Prevalence Of Malaria Infection Research Articles

Spatial distribution and determinants of intermittent preventive treatment for malaria during pregnancy: a secondary data analysis of the 2019 Ghana malaria indicators survey

BackgroundMalaria during pregnancy is associated with poor maternal, foetal, and neonatal outcomes. To prevent malaria infection during pregnancy, the World Health Organization recommended the use of intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp-SP) in addition to vector control strategies. Although Ghana’s target is to ensure that all pregnant women receive at least three (optimal) doses of SP, the uptake of SP has remained low; between 2020 and 2022, only 60% of pregnant women received optimal SP during their most recent pregnancy. This study sought to map the geospatial distribution and identify factors associated with SP uptake during pregnancy in Ghana.MethodsSecondary data analysis was conducted using the 2019 Ghana Malaria Indicator Survey dataset. The data analysed were restricted to women aged 15–49 years who reported having a live birth within the two years preceding the survey. A modified Poisson regression model was used to determine factors associated with SP uptake during pregnancy. Geospatial analysis was employed to map the spatial distribution of optimal SP uptake across the ten regions of Ghana using R software.ResultsThe likelihood that pregnant women received optimal SP correlated with early initiation of first antenatal care (ANC), number of ANC contacts, woman’s age, region of residence, and family size. Overall, the greater the number of ANC contacts, the more likely for pregnant women to receive optimal SP. Women with four or more ANC contacts were 2 times (aPR: 2.16; 95% CI: [1.34–3.25]) more likely to receive optimal SP than pregnant women with fewer than four ANC contacts. In addition, early initiation and a high number of ANC contacts were associated with a high number of times a pregnant woman received SP. Regarding spatial distribution, a high uptake of optimal SP was significantly observed in the Upper East and Upper West Regions, whereas the lowest was observed in the Eastern Region of Ghana.ConclusionsIn Ghana, there were regional disparities in the uptake of SP during pregnancy, with the uptake mainly correlated with the provision of ANC services. To achieve the country’s target for malaria control during pregnancy, there is a need to strengthen intermittent preventive treatment for malaria during pregnancy by prioritizing comprehensive ANC services.

Prevalence of Malaria among Under-5 Children in a Secondary Care Level, Ondo State, Nigeria

Background: Malaria continues to be a leading cause of ill health among children. Globally, this infection remains the major cause of morbidity and mortality especially among the under-five. Aim: The aim of the study was to investigate and document the prevalence of malaria infection among age groups, genders, birth orders, and blood groups of children who attend a secondary health care level, south-west, Nigeria. Subjects and Methods: Blood samples of 500 children whose ages ranged between 1 day and 5 years were collected through venipuncture, and these were tested for malaria parasites through the microscopy method, positivity was confirmed by Polymerase Chain Reaction (PCR) test. It was a hospital-based cross-sectional study. The children were recruited from various points of entry into the hospital which included the emergency room, newborn unit, and outpatient department (OPD). Data analyses were done using the SPSS statistical software and p-value < 0.05 was considered significant. Results: The prevalence of malaria among the neonates (age group 0 to 28 days) was 60.2%, the prevalence of malaria was 49.2% among the infants (aged 29 days to 1 year) while the prevalence was 52.9% among children aged 1 to 5 years (χ2 = 0.004, p < 0.05). The gender prevalence of malaria infection was 30.4% for males and 21.8% for females (χ2 =0.000, p<0.05). The prevalence of malaria infection among birth orders showed that children in the first, second, third, fourth, and fifth birth orders are 41.0%, 28.0%, 22.6%, 5.4%, and 3.1%, respectively (χ2 = 0.0210, p < 0.05). Prevalence of malaria among the blood groups are; A− (1.92%), A+ (13.41%), B− (1.15%), B+ (19.54%), O− (6.51%), O+ (51.73%), AB− (0.38%) and AB+ (5.36%). Conclusion: There is a high prevalence of malaria among the children examined in this study, there is therefore the need to intensify efforts to reduce the burden of the infection in the study area, especially among the children.

