Risk Factors For Malaria Research Articles

Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya.

While many studies have characterized mobility patterns and disease dynamics of settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the variability of their environments, reduce their access to health care, and limit the number of intervention strategies suitable for their lifestyles. Quantifying the movements and their associated disease risks will be key to developing interventions more suitable for mobile populations. Turkana, Kenya is an ideal setting to characterize these relationships. While the vast, semi-arid county has a large mobile population (>60%) and was recently shown to have endemic malaria, the relationship between mobility and malaria risk in this region has not yet been defined. Here, we worked with 250 semi-nomadic households from four communities in Central Turkana to 1) characterize mobility patterns of travelers and 2) test the hypothesis that semi-nomadic individuals are at greater risk of malaria exposure when migrating with their herds than when staying at their semi-permanent settlements. Participants provided medical and travel histories, demographics, and a dried blood spot for malaria testing before and after the travel period. Further, a subset of travelers was given GPS loggers to document their routes. Four travel patterns emerged from the logger data, Long Term, Transient, Day trip, and Static, with only Long Term and Transient trips being associated with malaria cases detected in individuals who carried GPS devices. After completing their trips, travelers had a higher prevalence of malaria than those who remained at the household (9.2% vs 4.4%), regardless of gender and age. These findings highlight the need to develop intervention strategies amenable to mobile lifestyles that can ultimately help prevent the transmission of malaria.

Subclinical malaria among pregnant women living in refugee settlements in Northern Uganda.

Malaria during pregnancy contributes to significant perinatal morbidity and mortality, accounting for almost 25% of global maternal mortality. However, the epidemiology and risk factors for subclinical malaria among pregnant women living in refugee settlements is poorly understood. To determine the prevalence and predictors of subclinical malaria among pregnant women in refugee settlements in Northern Uganda. We conducted a multi-center, cross-sectional study. The study was conducted between April and June 2023 and involved pregnant women aged 18-45 years attending routine antenatal care (ANC) at three health facilities serving refugee communities in Adjumani district, Uganda. We collected sociodemographic, environmental, maternal, and obstetric factors using a structured questionnaire. Both CareStart Malaria HRP-2/pLDH (Pf/Pan) combo rapid diagnostic test (RDT) and blood smear microscopy with 3% Giemsa staining were simultaneously performed on samples from each patient. Logistic regression analysis identified factors independently associated with subclinical malaria, reported as adjusted odds ratios (aORs) and 95% confidence intervals (CIs). We enrolled 304 pregnant women, with a mean age of 25 years. In total, 68.8% (n = 209) had lived in the settlement for over 12 months, 25.7% (n = 78) were primigravida, and 1.0% (n = 3) were living with HIV. Malaria prevalence was 5.3% (n = 16) by RDT and 3.2% (n = 10; seven Plasmodium falciparum and three P. malariae) by microscopy. Only 4 (25.0%) of the RDT-positive cases were also positive by microscopy (Cohen's kappa: 0.278-Fair agreement). All participants were asymptomatic. Factors associated with higher odds of subclinical malaria included primiparity (aOR: 2.79, 95% CI: 1.25-6.25, p = 0.013), ⩾4 ANC visits (aOR: 2.41, 95% CI: 1.34-4.34, p = 0.003), and residence in the settlement for less than 12 months (aOR: 2.54, 95% CI: 2.0-3.22, p < 0.001). Living in the settlement for over 3 years, being primigravida, and being married were associated with 68%, 50%, and 68% lower odds of subclinical malaria, respectively (aOR: 0.32, 95% CI: 0.13-0.79, p = 0.014; aOR: 0.50, 95% CI: 1.22-5.52, p = 0.016; aOR: 0.32, 95% CI: 0.13-0.78, p = 0.012). Our study reveals the high prevalence of subclinical malaria among pregnant women in refugee settlements, particularly among primiparous women and recent arrivals. The poor agreement between RDT and microscopy suggests the need for dual screening in asymptomatic pregnant women.

Fine-Scale Spatial Prediction on the Risk of Plasmodium vivax Infection in the Republic of Korea.

