИНГА В ТУЛЬСКОЙ ОБЛАСТИ ЗА ПЕРИОД С 2012 ПО 2021 ГГ

Twenty two imported cases of malaria from Africa have been reported in Tula region of Russian Federation in 2012-2021, of which two were with fatal outcome. The age of malaria patients ranged from 20 to 40 years old. Men prevailed among patients (85 %). There were 19 cases of Plasmodium falciparum, 2 Plasmodium ovale; and one of Plasmodium malariae. Cases have been verified by a reference centre. From 2012 to 2021 10 cases of dirofilariasis have been recorded in humans, a vector-borne helminthiasis of carnivorous animals transmitted by mosquitoes. The results of laboratory monitoring determined necessary measures of surveillance and prevention in relation to vector-borne parasitoses. Key worlds: malaria, dirofilariases, mosquitoes, vector-borne parasitic diseases, reference center.

Volatile pyrethroid spatial repellents for malaria prevention

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of volatile pyrethroid spatial repellents (VPSRs) for preventing new cases of Plasmodium falciparum and Plasmodium vivax malaria.

Changing transmission dynamics among migrant, indigenous and mining populations in a malaria hotspot in Northern Brazil: 2016 to 2020

BackgroundRoraima state is the northernmost state in Brazil and the primary border-crossing point between Brazil and Venezuela. The uncontrolled surge of malaria in Venezuela, coupled with mass migration of Venezuelans to neighbouring countries and the upward trend in informal mining in the state, pose a serious threat to the broader region, especially to migrant, indigenous and mining populations, jeopardizing malaria elimination efforts. This study describes changes in the epidemiological profile of malaria in Roraima state related to time, place and populations at risk from 2016 to 2020.MethodsDe-identified malaria surveillance data were obtained from the Malaria Epidemiological Surveillance System from 2016 to 2020. Pearson’s chi-square tested differences between imported and autochthonous cases. Multivariable logistic regression was used to identify risk factors for imported versus autochthonous cases by demographic characteristics.ResultsOdds of being an imported case were higher for Plasmodium falciparum cases (AOR = 2.08). However, as the number of cases from Venezuela decreased in 2020 following closure of the border, the proportion of P. falciparum cases increased markedly, from 6.24% in 2019 to 18.50% in 2020. Over the 5-year period, the odds of being an imported case among miners were about nine times higher than the general population (AOR = 8.99). The proportion of total malaria cases that were among indigenous people increased from 33.09% in 2016 to 54.83% in 2020. Indigenous children had a higher burden of malaria with over 40% of cases in children 0 to 9 years old, compared to 8% in non-indigenous children 0 to 9 years old. In some municipalities, place of infection differed from place of notification, with a large proportion of cases in these municipalities reporting in Boa Vista.ConclusionsMalaria remains a serious threat in Roraima state, especially among high-risk populations, such as miners, migrants, and indigenous people. As malaria cases have increased among indigenous people and miners, and the proportion of P. falciparum cases has increased, elimination efforts require understanding of these risk factors to tailor interventions appropriately. Furthermore, cross-border surveillance systems need to be urgently strengthened at formal and unofficial border points, especially since the border with Venezuela reopened in July 2021.

Malaria prevalence, knowledge and associated factors among household heads in Maygaba town, Ethiopia.

Malaria remains a leading public health issue in Ethiopia, despite wide use of insecticide-treated mosquito nets (ITNs). Consistent use of ITNs reduces malaria transmission by 90%. However, coverage and proper use of ITNs are the major challenge for most rural settings of Ethiopia. We assessed the prevalence of malaria, ITNs use and associated factors among household heads in Maygaba town, northwest Ethiopia. A cross-sectional study was carried out among 403 households using a structured questionnaire. Blood samples were collected from household heads and examined for malaria parasites by microscopy. Chi-square test and logistic regression were used to check the association between the dependent and independent variables. Of the 403 blood samples, 19 (4.7%) had malaria parasites (12 cases of Plasmodium falciparum and 7 cases of Plasmodium vivax). Majority of the respondents were aware of the cause, communicability, preventability and curability of the disease. ITNs use was identified as the main malaria prevention method. About 64% (257) of the respondents owned ITNs, of which, 66.9% (172) consistently slept under the nets during the peak malaria season. Majority of the respondents (83.6%) had positive attitude towards the benefit of sleeping under ITNs. Educational status and livelihood of the respondents had statistically significant (p < 0.05) association with malaria knowledge. Malaria infection was significantly (p < 0.05) higher among household heads aged 18-30 years (AOR = 5.982; 95% CI = 1.715-20.863). Moderate prevalence rate and acceptable ITNs ownership was detected among the community of Maygaba town. However, a considerable proportion had misconceptions about the use of ITNs. A comprehensive malaria control measures and health education about the use of ITNs should be in place for effective prevention and control of malaria in the locality.

Malaria Elimination in Two Endemic Coastal Environments of Southern India: An Eco-Epidemiological Analysis from 2004 to 2019.

Presently, India is heading towards malaria elimination. In this context, analysing malaria epidemiological data of endemic pockets is important. In the present investigation, malaria prevalence in two endemic coastal localities of India viz., Besant Nagar (Chennai district) and Pamban (Ramanathapuram district) was analysed from 2004 to 2019 and correlated with the highest maximum temperature. Malaria surveillance data and entomological data from the malaria clinics were used to investigate epidemiological parameters. The annual malaria cases were correlated with the highest maximum temperature. The analysis showed that the malaria case (P.v. and P.f.) reports were directly proportional to the temperature increase. Malaria cases were remarkably increased from 2004 to 2011 and subsequently, both Plasmodium vivax and Plasmodium falciparum cases were drastically reduced till 2019. P. vivax was higher than P. falciparum and the male population was found to be more affected. Mixed infection of P. vivax and P. falciparum was observed only in the Besant Nagar site (0.3%). The most affected age group was the adult age group (15years and above) in both Besant Nagar (76.1%) and Pamban (69.5%). Improved surveillance, complete treatment and integrated vector control activities correlated with a declining trend of malaria cases in both the coastal sites towards malaria elimination.