Seasonal Variation of Malaria Infections among Outpatients Attending Muhammad Abdullahi Wase Teaching Hospital Kano State, Nigeria

Malaria is a serious public health problem in Sub-saharan Africa including Nigeria, with the potential to increase significantly in response to seasonal changes. The aim of the study was to determine the influence of seasonal variations on the prevalence of malaria infection among outpatient attending Muhammad Abdullahi Wase teaching hospital Kano state, Nigeria. The objectives were to establishing the correlation between malaria infections and seasonal variations, and also determining the prevalence during different seasons, and evaluating the gender distribution of infection. The study was carried out from January to December, 2019, involving the use of microscopic examination of 840 blood samples using thick and thin film methods. Out of 840 patients examined (57.1%) had a malaria infection. Wet season had the highest prevalence rate of malaria infection (33.2%) than dry season (23.9%).There was a statistically significant differences (P<0.05) in the prevalence rate of malaria infection in relation to season. In relation to the gender females had higher (31.9%) prevalence rate of malaria infection than males (25.2%) and there was no significant difference in the prevalence rate of the infection in relation to sex (P>0.05). Concerning age groups, patients aged 26-30 years had the highest prevalence rate (9.04%), while those aged 40 and above had the lowest. However, the variation in prevalence among age groups was not statistically significant (P>0.05).This study confirmed that malaria infection still remains an important public health problem in the study area. Therefore, full implementation of adequate public health measures need to be undertaken to mitigate the endemicity of the disease, such as the Roll Back Malaria control Strategies as well as health education and environmental modifications are advocated is recommended.

Knowledge and Practices of Women Regarding Malaria and Its Prevention: A Community-Based Study in an Area under Malaria Elimination Programme in Iran

Background: Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are two core interventions for control and prevention of malaria infection. This descriptive cross-sectional study aimed to determine the knowledge and practices of women regarding malaria and its preventive measures in a malarious area in the Jask County, southeast of Iran.
 Methods: Data was collected from 400 households through a two-stage random cluster sampling method in six villages. Pre-tested structured questionnaire was used to collect data. During the survey, visual observations were also made by the interviewers to check use of LLINs and IRS. The data were analyzed by SPSS software version 21.
 Results: The majority of households had a high level of knowledge about symptoms (98%, n=392) and transmission (74.5%, n=298) of malaria. The main preventive measures against malaria were: LLINS (39.5%, n=158), IRS (32%, n=128), and screens on doors/windows (16.7%, n=67). In addition, participants with primary or higher educational level reported that they practice more malaria preventive measures, compared to those who were illiterate (OR=3.3, 95% CI= 1.6–6.6, p=0.0001, Table 6). In spite of positive perceptions about IRS and LLINs, only 35.5% (n=142) and 17% (n=68) of households used IRS and LLINs, respectively.
 Conclusion: According to the results of this study, despite a high level of knowledge about malaria and its preventive measures, a small number of participants use LLINs and IRS for malaria prevention. Therefore, implementation of ef­fective educational interventions is recommended to improve preventive practices against malaria in the study area.

Mass Testing and Treatment to Accelerate Malaria Elimination: A Systematic Review and Meta-Analysis.

In regions where malaria transmission persists, the implementation of approaches aimed at eliminating parasites from the population can effectively decrease both burden of disease and transmission of infection. Thus, mass strategies that target symptomatic and asymptomatic infections at the same time may help countries to reduce transmission. This systematic review assessed the potential benefits and harms of mass testing and treatment (MTaT) to reduce malaria transmission. Searches were conducted in March 2021 and updated in April 2022 and included cluster-randomized controlled trials (cRCTs) as well as nonrandomized studies (NRSs) using malaria infection incidence, clinical malaria incidence, or prevalence as outcomes. The risk of bias was assessed with Cochrane's risk of bias (RoB2) tool and Risk of Bias Tool in Nonrandomized Studies - of Interventions (ROBINS-I), and the certainty of evidence (CoE) was graded for each outcome. Of 4,462 citations identified, seven studies (four cRCTs and three NRSs) contributed outcome data. The analysis revealed that MTaT did not reduce the incidence (risk ratio [RR]: 0.95, 95% CI: 0.87-1.04; 1,181 participants; moderate CoE) or prevalence (RR: 0.83, 95% CI: 0.67-1.01; 7,522 participants; moderate CoE) of malaria infection but resulted in a small reduction in clinical malaria (RR: 0.82; 95% CI: 0.70-0.95; 334,944 participants; moderate CoE). Three studies contributing data on contextual factors concluded that MTaT is an acceptable, feasible, and cost-effective intervention. Mathematical modeling analyses (n = 10) suggested that MTaT effectiveness depends on the baseline transmission level, diagnostic test performance, number of rounds, and other co-interventions. Based on the limited evidence available, MTaT has little to no impact on reducing malaria transmission.