Malaria elimination strategies in the Republic of Korea (ROK) have decreased malaria incidence but face challenges due to delayed case detection and response. To improve this, machine learning models for predicting malaria, focusing on high-risk areas, have been developed. The study targeted the northern region of ROK, near the demilitarized zone, using a 1-km grid to identify areas for prediction. Grid cells without residential buildings were excluded, leaving 8,425 cells. The prediction was based on whether at least one malaria case was reported in each grid cell per month, using spatial data of patient locations. Four algorithms were used: gradient boosted (GBM), generalized linear (GLM), extreme gradient boosted (XGB), and ensemble models, incorporating environmental, sociodemographic, and meteorological data as predictors. The models were trained with data from May to October (2019-2021) and tested with data from May to October 2022. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). The AUROC of the prediction models performed excellently (GBM = 0.9243, GLM = 0.9060, XGB = 0.9180, and ensemble model = 0.9301). Previous malaria risk, population size, and meteorological factors influenced the model most in GBM and XGB. Machine-learning models with properly preprocessed malaria case data can provide reliable predictions. Additional predictors, such as mosquito density, should be included in future studies to improve the performance of models.

Plasmodium infections and associated risk factors among parturients in Jawi district, northwest Ethiopia: a cross-sectional study

BackgroundPregnant women have an increased risk of Plasmodium infections and disease. Malaria in pregnancy is a major public health problem in endemic areas. Assessment of the burden and risk factors of malaria in pregnancy across different malaria transmission settings is required to guide control strategies and for malaria elimination. Thus, the current study is generating such evidence from parturient women in northwest Ethiopia.MethodsA cross-sectional study was conducted among 526 pregnant women admitted to the delivery rooms of selected health facilities in Jawi district, northwest Ethiopia, between November 2021 and July 2022. Data on the socio-demographic, clinical, obstetric, and malaria prevention practices of pregnant women were collected using interviewer-administered questionnaires and from women’s treatment cards. Malaria was diagnosed by light microscopy, rapid diagnostic test, and multiplex real-time polymerase chain reaction. Risk factors for malaria were evaluated using bivariable and multivariable logistic regression models. A P-value of < 0.05 was considered statistically significant.ResultsAmong the examined parturient women, 14.3% (95% CI 11.4–17.5%) had Plasmodium infections. The prevalence of peripheral, placental, and congenital malaria was 12.2% (95% CI 9.5–15.3%), 10.9% (95% CI 8.2–14.1%), and 3.7% (95% CI 2.3–6.1%), respectively. About 90.6% of peripheral and 92% of placental Plasmodium infections were asymptomatic. Plasmodium infection at parturiency was independently predicted by maternal illiteracy (AOR = 2.03, 95% CI 1.11–3.74), primigravidity (AOR = 1.88, 95% CI 1.01–3.49), lack of antenatal care follow-up (AOR = 2.28, 95% CI 1.04–5.03), and history of symptomatic malaria during pregnancy (AOR = 4.2, 95% CI 2.32–7.59). Moreover, the blood group O phenotype was significantly associated with placental malaria among the primiparae.ConclusionsOverall, asymptomatic Plasmodium infections were prevalent among parturients in northwest Ethiopia. Maternal illiteracy, primigravidity, lack of antenatal care follow-up, and history of symptomatic malaria during pregnancy were the risk factors for malaria during parturiency. Thus, promotion of a healthy pregnancy through ANC follow-up, strengthening malaria prevention and control practices, and screening of malaria in asymptomatic pregnant women are suggested to reduce its burden in pregnancy.

Rituximab Is Associated with an Increased Risk of Malaria Infection in a Malaria-Endemic Region

