Prevalence Of Malaria Parasitaemia Research Articles

Investigation on Malaria Parasitaemia, Knowledge and Attitudes towards Mosquito Control among Residents of Wukari Metropolis

This study was conducted to investigate malaria parasitaemia, knowledge and attitudes towards mosquito control. 162 subjects were selected at random from different locations in Wukari Metropolis and were examined for malaria parasitaemia. Blood samples from each of the subjects were collected by finger pricking for the determination of malaria parasite using the Rapid Diagnostic Test method. Out of 162 samples examined, the prevalence of malaria parasitaemia was 91(56.17%). Female subjects had the highest prevalence of malaria parasitaemia of (72.0%), while the male had (35.0%) and the difference was statistically significant (p<0.05) between the rate of infection and gender. Age group ≥20 years recorded the highest infection rate of (62.12%), age group 14-16 years had the lowest infection rate of (48.94%), and there was no significant difference p>0.05 between malaria prevalence and age groups. The hospital location had the highest prevalence of malaria parasitaemia at (64.44%) and (31.89%) within malaria, while the Fuwukari location had the least prevalence of malaria parasitaemia of (47.22%) and (18.68%) within malaria. The test on knowledge and awareness of malaria indicates that (31.48%) of the subjects have erroneous perception about the cause and means through which malaria is transmitted. It can be concluded that despite the high infectivity rate of malaria in the study area there is much knowledge and awareness of malaria in the study. There is a need for a comprehensive strategy for preventing malaria transmission such as effective use of insecticide-treated nets, public awareness campaigns, proper environmental sanitation and use of drugs.

Prevalence of Malaria and Helicobacter Pylori Coinfection and Associated Sociodemographic Factors among Blood Donors in Douala General Hospital

Background: The malaria parasite Plasmodium is intra-erythrocyte hence can be transmitted by transfusion of any blood component containing infected red blood cells. Helicobacter pylori infection affects more than half of the human population worldwide. Infection remains asymptomatic in most individuals, although some individuals develop acute gastritis, peptic or duodenal ulcers, gastric cancer, and mucosa associated tissue lymphoma. H. pylori infection have been implicated in some haematological manifestations such as anaemia and micronutrient deficiency. Objective: This research was designed to determine the prevalence of malaria parasitaemia and H. pylori coinfection in association with sociodemographic characteristics among donors in Douala General Hospital. Methodology: The study was a hospital-based study carried out from January to May 2022. The study population comprised of 106 donors who came to the hospital laboratory for blood donation. A structured questionnaire was used to get demographic and clinical data. Two ml of blood was collected from individuals to prepare a thick and thin blood film for malaria parasite determination and to centrifuge at 3000 rpm for 5 minutes to obtain plasma for H. pylori test strip. Results and Discussion: The overall prevalence of H. pylori in the study area was 70.8%. The female donors had a prevalence of 72.0%. A greater proportion of blood group O donors had H. pylori than groups A, AB and B but this difference was not significant (P-value = 0.571). The prevalence of malaria parasites infection was 36.8%. Those of blood group A had a higher prevalence rate of 42.3% (11/26). Out of the 106 donors, 23 (21.7%) had malaria and H. pylori coinfection. 68 (64.2%) donors had a mono-infection that is either having malaria mono-infection or H. pylori mono-infection and 15 (14.2%) had no infection. Malaria and H. pylori coinfection was higher in female donors than males (OR = 1.059, 95% Cl 0.359 -3.119, P =0.917), in donors aged below 25 years old (OR = 0.338, 95% Cl 0.075 - 1.535, P =0.160), replacement donors (OR = 1.350, 95% Cl 0.460 – 3.964, P =0.585); blood donors of blood group AB (OR = 0.654, 95% Cl 0.181 – 2.366, P =0.517) and Rhesus negative donors (OR = 1.500, 95% Cl 0.130 – 17.36, P =0.746). Conclusion: The prevalence of H. pylori infection and Malaria among blood donors in Douala General Hospital were high and coinfection was higher in females than males. Both malaria parasites and H. pylori infections have been implicated in blood parameters such as anaemia and micronutrient deficiency. It is therefore recommended that routine screening for malaria parasites and H. pylori be done in blood banks before transfusion for a high blood quality.