Prevalence of Human Malaria Parasite among Pregnant Women Attending Antenatal Care at Eldin Specialist Hospital Jos, Plateau State, Nigeria

Malaria infection is a severe parasitic infectious disease transmitted by the bite of an infected female Anopheles mosquito. The disease presents with severe consequences in pregnant women and children <5 years, particularly in sub-Saharan Africa where the burden of the disease is highest. Malaria in pregnancy may present with severe symptoms such as miscarriages, premature delivery, low-birth-weight neonates, and neonatal death. This study therefore determined the prevalence of malaria infection among pregnant women in Jos Metropolis. Capillary blood samples were collected from 200 symptomatic pregnant women attending Eldin Specialist Hospital, in Jos, and thin and thick blood Giemsa-stained films were prepared and examined for the presence of malaria parasites. Our findings revealed that 70(35%) of the 200 pregnant women sampled were infected. Based on gravidity, incidence of malaria infection was highest in the primigravidae 45 (41.9%) as compared to multigravidae 25 (27.8%) although decreasing with gestational age, as subjects in their first trimester were more infected 44 (44.0%) with the least being those in their third trimester14 (21.5%). Two peaks of infection were encountered in respect to age; 46.2% in subjects aged 20-24 years and 42.9% in subjects aged 30-39 years with the least infection recorded in subjects aged > 39 years, 17.9%. Malaria incidence is decreasing in the country due to scale up intervention and prevention measures, however, malaria still remains a major public health problem among pregnant women and deliberate efforts need to be put in place to forestall the negative impact of this disease.

Genotype-environment associations reveal genes potentially linked to avian malaria infection in populations of an endemic island bird.

Patterns of pathogen prevalence are, at least partially, the result of coevolutionary host-pathogen interactions. Thus, exploring the distribution of host genetic variation in relation to infection by a pathogen within and across populations can provide important insights into mechanisms of host defence and adaptation. Here, we use a landscape genomics approach (Bayenv) in conjunction with genome-wide data (ddRADseq) to test for associations between avian malaria (Plasmodium) prevalence and host genetic variation across 13 populations of the island endemic Berthelot's pipit (Anthus berthelotii). Considerable and consistent spatial heterogeneity in malaria prevalence was observed among populations over a period of 15 years. The prevalence of malaria infection was also strongly positively correlated with pox (Avipoxvirus) prevalence. Multiple host loci showed significant associations with malaria prevalence after controlling for genome-wide neutral genetic structure. These sites were located near to or within genes linked to metabolism, stress response, transcriptional regulation, complement activity and the inflammatory response, many previously implicated in vertebrate responses to malarial infection. Our findings identify diverse genes - not just limited to the immune system - that may be involved in host protection against malaria and suggest that spatially variable pathogen pressure may be an important evolutionary driver of genetic divergence among wild animal populations, such as Berthelot's pipit. Furthermore, our data indicate that spatio-temporal variation in multiple different pathogens (e.g. malaria and pox in this case) may have to be studied together to develop a more holistic understanding of host pathogen-mediated evolution.

Prevalence of non-falciparum malaria infections among asymptomatic individuals in four regions of Mainland Tanzania

BackgroundRecent studies point to the need to incorporate the detection of non-falciparum species into malaria surveillance activities in sub-Saharan Africa, where 95% of the world’s malaria cases occur. Although malaria caused by infection with Plasmodium falciparum is typically more severe than malaria caused by the non-falciparum Plasmodium species P. malariae, P. ovale spp. and P. vivax, the latter may be more challenging to diagnose, treat, control and ultimately eliminate. The prevalence of non-falciparum species throughout sub-Saharan Africa is poorly defined. Tanzania has geographical heterogeneity in transmission levels but an overall high malaria burden.Methods To estimate the prevalence of malaria species in Mainland Tanzania, we randomly selected 1428 samples from 6005 asymptomatic isolates collected in previous cross-sectional community surveys across four regions and analyzed these by quantitative PCR to detect and identify the Plasmodium species.ResultsPlasmodium falciparum was the most prevalent species in all samples, with P. malariae and P. ovale spp. detected at a lower prevalence (< 5%) in all four regions; P. vivax was not detected in any sample.Conclusions The results of this study indicate that malaria elimination efforts in Tanzania will need to account for and enhance surveillance of these non-falciparum species.Graphical

Prevalence and genetic diversity of simian malaria in wild macaque populations across Thailand: Implications for human health