Rituximab has become a standard of care for the treatment of lymphoproliferative B-cell neoplasms, such as diffuse large B cell lymphoma (DLBCL). As an anti-CD20 monoclonal antibody, rituximab depletes the B lymphocyte compartment and is associated with downstream impairment in humoral immunity and increased risk of infections. While such infections are often bacterial, non-bacterial infections also do occur. Malaria is a vector-borne protozoal infection caused by plasmodium species and is endemic in most parts of sub-Saharan Africa (SSA) where HIV infection is also endemic and an independent risk factor for malaria. Most studies evaluating the safety and efficacy of rituximab were in non-endemic malaria areas with a low prevalence of HIV in the US and Europe. Therefore, the effect of rituximab-induced immunodeficiency on malaria-specific immunity and the risk of malaria among DLBCL in malaria-endemic regions is not well established. The incidence of DLBCL in SSA is increasing due to the growth and aging of the population as well as epidemic levels of HIV infection. The objective of this retrospective study is to evaluate the risk for malaria infection among DLBCL patients treated with standard chemotherapy in Malawi, a malaria-endemic country with high HIV prevalence. We performed a retrospective analysis of 96 patients, aged ≥18 with DLBCL from the Kamuzu Central Hospital (Lilongwe, Malawi) Lymphoma Study, a prospective observational cohort treated with CHOP or R-CHOP 2013-2019. Symptomatic malaria cases were determined by retrospective chart review and defined as individuals with documented positive malaria rapid diagnostic test (MRDT) or peripheral blood film (PBF) during treatment or up to one year of follow-up. Laboratory malaria cases were individuals with positive P. falciparum histidine-rich protein 2 (HRP2) antigenemia using quantitative ELISA at mid-treatment (2 months), completion (4 months), or post-treatment (12 months). HRP2 antigenemia is suggestive of current or very recent P. falciparum malaria infection. Unadjusted odds ratios were calculated for risk factors for malaria using logistic regression. Treatment regimens varied slightly with 59 patients (62%) receiving CHOP, and 37 (38%) receiving R-CHOP. Fourteen of the 96 DLBCL (14.6%) patients developed symptomatic malaria during the treatment period and the remainder remained free of malaria-associated symptoms. Symptomatic malaria was not significantly associated with age, gender, DLBCL stage, number of treatment cycles received, prior history of TB, performance status, HIV infection, or HIV RNA viral load &amp;gt; 1,000 copies. However, among the symptomatic malaria cases, five (36%) received CHOP, and nine (64%) received R-CHOP. Patients treated with R-CHOP were more likely to develop symptomatic malaria than CHOP patients (OR 3.38, 95% CI 1.05-12.26; p=0.03). Thirty-two (24 CHOP, 8 R-CHOP) patients were positive for malaria based on the HRP-2 antigen test and there was no correlation with rituximab treatment. However, HRP-2 antigen concentrations were significantly higher in R-CHOP patients compared to CHOP patients (2.3 OD vs 0.58 OD; p=0.01). To our knowledge, this is the first study to evaluate the effect of rituximab on malaria risk among DLBCL patients treated with chemotherapy in a malaria-endemic region. This study suggests that rituximab increases the risk of symptomatic malaria in adult DLBCL patients. Data investigating the effect of rituximab on malaria-specific antibody production is currently being analyzed. Further studies are needed to determine whether antimalarial chemoprophylaxis should be implemented to improve the comprehensive care of cancer patients residing in malaria-endemic areas.

Assessing risk factors for malaria and schistosomiasis among children in Misungwi, Tanzania, an area of co-endemicity: A mixed methods study.

Malaria and schistosomiasis are two major parasitic vector-borne diseases that are a particular threat to young children in Sub-Saharan Africa. In the present study, we investigated factors that are associated with malaria, schistosomiasis, and co-infection among school-aged children, using an explanatory sequential mixed-methods approach. A cross-sectional study was conducted in January 2022 in Misungwi, Tanzania, that sampled 1,122 children aged 5 to 14 years old for malaria and schistosomiasis infection. Mixed-effect logistic regression models were used to assess the association between infection prevalence or seroprevalence, and environmental determinants that create favorable conditions for vectors and parasites and social determinants that relate to disease exposure. Community mapping combined with direct field observations were conducted in August 2022 in three selected villages from the cross-sectional study to understand specific water use behaviors and to identify potential malaria mosquito larval breeding sites and freshwater snail habitat. The prevalence of malaria, seroprevalence of schistosomiasis, and co-infection in this study were 40.4%, 94.3%, and 38.1%, respectively. Individual-level factors emerged as the primary determinants driving the association with infection, with age (every one-year increase in age) and sex (boys vs girls) being statistically and positively associated with malaria, schistosomiasis, and co-infection (P<0.05 for all). Community maps identified many unimproved water sources in all three villages that were used by humans, cattle, or both. We found that children primarily fetched water, and that unprotected wells were dedicated for drinking water whereas ponds were dedicated for other domestic uses and cattle. Although not identified in the community maps, we found hand pumps in all three villages were not in use because of unpleasant taste and high cost. This study improves our understanding of individual, social and environmental factors that are associated with malaria, schistosomiasis, and co-infection, which can inform potential entry points for integrated disease prevention and control.