Malaria Parasitaemia, Risk Perception, and Preventive Practices Among Women Attending Ante-Natal Clinics in Ogun State

Malaria contributes over 10% of all deaths among pregnant women. The prevalence of malaria in pregnancy in Nigeria particularly in Ogun State is high. The coverage and uptake of Intermittent Preventive Treatment with Sulphodoxine Pyrimethamine (IPT-SP) and Long-Lasting Insecticidal Nets (LLINs) in Southwest Nigeria is still very low despite their proven cost effectiveness in improving maternal and infant health. This study therefore determined the malaria parasitaemia, risk perception, preventive practices and associated factors among women attending Ante-natal Clinics (ANCs) in Ogun state. A cross-sectional study was carried out using mixed methods. An estimated sample size of 426 was computed and selected from ANCs across the state through multistage sampling technique. Pre-tested semi-structured interviewer administered questionnaire was used to collect information. Also, focused group discussions (FGDs) were conducted among women attending ANC and blood samples were taken from asymptomatic women for laboratory analysis to determine prevalence of malaria parasitaemia. Measures of association between the dependent and independent variables were tested using Chi-square. All tests of significance were done based on a ɑ-level of 0.05. Response rate was 100% for this study. The mean age of respondents was 27.9 ±5.5 years. Risk perception of malaria was observed to be good. Malaria parasitaemia was 2.7% and was 100% due to <i>Plasmodium falciparum</i>. Maternal age was significantly associated with malaria parasitaemia. Therefore, it is recommended that malaria elimination programmes should be sustained; access and affordability of ANC care should be ensured by the Government.

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.
 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.
 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.
 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.
 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.

Systematic Review and Meta-Analysis of Seasonal Malaria Chemoprevention.

Seasonal malaria chemoprevention (SMC) for children under 5 years of age for up to four monthly cycles during malaria transmission season was recommended by the WHO in 2012 and has been implemented in 13 countries in the Sahel, reaching more than 30 million children annually. Malaria control programs implementing SMC have asked the WHO to consider expanding the age range or number of monthly cycles. We conducted a systematic review and meta-analysis of SMC among children up to 15 years of age and up to six monthly cycles. Twelve randomized studies were included, with outcomes stratified by age (< 5/≥ 5 years), by three or four versus five or six cycles, and by drug where possible. Drug regimens included sulfadoxine-pyrimethamine + amodiaquine, amodiaquine-artesunate, and sulfadoxine-pyrimethamine + artesunate. Included studies were all conducted in Sahelian countries in which high-grade resistance to sulfadoxine-pyrimethamine was rare and in zones with parasite prevalence ranging from 1% to 79%. Seasonal malaria chemoprevention resulted in substantial reductions in uncomplicated malaria incidence measured during that transmission season (rate ratio: 0.27, 95% CI: 0.25-0.29 among children < 5 years; rate ratio: 0.27, 95% CI: 0.25-0.30 among children ≥ 5 years) and in the prevalence of malaria parasitemia measured within 4-6 weeks from the final SMC cycle (risk ratio: 0.38, 95% CI: 0.34-0.43 among children < 5 years; risk ratio: 0.23, 95% CI: 0.11-0.48 among children ≥ 5 years). In high-transmission zones, SMC resulted in a moderately reduced risk of any anemia (risk ratio: 0.77, 95% CI: 0.72-0.83 among children < 5 years; risk ratio: 0.70, 95% CI: 0.52-0.95 among children ≥ 5 years [one study]). Children < 10 years of age had a moderate reduction in severe malaria (risk ratio: 0.53, 95% CI: 0.37-0.76) but no evidence of a mortality reduction. The evidence suggests that in areas in which sulfadoxine-pyrimethamine and amodiaquine remained efficacious, SMC effectively reduced malaria disease burden among children both < 5 and ≥ 5 years old and that the number of cycles should be commensurate with the length of the transmission season, up to six cycles.