Over the past year, P. falciparum infections have declined in Thailand, yet nonhuman primate malaria infections have correspondingly increased, including Plasmodium knowlesi and P. cynomolgi. Nevertheless, little is known about simian malaria in its natural macaque hosts, Macaca mulatta and Macaca fascicularis. This study aims to address several research questions, including the prevalence and distribution of simian malaria in these two Thai wild macaque species, variations in infection between different macaque species and between M. fascicularis subspecies, and the genetic composition of these pathogens.Blood samples were collected from 82 M. mulatta and 690 M. fascicularis across 15 locations in Thailand, as well as two locations in Vietnam and Myanmar. We employed quantitative real-time PCR targeting the Plasmodium genus-specific 18S ribosomal RNA (rRNA) gene to detect malaria infection, with a limit of detection set at 1,215.98 parasites per mL. We genotyped eight microsatellite markers, and the P. cynomolgi dihydrofolate reductase gene (DHFR) was sequenced (N = 29).In total, 100 of 772 samples (13 %) tested positive for malaria, including 45 (13 %) for P. cynomolgi, 37 (13 %) for P. inui, 16 (5 %) for P. coatneyi, and 2 (0.25 %) for Hepatocystis sp. in Saraburi, central and Ranong, southern Thailand. Notably, simian malaria infection was observed exclusively in M. fascicularis and not in M. mulatta (P = 0.0002). Particularly, P. cynomolgi was detected in 21.7 % (45/207) of M. f. fascicularis living in Wat Tham Phrapothisat, Saraburi Province. The infection with simian malaria was statistically different between M. fascicularis and M. mulatta (P = 0.0002) but not within M. fascicularis subspecies (P = 0.78). A haplotype network analysis revealed that P. cynomolgi shares a lineage with reference strains obtained from macaques. No mutation in the predicted binding pocket of PcyDHFR to pyrimethamine was observed.This study reveals a significant prevalence of simian malaria infection in M. fascicularis. The clonal genotypes of P. cynomolgi suggest in-reservoir breeding. These findings raise concerns about the potential spread of nonhuman primate malaria to humans and underscore the need for preventive measures.

Prevalence of Thalassemia in Nigeria: Pathophysiology and Clinical Manifestations

There is evidence linking genes for thalassaemia, sickle cell diseases, and glucose-6-phosphate dehydrogenase (G6PD) deficiency to a high prevalence of malaria infection. Haemoglobinopathies are hereditary conditions that mostly results in thalassaemia and sickle-cell anaemia. The current global haemoglobin gene carrier population (i.e., healthy individuals who have acquired only one mutant gene from one parent) is between 1 and 5%. Some haemoglobinopathy genes (alpha-thal, beta-thal and HbS) cause alpha-thalassaemia, beta-thalassaemia and sickle-cell anaemia, respectively. Nigerians have a prevalence of 25–30% for sickle cell anaemia (SCA), G6PD, but both alpha thalassaemia and beta thalassaemia are at the lower limit. Thalassaemia and SCA have comparable clinical manifestations. which is quite prevalent in Nigeria? This could lead to underdiagnosis of thalassaemia, which accompany hypochromia and microcytosis, that could be mistaken for iron deficiency anaemia. Depending on the levels of foetal haemoglobin and haemoglobin A2, thalassemia, iron deficiency anaemia, and sickle cell disease continue to be the most common chronic types of anaemia. This review provides details information on the prevalence of thalassaemia in Nigeria and molecular mechanisms in the expression of thalassaemia genes. The authors also suggest various possible way to minimize the occurrences of thalassaemia in Nigeria

Efficacy of chlorfenapyr-pyrethroid and piperonyl butoxide-pyrethroid long-lasting insecticidal nets (LLINs) compared to pyrethroid-only LLINs for malaria control in Côte d’Ivoire: a three group, cluster randomised trial

BackgroundThe massive scale-up of long-lasting insecticidal nets (LLIN) has led to a major reduction in malaria burden in many sub-Saharan African (SSA) countries. The World Health Organization (WHO) has recently issued a strong recommendation for the use of chlorfenapyr-pyrethroid LLINs compared to standard pyrethroid-only LLINs in areas of high insecticide resistance intensity. However, there is still a lack of conclusive evidence on the efficacy of piperonyl butoxide-pyrethroid (PBO-py) LLINs, especially in West Africa, where vector composition and resistance mechanisms may be different from vectors in East Africa.MethodsThis is a three-arm, superiority, triple-blinded, cluster randomised trial, with village as the unit of randomisation. This study conducted in Côte d’Ivoire will evaluate the efficacy on epidemiological and entomological outcomes of (1) the control arm: MAGNet® LN, which contains the pyrethroid, alpha-cypermethrin, (2) VEERALIN® LN, a net combining the synergist PBO and alpha-cypermethrin, and (3) Interceptor® G2 LN, which incorporates chlorfenapyr and alpha-cypermethrin, two adulticides with different mechanisms of action. A total of 33 villages with an average of 200 households per village will be identified, mapped, and randomised in a ratio of 1:1:1. Nets will be distributed at a central point following national guidelines with 1 net for every 2 people. The primary outcome of the trial will be incidence of malaria cases (confirmed by rapid diagnostic test (RDT)) in a cohort of 50 children aged 6 months to 10 years in each cluster, followed for 12 months (active case detection). Secondary outcomes are cross-sectional community prevalence of malaria infection (confirmed by RDT) in the study population at 6 and 12 months post-intervention (50 randomly selected persons per cluster), vector density, entomological inoculation rate (EIR), and phenotypic and genotypic insecticide resistance at baseline and 12 months post-intervention in 3 sentinel villages in each treatment arm.DiscussionIn addition to generating further evidence for next-generation LLINs, this study will also provide the first evidence for pyrethroid-PBO nets in a West African setting. This could further inform WHO recommendations on the pragmatic use of pyrethroid-PBO nets.Trial registrationClinicalTrials.gov NCT05796193. Registered on April 3, 2023.