Modelling the Linear and Nonlinear Effects of Malaria Risk Factors on Child Mortality

Generalized additive model was used to analyse data from Nigeria standard demographic and health survey (NDHS) 2018. The sample consists of 10609 children aged 6-59 months who were tested for malaria parasitemia through the rapid diagnostic test (RDT). Child mortality data was obtained by calculating the difference between the number of children ever born and the proportion of children alive during the survey. The analysis was carried out in R version 4.1.1 via mgcv package. The results obtained indicated linear and nonlinear effects of malaria risk factors on child mortality. The findings also revealed mosquito bed net usage, wealth index, maternal education, type of place of residence and malaria test outcome as significant predictors of child malaria mortality.

Modeling clinical malaria episodes in different ecological settings in Mali, 2018-2022

ObjectivesFollowing the scaling-up of malaria control strategies in Mali, understanding the changes in age-specific prevalence of infection and risk factors associated with remains necessary to determine new priorities to progress toward disease elimination. This study aimed to estimate the risk of clinical malaria using longitudinal data across three different transmission settings in Mali. MethodsCohort-based longitudinal studies were performed from April 2018 to December 2022. Incidence of malaria was measured through community health center-based passive case detection. Generalized estimation equation model was used to assess risk factors for clinical malaria. ResultsA total of 21,453 clinical presentations were reported from 4500 participants, mainly from July to November. Data shows a significant association between malaria episodes, sex, age group, season, and year. Women had lower risk, the risk of clinical episode increased with age up to 14 years then declined, and in both sites, the dry-season risk of clinical episode was significantly lower compared to the rainy season. ConclusionDetermining factors associated with the occurrence of clinical malaria across different ecological settings across the country could help in the development of new strategies aiming to accelerate malaria elimination in an area where malaria transmission remains intense.

Evaluation of the Public Perception Regarding Malaria during Pregnancy among Expectant Mothers at Bitereko Health Center III in Mitooma District

The study aimed to evaluate how pregnant mothers at Bitereko Health Center III in Mitooma district perceive malaria during pregnancy and propose preventive interventions. Employing a descriptive cross-sectional design encompassing qualitative and quantitative methods, the research involved 100 participants from the health center. Data analysis utilized Microsoft Excel and SPSS software. Results indicated that 80% of pregnant women were knowledgeable about malaria prevention, including the use of insecticide-treated nets and environmental measures like clearing bushes and stagnant water. However, 20% lacked awareness regarding preventive measures. Identified predisposing risk factors for malaria during pregnancy encompassed poor nutrition, poverty hindering access to balanced diets, unsanitary conditions fostering mosquito breeding sites, and inadequate antenatal care. The study found significant associations between age, occupation, mental state, and education level with knowledge and perception of malaria in pregnancy. Recommendations included government-led health education during antenatal care focusing on malaria causes, prevention, and management of associated complications. Regular medical check-ups before and after delivery were encouraged, along with the consistent use of mosquito nets and other preventive measures against malaria. Keywords: Malaria in pregnancy, Insecticide-treated mosquito nets, Pregnant mothers, Mosquito, antenatal care.

The provision of malaria services in border districts of four countries in Southern Africa: results from a cross-sectional community assessment of malaria border health posts

BackgroundThe importation of parasites across borders remains a threat to malaria elimination. The Southern African Development Community Malaria Elimination Eight (E8) established 39 border health facilities on 5 key international borders between high and low-burden countries. These clinics aimed to improve access to prevention, diagnosis, and treatment of malaria for residents in border areas and for mobile and migrant populations who frequently cross borders. Studies were conducted in each of the four high-burden E8 countries (Angola, Mozambique, Zambia, and Zimbabwe) to evaluate malaria services in border areas.MethodsCross-sectional surveys were conducted within 30 km of recently established E8 Border Health Posts. Structured questionnaires were administered to randomly selected respondents to assess malaria-related knowledge and behavior, access to malaria prevention, diagnosis and treatment of malaria, and risk factors for malaria associated with local and cross-border travel.ResultsResults showed that most providers followed appropriate guidelines performing blood tests when individuals presented with fever, and that nearly all those who reported a positive blood test received medication. Lack of access to health care due to distance, cost or mistrust of the provider was rare. A minority of respondents reported not receiving timely diagnosis either because they did not seek help, or because they were not offered a blood test when presenting with fever. There was a high level of correct knowledge of causes, symptoms, and prevention of malaria. A majority, of border residents had access to primary prevention against malaria through either long-lasting insecticidal nets (LLINs) or indoor residual spraying (IRS). Cross border travel was common with travellers reporting sleeping outside without protection against malaria.ConclusionsThe study demonstrated the importance of border health facilities in providing access to malaria services. Prevention needs to be improved for people who travel and sleep outdoors. Community health workers can play a key role in providing access to information, testing and treating malaria.