Multiple imputation of incomplete multilevel data using Heckman selection models.

Missing data is a common problem in medical research, and is commonly addressed using multiple imputation. Although traditional imputation methods allow for valid statistical inference when data are missing at random (MAR), their implementation is problematic when the presence of missingness depends on unobserved variables, that is, the data are missing not at random (MNAR). Unfortunately, this MNAR situation is rather common, in observational studies, registries and other sources of real-world data. While several imputation methods have been proposed for addressing individual studies when data are MNAR, their application and validity in large datasets with multilevel structure remains unclear. We therefore explored the consequence of MNAR data in hierarchical data in-depth, and proposed a novel multilevel imputation method for common missing patterns in clustered datasets. This method is based on the principles of Heckman selection models and adopts a two-stage meta-analysis approach to impute binary and continuous variables that may be outcomes or predictors and that are systematically or sporadically missing. After evaluating the proposed imputation model in simulated scenarios, we illustrate it use in a cross-sectional community survey to estimate the prevalence of malaria parasitemia in children aged 2-10 years in five regions in Uganda.

Protocol for a randomised, multicentre, four-arm, double-blinded, placebo-controlled trial to assess the benefits and safety of iron supplementation with malaria chemoprevention to children in Malawi: IRMA trial

IntroductionApproximately 40% of children aged 6–59 months worldwide are anaemic. Iron-containing multiple micronutrient powders (MNPs) and iron supplements (syrup/drops) are used to combat anaemia in children in different parts of...

Prevalence of malaria parasitaemia among pregnant women at booking in Nigeria.

Malaria is a major public health concern among pregnant women in sub-Saharan Africa. Within the region, Nigeria has the highest malaria cases. This study aimed to determine the prevalence and factors associated with malaria parasitaemia among pregnant women at a booking clinic in Ibadan, Nigeria. A cross-sectional study was conducted between January and April 2021 at the University College Hospital in Ibadan, Nigeria. A sample of 300 pregnant women participated, and anaemia and malaria were diagnosed using packed cell volume and Giemsa-stained blood smears, respectively. Data analysis was done using SPSS 25.0. The study found that 26 (8.70%) pregnant women tested positive for malaria parasitaemia. Factors such as age, religion, level of education, and occupation were significantly related to the prevalence of malaria parasitaemia among pregnant women with p < 0.05. Our study identified a high prevalence of malaria parasitaemia among pregnant women with demographic factors such as age, religion, level of education, and occupation significantly associated. Targeted malaria control interventions for pregnant women with low levels of education and low-income occupations are necessary, with more research needed to evaluate their effectiveness.

Women attending antenatal care as a sentinel surveillance population for malaria in Geita region, Tanzania: feasibility and acceptability to women and providers

BackgroundMeasurement of malaria prevalence is conventionally estimated through infrequent cross-sectional household surveys that do not provide continuous information regarding malaria parasitaemia. Recent studies have suggested that malaria parasitaemia prevalence among women attending antenatal care (ANC) correlates with prevalence among children under 5 years old and that pregnant women could be a sentinel population for tracking malaria prevalence. In mainland Tanzania, 97% of women are tested for malaria parasitaemia during first ANC visits. However, acceptability among pregnant women and healthcare providers of collecting malaria risk factor data during ANC visits is limited.MethodsA tablet-based questionnaire including 15 questions on insecticide-treated net ownership and use and care-seeking for febrile children was introduced at 40 healthcare facilities in Geita Region, Tanzania. Facilities were randomly selected from among those with 15–120 first ANC visits per month. To assess perspectives regarding introduction of the questionnaire, 21 semi-structured interviews were held with providers and facility in-charges at 12 facilities. Thirty pregnant and recently delivered women participated in focus group discussions at seven facilities to assess the acceptability of spending additional time answering questions about malaria risk.ResultsAll pregnant women reported that introduction of ANC surveillance and spending 10 more minutes with providers answering questions about their health would be neutral or beneficial. They perceived being asked about their health as standard of care. Providers and in-charges reported that introduction of ANC surveillance was within their scope of practice. Nine of 21 indicated it could potentially benefit women’s health. Six providers expressed concern about staffing shortages and need for reimbursement for extra time and noted that data management occurs after hours.ConclusionsPregnant women and providers generally perceived ANC surveillance for malaria as acceptable and positive. Pregnant and recently delivered women saw this as a reasonable and even helpful intervention. To be seen as a part of standard practice, efforts are needed to ensure providers perceive a benefit for ANC clients and that staffing concerns are addressed. In addition, staff should receive feedback related to data submissions regarding malaria prevalence and risk factors among women at their facility, with actions to take.