Prevalence of Malaria and Helminth Infections and Their Link to Knowledge on Preventive Strategies among Asymptomatic Pupils in Rural-urban Cameroon

Aim: The aim of our study was to investigate the prevalence of malaria and helminth infection among asymptomatic primary school children in rural and urban Yaoundé-Cameroon, to assess pupils’ knowledge about malaria and STH infection, and to evaluate the association between this knowledge and actual disease prevalence.&#x0D; Study Design: This study was a cross-sectional and was carried out between October 2019 and December 2019 in six primary schools in the Centre region of Cameroon.&#x0D; Methodology:Pupils in classes 3 to six were recruited for the study. Blood and stool samples were collected and analysed to determine pupils’ disease prevalence. Questionnaires following the KAP and health belief model frameworks were administered to evaluate pupils’ health literacy in malaria and helminths.&#x0D; Results: 457 pupils from rural and urban zones participated in this study. 245 (53.6 %) were female and 212 (46.4 %) were male. The prevalence of anaemia was higher in urban than rural zones. Total malaria prevalence was 17.7%. Malaria parasitaemia prevalence classified according to settings revealed rural zones at 28.6% and urban zones at 13.9%. STH infection showed a total prevalence of 4.8% and 7.9% and 3.7% in rural and urban zones respectively. The prevalence of co-infection was 1.2%. Health-literacy gaps in malaria and helminths were identified. Schooling in rural settings and being older were predictors for having a good knowledge of the diseases. However, having good knowledge was not significantly associated to actual malaria parasitaemia or STH prevalence.&#x0D; Conclusion: Insights from this study are essential for the implementation of successful, sustainable and targeted health-promotion strategies to improve the health and well-being of pupils.

Prevalence of Malaria Infection in Pregnant Women Attending Antenatal Clinics in Southern Senegal.

Despite marked progress in Senegal, three regions in the southeast part continue to have a high burden of malaria, but there have been no recent studies assessing the prevalence of malaria associated with pregnancy. This study aimed to determine the prevalence of malaria infection in pregnant women attending antenatal clinics in Senegal. During the malaria transmission season of 2019, pregnant women attending 11 health care facilities for a scheduled visit and those presenting unwell with signs of malaria were invited to participate in a malaria screening study. A finger prick blood sample was taken for malaria diagnosis by rapid diagnosis test (RDT) and polymerase chain reaction (PCR). A total of 877 pregnant women were enrolled, 787 for a scheduled antenatal consultation and 90 for an unscheduled consultation with signs of malaria. The prevalence of Plasmodium falciparum among the first group was 48% by PCR and 20% by RDT, and that among the second group was 86% by PCR and 83% by RDT. RDT sensitivity in capturing asymptomatic, PCR-positive infections was 9.2% but ranged from 83% to 94% among febrile women. The prevalence of infection by PCR in women who reported having received at least three doses of sulfadoxine pyrimethamine (SP) was 41.9% compared with 58.9% in women who reported they had not received any SP doses (prevalence ratio adjusted for gravidity and gestational age, 0.54; 95% CI, 0.41-0.73). The burden of P. falciparum infections remains high among pregnant women, the majority of which are not captured by RDT. More effective measures to prevent malaria infection in pregnancy are needed.