Prevalence of Asymptomatic Malaria Parasitemia among Blood Donors in Cape Coast, Ghana: A Cross-Sectional Study.

Malaria is an important transfusion-associated infection in many parts of the world, particularly in sub-Saharan Africa, where it is endemic. We studied the prevalence of malaria parasites among blood donors in the Cape Coast Metropolitan Area. A malaria parasite examination was added to the blood donor screening protocol for 240 voluntary and replacement blood donors (224 males and 16 females) between December 2020 and July 2021. Overall, 2.5% (6/240) had Plasmodium falciparum trophozoites detected in their blood sample. The remaining had no parasites detected. Four of the 148 who passed the blood donor screening tests were infected. The remaining two with malaria parasites failed one screening test. These included one donor with "hepatitis B + P. falciparum" and another with "syphilis + P. falciparum" parasite coinfection. All blood donors who had malaria parasites detected in their blood were males. Most donors, 45.8% (110/240), were in the 26-35 age group, with the highest prevalence of 1.3% (3/240). Blood group O was predominant (75.0%, 180/240), followed by B (12.9%, 31/240), A (11.3%, 27/240), and AB (0.8%, 2/240). All malaria parasites detected were among individuals with blood group O. Moreover, 96.3% (231/240) were rhesus-positive and had the highest prevalence of 2.1% (5/240). Screening of blood donors in Ghana does not include malaria, although there is the potential for transmission through blood products. Malaria transmission via blood transfusion remains an issue of public health concern, as indicated in the results of this current study. We recommend studies on malaria prevention, pretransfusion and posttransfusion, and pathogen reduction technology.

The Quantity, Quality and Two Major Effector Functions of Antibodies to VAR2CSA and their Association with Pregnancy Outcomes in a Low Malaria Transmission Area

Background: Women produce antibodies to VAR2CSA when infected with Plasmodium falciparum during pregnancy that reduce disease severity in the current and subsequent pregnancies. In addition to antibody quantity, antibody quality (e.g., avidity) and function (e.g., inhibition of binding and opsonic phagocytosis) are immunologically important. Studies comparing the quantity, avidity and effector mechanisms of antibodies to VAR2CSA in the same group of women with pregnancy outcomes, especially in low transmission areas, are limited. Aims: The purpose of this study was to characterize antibodies to VAR2CSA using four assays, determine the correlation among the assays, and relate this to pregnancy outcome. Methods: A panel of 310 plasma samples from women in Yaoundé (a city with low malaria transmission) who had antibodies to full-length VAR2CSA were screened in assays that measured i) level of antibodies to VAR2CSA, ii) antibody avidity, iii) reduction in binding (RiB) of fluorescent VAR2CSA-coupled beads to fluorescent-CSA-coupled beads, and iv) opsonic phagocytosis using VAR2CSA-coupled beads and human THP1 cells. Results from the assays were compared with clinical information from 614 women who were Ab-negative. Results: A modest association was found among the 4 assays, i.e., as the amount of antibodies increased, a small increase in avidity, RiB and phagocytosis was observed; however, the association between RiB and avidity was poor. When results were dichotomized to above and below the median, antibody avidity, but not antibodies in the other assays, was associated with a significant reduction in prevalence of placental malaria and lower placental parasitemia. However, women who had antibody values above the median in amount (p=0.03), avidity (p=0.006), reduction in binding (p=0.018) and probably phagocytosis (p=0.065) had significantly lower placental parasitemia than women who lacked Abs to VAR2CSA. Conclusions: In this urban setting, women with the highest (above the median) antibody levels, in the four assays had a lower prevalence of placental malaria and placental parasitemia than women who lacked anti-VAR2CSA antibodies. Thus, VAR2CA-based vaccine trials in low transmission areas should consider using all four assays before and after vaccination.