Prevalence of Helicobacter pylori, Mycobacterium tuberculosis, Malaria Infections, and High Serum Prostate Specific Antigen Levels among Individuals at the Rivers State University, Nigeria: Findings of a Free Medical Outreach

Background: Co-morbidity of infections and non-infectious diseases is increasing in developing societies with little effort in identifying these trends. The study aimed to estimate the prevalence of Helicobacter pylori, Mycobacterium tuberculosis, malaria infections, and high serum prostate-specific antigen levels among individuals and residents at Rivers State University, Port Harcourt, Nigeria.&#x0D; Experimental Design: The study is a cross-sectional descriptive study, which consisted of 501 participants in a free medical outreach organized by the Association of Medical Laboratory Scientists of Nigeria, Rivers State University Chapter, Rivers State, Nigeria, in commemoration of the 2022 International Biomedical Day. The test subjects consisted of males and females, who were students, staff, and residents at the Rivers State University, Port Harcourt, Nigeria. The age range of the test subjects was 18-64 years.&#x0D; Methods: The cross-sectional descriptive study encompassed 501 adults (males and females) who gave consent for their blood screening during our free medical outreach. As a procedure, venous blood specimens were collected at the antecubital fossa from the attendees by venipuncture technique and were screened forH. Pylori antibody, Mycobacterium tuberculosis, malaria parasite, and prostate-specific antigen with the use of Accu-Tell rapid diagnostic test kits. Each test was read within 10 minutes. Red lines on the test zone and control zones of the test kits were read and recorded as positive cases, while a red line on the control zone and the absence of a red line on the test zone of the test kit were read, and recorded as negative case, in line with the rapid diagnostic manufacturer’s instructions.&#x0D; Results: Out of a total of 501 participants, the prevalence of H. pylori, M. tuberculosis, Plasmodium falciparum, and prostate-specific antigen were 9 (1.79 %), 3 (0.6 %), 12 (2.40 %), 6 (4.65 %%) respectively. The sex-based comparison showed that males have the same prevalence for all infectious diseases (H. pylori, M. tuberculosis, and P. falciparum) of 3 (2.32 %), and 6 (4.65 %) for a prostate-specific antigen. For the females, the prevalence of H. pylori, M. tuberculosis and P. falciparum were 6 (2.20 %), 0 (0.00 %), and 9 (2.42 %) respectively.&#x0D; Conclusion: M. tuberculosis prevalence was observed to be greater in the males than in the females of the studied population while that of H. pylori was observed to be higher in the females than the male participants. So continuous screening of the public to monitor and prepare them against the insurgence of these diseases which are of public health concern is important.

Malaria infection and associated household level risks in an urban and rural areas of West Bengal.

Malaria is one of the most critical public health problem globally as well as nationally. Recent times have seen an increase in the importance of the possible effects of environmental and demographic factors on the local transmission of malaria. We conducted a community-level study between urban and rural areas to find out the factors associated with malaria infection. A community based observational cross-sectional study was conducted between October 2020 to September 2022 among 330 households from urban area of Chetla, Kolkata and rural areas of Singur district of West Bengal. Households were selected by two stage random sampling method. Study done by face-to-face interview, review of medical records and observation of the households. SPSS software was used for data analysis. Multivariable logistic regression (hierarchical model) done. (p-value equal to or less than 0.05 was taken as significant). The prevalence of malaria infection among participants and household level risks of malaria infection were found 6.1%, 1.8% and 18.8%, 6.7% respectively in the urban and rural areas. Significant predictors of malaria infection were household with ≥5 family members [AOR=2.91{CI (1.19-7.15)}], households not used any mosquito protective measure [AOR=3.71{CI (1.04-13.13)}], presence of mosquito breeding place [AOR=4.93{CI (1.53-15.93)}], absence of effective window screen [AOR=3.19{CI (1.16-8.71)}], absence of separate kitchen [AOR=2.38{CI (1.06-5.34)}], and inadequate lighting condition of house [AOR=4.35{CI (1.78-10.64)}]. This study provides important insights into the epidemiology of malaria in a high and also low-transmission setting in West Bengal. Intensified efforts to be strengthen towards community mobilization for preventing breeding places for mosquito. Policy should strengthen investment in housing programme that may complement reduction of malaria transmission. Disease reduction effects of Government and local NGOs should be directed towards those areas in order to decrease disease load.

CD8+ Trms against malaria liver-stage: prospects and challenges.

Attenuated sporozoites provide a valuable model for exploring protective immunity against the malarial liver stage, guiding the design of highly efficient vaccines to prevent malaria infection. Liver tissue-resident CD8+ T cells (CD8+ Trm cells) are considered the host front-line defense against malaria and are crucial to developing prime-trap/target strategies for pre-erythrocytic stage vaccine immunization. However, the spatiotemporal regulatory mechanism of the generation of liver CD8+ Trm cells and their responses to sporozoite challenge, as well as the protective antigens they recognize remain largely unknown. Here, we discuss the knowledge gap regarding liver CD8+ Trm cell formation and the potential strategies to identify predominant protective antigens expressed in the exoerythrocytic stage, which is essential for high-efficacy malaria subunit pre-erythrocytic vaccine designation.