Prevalence of Malaria Parasitemia and Perceptions of the Use of Long-Lasting Insecticide Nets in a Sample of Pregnant Women in a Malaria-Endemic Nigerian Community

Objectives: The objectives of the study were to evaluate the prevalence of malaria and the perception on the use of long-lasting insecticide-treated nets (LLINs) among pregnant women attending antenatal care at Neni Community Health Center, Anaocha Local Government Area, Anambra State, Nigeria. Methods: A sample of 364 pregnant women were randomly selected for the study. Malaria parasitemia and the use of LLINs were critically evaluated among pregnant women in the study area. Two milliliters of venous blood samples was collected by a medical laboratory scientist from each pregnant woman; it was stored in an ethylenediaminetetraacetic acid container. This was done under sterile conditions and examined for malaria parasites using Giemsa-stained thin and thick blood films under a microscope. Interviews and observations were used to collect information from pregnant women regarding their sociodemographic characteristics and use of LLINs. The level of statistical significance was set at Ρ ≤0.05. Results: The prevalence of malaria in relation to parity indicated that primigravidae had the highest proportion (46.2%). In terms of gestational stage, malaria infection was highest among women in their first trimester (37.2%). Based on occupational status, farmers recorded the highest prevalence of 40.7%. There was a significantly higher proportion of pregnant women who were aware of LLINs (χ2 = 25.36, P &lt; 0.05), chose antenatal classes as a source of information on awareness of LLINs (χ2 = 27.33, P &lt; 0.05), and had reasons for noncompliance with LLINs (χ2 = 25.71, P &lt; 0.05). Conclusions: This study reveals a relatively high prevalence of malaria parasitemia and low compliance with the use of long-lasting insecticide nets among pregnant women attending antenatal care at Neni Community Health Center in Anambra State, Nigeria.

Malaria an opportunistic infection in HIV/AIDS patients? - A Nigerian experience.

HIV and malaria interact at the level of the host's susceptibility to infection, but little is known about the effect of HIV on malaria infection in Nigeria. This study estimated the prevalence of malaria parasitaemia and its relationship with HIV immunodeficiency. This cross-sectional study was conducted in two hospitals in Abuja, Nigeria between October 2012 and March 2013 among 600 respondents, comprising 200 HIV-negative controls, 200 HIV-positive patients on antiretroviral therapy (ART), and 200 HIV-positive patients not on ART. Malaria parasites, malaria density and absolute CD4 counts were carried out on all three groups. Participants with CD4 counts below 350 cells/mm3 were considered immunocompromised and likely to develop opportunistic infections. Most study participants were aged 21-40 years (65.2%). The mean CD4 counts of HIV-positive patients not on ART (300 ± 211 cells/mm3) and those on ART (354 cells/mm3) were significantly lower than among controls (834 cells/mm3) (p < 0.001). Malaria prevalence was not statistically different between the controls (44.5%), patients on ART (40.5%), and those not on ART (39.5%) (p = 0.562). Compared to 7% immunodeficiency among controls, 56% of patients on ART and 65.5% of those not on ART had a CD4 count < 350 cells/mm3 (p < 0.001). The prevalence of malaria parasitaemia among immunodeficient individuals (42.4%) was similar to prevalence among those with CD4 counts > 350 cells/mm3 (40.8%; p = 0.695). These findings suggest that malaria parasitaemia is not an opportunistic infection among HIV-positive individuals in Nigeria.