Dynamics of malaria vector composition and Plasmodium falciparum infection in mainland Tanzania: 2017–2021 data from the national malaria vector entomological surveillance

BackgroundIn 2015, Tanzania National Malaria Control Programme (NMCP) established a longitudinal malaria vector entomological surveillance (MVES). The MVES is aimed at a periodical assessment of malaria vector composition and abundance, feeding and resting behaviours, and Plasmodium falciparum infection in different malaria epidemiological strata to guide the NMCP on the deployment of appropriate malaria vector interventions. This work details the dynamics of malaria vector composition and transmission in different malaria epidemiological strata.MethodsThe MVES was conducted from 32 sentinel district councils across the country. Mosquitoes were collected by the trained community members and supervised by the NMCP and research institutions. Three consecutive night catches (indoor collection with CDC light trap and indoor/outdoor collection using bucket traps) were conducted monthly in three different households selected randomly from two to three wards within each district council. Collected mosquitoes were sorted and morphologically identified in the field. Thereafter, the samples were sent to the laboratory for molecular characterization using qPCR for species identification and detection of P. falciparum infections (sporozoites). ELISA technique was deployed for blood meal analysis from samples of blood-fed mosquitoes to determine the blood meal indices (BMI).ResultsA total of 63,226 mosquitoes were collected in 32 district councils from January 2017 to December 2021. Out of which, 39,279 (62%), 20,983 (33%) and 2964 (5%) were morphologically identified as Anopheles gambiae sensu lato (s.l.), Anopheles funestus s.l., and as other Anopheles species, respectively. Out of 28,795 laboratory amplified mosquitoes, 13,645 (47%) were confirmed to be Anopheles arabiensis, 9904 (34%) as An. funestus sensu stricto (s.s.), and 5193 (19%) as An. gambiae s.s. The combined average entomological inoculation rates (EIR) were 0.46 (95% CI 0.028–0.928) for An. gambiae s.s., 0.836 (95% CI 0.138–1.559) for An. arabiensis, and 0.58 (95% CI 0.165–0.971) for An. funestus s.s. with variations across different malaria transmission strata. Anopheles funestus s.s. and An. arabiensis were predominant in the Lake and South-Eastern zones, respectively, mostly in high malaria transmission areas. Monthly mosquito densities displayed seasonal patterns, with two peaks following the rainy seasons, varying slightly across species and district councils.ConclusionAnopheles arabiensis remains the predominant vector species followed by An. funestus s.s. in the country. Therefore, strengthening integrated vector management including larval source management is recommended to address outdoor transmission by An. arabiensis to interrupt transmission particularly where EIR is greater than the required elimination threshold of less than one (< 1) to substantially reduce the prevalence of malaria infection.

Prevalence of Malaria among Pregnant Women Attending Muhammad Abdullahi Wase Teaching Hospital Kano State, Nigeria

Malaria in pregnant women remains a major public health problem especially in sub-Saharan Africa. Approximately twenty five million pregnant women in sub-Saharan Africa live at risk of malaria. The study was carried out between July and August 2021, to determine the prevalence of malaria parasite among pregnant women attending Mohammad Abdullahi Wase Teaching Hospital Kano. Microscopic examinations of both thick and thin smears were made using Giemsa Stained solution. Out of one hundred and forty blood samples examined, 60(42.9%) were positive for plasmodium falciparum parasite infection. Age group 18-22 years recorded the highest prevalence rate of (17.90%) and the difference between the age group of the pregnant women was statistically significant (P&lt;0.05) .Primigravida women recorded highest infection rate (23.60%). However, those in first trimester recorded the highest prevalence of (25%) followed by those in the second trimester (13.57%). These results show that pregnant women are more predisposed to malaria infection as they are immunosuppressed especially at early stage and as a primigravida and as teenage mothers than multigravida and older mothers. The problem of P. falciparum in pregnant women can be prevented by the preventive package of intermittent preventive treatment (IPT) with sulfadoxine pyrimethamine (SP) at 2 doses given to the pregnant women during their antenatal clinical visits. During this study, the prevalence of malaria infection among pregnant women attending Muhammad Abdullahi Wase Teaching Hospital was notably higher. P. falciparum is the most common Plasmodium parasite in this region therefore, more special attention should be directed towards pregnant women who exhibit identified risk factors for malaria infection.