Assessment of malaria parasitemia in people living with HIV/AIDS in Kumba, Cameroon

Background: Malaria parasitemia and HIV infections are globally important public health concerns. People residing in regions where these two infections are endemic are prone to develop co-infection. Sub-Saharan Africa has the greatest burden of both diseases and Cameroon particularly the South West Region has been reported as one of the regions with the highest malaria and HIV prevalence. Hence, there is a need for continuous monitoring and epidemiologic inquiry to generate updated data on the burden of malaria parasitemia on HIV/AIDS. The aim of this study was to determine the prevalence of malaria parasitemia and the association between viral load and malaria parasite density in people living with HIV/AIDS in Kumba, Cameroon. Methods: A cross-sectional study was conducted involving 250 people living with HIV/AIDS selected from five main Community Based Organizations in Kumba during a period of 5 months from April to August 2021. Participants’ consent was obtained followed by socio-demographic and other useful data via a standardized questionnaire. Capillary blood samples were collected and Giemsa-stained blood films were examined to detect malaria parasitemia. The recent viral loads were collected from the participants’ medical files. Pearson’s chi-square was used for the comparison of proportions and correlation analysis to determine the association between parasite density and viral load. Statistical significance was set at p &lt; 0.05. Results: An overall prevalence of malaria parasitemia in people living with HIV/AIDS in Kumba was 27.2%; [95% CI: 21.8% – 33.2%]. Among 215 participants who were HAART-experienced, 49(22.79%); [95% CI: 17.6% – 27.9%] were found to be positive for malaria parasitemia while 19(54.29%); [95% CI: 48.1% – 60.5%] out of the 35 HAART naïve individuals were positive for malaria parasitemia. This difference in prevalence was statistically significant (X2 = 15.078, df = 1, N = 250, p &lt; 0.000). Also, malaria parasite density was significantly dependent on viral load (X2 = 61.065, df = 6, N = 49, p &lt; 0.000). HAART-experienced participants with high viral load(&gt;1000copies/ml) had significantly higher malaria parasite density(&gt;400trophozoites/µL) than HAART-experienced participants with ‘not detectable’ viral load. Conclusion: The prevalence of malaria parasitemia in the study population was 27.2%. HAART naïve individuals had significantly higher malaria parasitemia prevalence and malaria parasite density than HAART-experienced individuals. Malaria parasite density was significantly dependent on viral load in HAART-experienced individuals.

Novel application of one-step pooled molecular testing and maximum likelihood approaches to estimate the prevalence of malaria parasitaemia among rapid diagnostic test negative samples in western Kenya

BackgroundDetection of malaria parasitaemia in samples that are negative by rapid diagnostic tests (RDTs) requires resource-intensive molecular tools. While pooled testing using a two-step strategy provides a cost-saving alternative to the gold standard of individual sample testing, statistical adjustments are needed to improve accuracy of prevalence estimates for a single step pooled testing strategy.MethodsA random sample of 4670 malaria RDT negative dried blood spot samples were selected from a mass testing and treatment trial in Asembo, Gem, and Karemo, western Kenya. Samples were tested for malaria individually and in pools of five, 934 pools, by one-step quantitative polymerase chain reaction (qPCR). Maximum likelihood approaches were used to estimate subpatent parasitaemia (RDT-negative, qPCR-positive) prevalence by pooling, assuming poolwise sensitivity and specificity was either 100% (strategy A) or imperfect (strategy B). To improve and illustrate the practicality of this estimation approach, a validation study was constructed from pools allocated at random into main (734 pools) and validation (200 pools) subsets. Prevalence was estimated using strategies A and B and an inverse-variance weighted estimator and estimates were weighted to account for differential sampling rates by area.ResultsThe prevalence of subpatent parasitaemia was 14.5% (95% CI 13.6–15.3%) by individual qPCR, 9.5% (95% CI (8.5–10.5%) by strategy A, and 13.9% (95% CI 12.6–15.2%) by strategy B. In the validation study, the prevalence by individual qPCR was 13.5% (95% CI 12.4–14.7%) in the main subset, 8.9% (95% CI 7.9–9.9%) by strategy A, 11.4% (95% CI 9.9–12.9%) by strategy B, and 12.8% (95% CI 11.2–14.3%) using inverse-variance weighted estimator from poolwise validation. Pooling, including a 20% validation subset, reduced costs by 52% compared to individual testing.ConclusionsCompared to individual testing, a one-step pooled testing strategy with an internal validation subset can provide accurate prevalence estimates of PCR-positivity among RDT-negatives at a lower cost.