Chemoprevention for malaria with monthly intermittent preventive treatment with dihydroartemisinin–piperaquine in pregnant women living with HIV on daily co-trimoxazole in Kenya and Malawi: a randomised, double-blind, placebo-controlled trial

The efficacy of daily co-trimoxazole, an antifolate used for malaria chemoprevention in pregnant women living with HIV, is threatened by cross-resistance of Plasmodium falciparum to the antifolate sulfadoxine-pyrimethamine. We assessed whether addition of monthly dihydroartemisinin-piperaquine to daily co-trimoxazole is more effective at preventing malaria infection than monthly placebo plus daily co-trimoxazole in pregnant women living with HIV. We did an individually randomised, two-arm, placebo-controlled trial in areas with high-grade sulfadoxine-pyrimethamine resistance in Kenya and Malawi. Pregnant women living with HIV on dolutegravir-based combination antiretroviral therapy (cART) who had singleton pregnancies between 16 weeks' and 28 weeks' gestation were randomly assigned (1:1) by computer-generated block randomisation, stratified by site and HIV status (known positive vs newly diagnosed), to daily co-trimoxazole plus monthly dihydroartemisinin-piperaquine (three tablets of 40 mg dihydroartemisinin and 320 mg piperaquine given daily for 3 days) or daily co-trimoxazole plus monthly placebo. Daily co-trimoxazole consisted of one tablet of 160 mg sulfamethoxazole and 800 mg trimethoprim. The primary endpoint was the incidence of Plasmodium infection detected in the peripheral (maternal) or placental (maternal) blood or tissue by PCR, microscopy, rapid diagnostic test, or placental histology (active infection) from 2 weeks after the first dose of dihydroartemisinin-piperaquine or placebo to delivery. Log-binomial regression was used for binary outcomes, and Poisson regression for count outcomes. The primary analysis was by modified intention to treat, consisting of all randomised eligible participants with primary endpoint data. The safety analysis included all women who received at least one dose of study drug. All investigators, laboratory staff, data analysts, and participants were masked to treatment assignment. This trial is registered with ClinicalTrials.gov, NCT04158713. From Nov 11, 2019, to Aug 3, 2021, 904 women were enrolled and randomly assigned to co-trimoxazole plus dihydroartemisinin-piperaquine (n=448) or co-trimoxazole plus placebo (n=456), of whom 895 (99%) contributed to the primary analysis (co-trimoxazole plus dihydroartemisinin-piperaquine, n=443; co-trimoxazole plus placebo, n=452). The cumulative risk of any malaria infection during pregnancy or delivery was lower in the co-trimoxazole plus dihydroartemisinin-piperaquine group than in the co-trimoxazole plus placebo group (31 [7%] of 443 women vs 70 [15%] of 452 women, risk ratio 0·45, 95% CI 0·30-0·67; p=0·0001). The incidence of any malaria infection during pregnancy or delivery was 25·4 per 100 person-years in the co-trimoxazole plus dihydroartemisinin-piperaquine group versus 77·3 per 100 person-years in the co-trimoxazole plus placebo group (incidence rate ratio 0·32, 95% CI 0·22-0·47, p<0·0001). The number needed to treat to avert one malaria infection per pregnancy was 7 (95% CI 5-10). The incidence of serious adverse events was similar between groups in mothers (17·7 per 100 person-years in the co-trimoxazole plus dihydroartemisinin-piperaquine group [23 events] vs 17·8 per 100 person-years in the co-trimoxazole group [25 events]) and infants (45·4 per 100 person-years [23 events] vs 40·2 per 100 person-years [21 events]). Nausea within the first 4 days after the start of treatment was reported by 29 (7%) of 446 women in the co-trimoxazole plus dihydroartemisinin-piperaquine group versus 12 (3%) of 445 women in the co-trimoxazole plus placebo group. The risk of adverse pregnancy outcomes did not differ between groups. Addition of monthly intermittent preventive treatment with dihydroartemisinin-piperaquine to the standard of care with daily unsupervised co-trimoxazole in areas of high antifolate resistance substantially improves malaria chemoprevention in pregnant women living with HIV on dolutegravir-based cART and should be considered for policy. European and Developing Countries Clinical Trials Partnership 2; UK Joint Global Health Trials Scheme (UK Foreign, Commonwealth and Development Office; Medical Research Council; National Institute for Health Research; Wellcome); and Swedish International Development Cooperation Agency.

Assessment of prevalence of malaria infection among individuals of different blood groups: An observational study

Assessment of prevalence of malaria infection among individuals of different blood groups: An observational study