Malaria Infection, Parasitemia, and Hemoglobin Levels in Febrile Patients Attending Sibu Sire Health Facilities, Western Ethiopia.

Background Malaria is endemic in tropical and subtropical regions and causes up to one million deaths each year. It mostly affects sub-Saharan African countries including Ethiopia. In Ethiopia, it was estimated that about 75% of the land and 68% of the population are exposed to malaria. The aim of the current study was to determine malaria cases, its impact on the level of hemoglobin, and parasitemia and predisposing factors among febrile patients who visited Sibu Sire Health Care centers. Methods Institution-based cross-sectional study was undertaken from May to October, 2020. Febrile patients who visited Sibu Sire Health Care centers were purposefully selected as the target population for the present study. Blood samples were collected and thick and thin smears stained with Giemsa. Hemoglobin level was determined using HemoCue Hb 301. Structured questionnaire and SPSS statistical software were used to collect and analyze data. P value < 0.05 was stated as statistically significant. Results The overall prevalence of malaria was 168/979 (17.2%) out of which Plasmodium falciparum was 132/168 (78.5%), Plasmodium vivax was 27/168 (16.1%), and mixed infection was 9/168 (5.4%). To assess factors associated with dependent variable and determine the strength of association, binary logistic regression was used at adjusted odds ratios with 95% confidence intervals. The associations between malaria cases, hemoglobin levels, and parasitemia were estimated to evaluate the impacts of malaria on hemoglobin levels and parasitemia level. Out of 979 febrile patients (male 453 and female 526), 168 (male 99 and female 69) individuals were infected with Plasmodium species and Plasmodium falciparum were the predominant parasites. The majority of the study participants 144/168 (85.7%) were from rural residences. Highest malaria-infected patients 74/168 (44%) were aged between 15 and 30 years old. The level of hemoglobin and parasitemia was highly associated with malaria cases; hence, in this study area, intensities of hemoglobin and parasitemia are significantly associated with Plasmodium species. Conclusion There was a moderate prevalence of malaria parasitemia and hemoglobin level among patients visiting Sibu Sire Health Care center; however, it needs further intervention to prevent and control malaria transmission in this malaria hotspot area.

Malaria Prevalence among Pregnant Women in Relation to Parity, Gestation Period and Age in Gombe, North Eastern Nigeria

This study was conducted in order to determine malaria prevalence in relation to parity, gestational period and age of the pregnant women in Gombe, Nigeria. Three hundred and eighty four (384) pregnant women who registered for antenatal care in five randomly selected health care facilities (Tudun Wada Primary Health Care, Idi Health Clinic, Madaki Health Clinic, Pantami Primary Health Care And Gombe Town Maternity) residing within Gombe Local Government Area, Gombe State, Nigeria, constituted the study population. Five (5) ml of the maternal peripheral blood was obtained from each participant by the use of a sterile syringe and placed in a sterile Ethylene Diamine Tetraacetic Acid (EDTA) container for laboratory analysis. The malaria parasite was detected by microscopic examination of Giemsa-stained thick blood films. A high prevalence of 78.4% was observed among the studied population, with the primigravidae having higher prevalence (87.8%) than the multigravidae (73.6%). Women in second trimester recorded the highest prevalence (81.6%) followed by those in third trimester (76.4%), then the first trimester (68.4%). In relation to age, younger women (17 – 20 years) had the highest prevalence (88.4%) of malaria parasitaemia followed by 21-25 years category (79.1%), while those above 25years had the lowest prevalence (67.7%).significant association between age and malaria infection was established. The vulnerable age group need to be cautious of their exposure to mosquitoes’ bites so as to reduce the pressure on the already overstretched health facilities.

Evaluation of Asymptomatic Malaria Antigenaemia and Parasitaemia in Human Immunodeficiency Virus-Infected Children in Benin City, Nigeria

Background: Malaria and HIV/AIDS are rampant in subSaharan Africa with prevalence of one reinforcing the other and control of one impactful on control of the other. Malaria parasitaemia (MP) prevalence is increased in HIV-infected individuals while certain drugs used in latter cause decline in MP but it is uncertain how they affect malaria antigenaemia (MA). How certain bio-social and disease characteristics affect MA and MP in this cohort is unknown.&#x0D; Objectives: To determine prevalence of asymptomatic MP and MA and their clinical and social determinants in HIV infected.&#x0D; Methods: In a prospective cross-sectional study carried out at the University of Benin Teaching Hospital (April to June 2016), 221 HIV-infected children (aged 1-17years) asymptomatic for malaria and 221 apparently healthy HIV-negative controls were studied. MA was assessed using rapid diagnostic test while MP was evaluated using microscopy. Standard method was used to determine parasite count.&#x0D; Results: Prevalence of asymptomatic MP was 24.4% in subjects and 17.6% in controls while MA prevalence in subjects and controls were comparable (20.8% vs 18.1%). Malaria parasitaemia rate (MPr) of 24.4% was higher than malaria antigenaemia rate (MAr) (20.8%). MP and MA rates were independent of socioeconomic status, access to anti-retroviral drugs, their duration of use and clinical disease stage.&#x0D; Conclusion: MA occurred frequently enough to warrant its use as malaria case definition surrogate in asymptomatic children with HIV/AIDS receiving trimethoprim-sulfamethoxazole prophylaxis and protease inhibitors.&#x0D; Authors&#x0D; M O Ibadin 1, N Eghafona 2

Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania.

In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.

The Rate of Asymptomatic Plasmodium Parasitemia and Placental Parasitization in Urban and Rural Areas of Cross River State, Nigeria

Background: Malaria in pregnancy contributes to feto-maternal morbidity and mortality even in asymptomatic forms of the disease especially in malaria endemic regions such as Nigeria. Objective: To determine the rate of asymptomatic malaria parasitemia and placental parasitization among the rural and urban pregnant women and its feto-maternal effects in Cross River State, Nigeria. Methodology: This was a prospective study of 440 pregnant women in rural and urban settings. Participants completed structured questionnaire and also have their blood samples and placentas examined for presence of malaria parasites by microscopy and histology respectively. Maternal hemoglobin concentration, birth weight, neonatal length, Apgar score and other anthropometric measurements were obtained to assess feto-maternal effect of asymptomatic malaria parasitemia and placental parasitisation in pregnancy. Data were analyzed using SPSS version 21.0 and level of significance was set as 0.05. ResultsThe prevalence of asymptomatic malaria parasitemia was 40.2% while malaria placental parasitization was 70.2%. Based on residential status, 49.5% of rural residents had malaria parasitemia which is significantly higher than their urban resident counterparts 30.9% (p=0.000). The prevalence of placental parasitization was significantly higher among rural residents 80.9% than their urban resident counterparts 59.5% (p=0.000). Concerning obstetric outcome of patients with positive malaria placental parasitisation, preterm delivery, low 5th minutes Apgar score (&lt;7), low birth weight (&lt;2.5kg) and low neonatal length were significantly higher in pregnancy with positive placental parasitisation than in women with negative placental malaria parasitisation. Also, preterm delivery, anemia, low 5th minutes Apgar score (&lt;7) and low birth weight (&lt;2.5kg) were significantly higher in pregnancy with positive malaria parasitemia than women with negative malaria parasitemia. ConclusionAsymptomatic malaria parasitemia (40.2%) and malaria placental parasitization (70.2%) in this study is high and contributes to poor obstetric outcomes mostly in the rural areas. Rural pregnant women have the highest burden than the urban women. Promotion of the use of ITNs, IPT during pregnancy and other malaria preventive measures are necessary especially in rural areas where malaria burden is highest.