Bayesian belief network modelling approach for predicting and ranking risk factors for malaria infections among children under 5 years in refugee settlements in Uganda

BackgroundMalaria risk factors at household level are known to be complex, uncertain, stochastic, nonlinear, and multidimensional. The interplay among these factors, makes targeted interventions, and resource allocation for malaria control challenging. However, few studies have demonstrated malaria’s transmission complexity, control, and integrated modelling, with no available evidence on Uganda’s refugee settlements. Using the 2018–2019 Uganda’s Malaria Indicator Survey (UMIS) data, an alternative Bayesian belief network (BBN) modelling approach was used to analyse, predict, rank and illustrate the conceptual reasoning, and complex causal relationships among the risk factors for malaria infections among children under-five in refugee settlements of Uganda.MethodsIn the UMIS, household level information was obtained using standardized questionnaires, and a total of 675 children under 5 years were tested for malaria. From the dataset, a casefile containing malaria test results, demographic, social-economic and environmental information was created. The casefile was divided into a training (80%, n = 540) and testing (20%, n = 135) datasets. The training dataset was used to develop the BBN model following well established guidelines. The testing dataset was used to evaluate model performance.ResultsModel accuracy was 91.11% with an area under the receiver-operating characteristic curve of 0.95. The model’s spherical payoff was 0.91, with the logarithmic, and quadratic losses of 0.36, and 0.16 respectively, indicating a strong predictive, and classification ability of the model. The probability of refugee children testing positive, and negative for malaria was 48.1% and 51.9% respectively. The top ranked malaria risk factors based on the sensitivity analysis included: (1) age of child; (2) roof materials (i.e., thatch roofs); (3) wall materials (i.e., poles with mud and thatch walls); (4) whether children sleep under insecticide-treated nets; 5) type of toilet facility used (i.e., no toilet facility, and pit latrines with slabs); (6) walk time distance to water sources (between 0 and 10 min); (7) drinking water sources (i.e., open water sources, and piped water on premises).ConclusionRanking, rather than the statistical significance of the malaria risk factors, is crucial as an approach to applied research, as it helps stakeholders determine how to allocate resources for targeted malaria interventions within the constraints of limited funding in the refugee settlements.

Epidemiology of malaria in Rohingya refugee camps in Bangladesh within 2017–2020

BackgroundMalaria causes significant morbidity and mortality in tropical and sub-tropical regions, particularly in humanitarian emergencies including refugee camps in malaria endemic areas. An epidemiological investigation was conducted on malaria disease distribution and risk factors in the world’s largest refugee settlement, the Rohingya refugee camps on the south-eastern border area of Bangladesh, within 2017–2020.MethodsFrom February 2017 to March 2020, 30,460 febrile patients were tested for malaria using light microscopy and rapid diagnostic tests. Most were self-presenting symptomatic patients and a minority were from door-to-door malaria screening. Diagnostic tests were done by trained medical technologists upon the advice of the concerned physicians in the camps. Test positivity rate (%) and annual parasite incidence were calculated and compared using chi-squared (χ 2) test or odds ratios.ResultsThe overall average annual test positivity rate (TPR) was 0.05%. TPR was highest in people who had travelled to the forest in the previous 2 months, at 13.60%. Cases were clustered among male adults aged 15–60 years. There were no cases among children under five years or pregnant women and no deaths from malaria.ConclusionThis study found very few malaria cases among Rohingya refugees with the majority of cases being imported from hilly forested areas, which were thus assumed to act as the reservoir for transmission.

Malaria and Typhoid Fever Coinfection among Febrile Patients in Ngaoundéré (Adamawa, Cameroon): A Cross-Sectional Study.

Malaria and typhoid fever remain the major cause of morbidity and mortality in tropical and subtropical countries. It is common today to see patients being concurrently infected or treated for the two diseases. The aim of the present study was to determine the prevalence of malaria, typhoid fever, and their coinfection among febrile patients at Ngaoundéré Regional Hospital, Adamawa, Cameroon. Methodology. A cross-sectional and descriptive study was conducted on 208 febrile patients coming for medical consultation at Ngaoundéré Regional Hospital and suspected for malaria and/or typhoid fever from September to November 2019. After receiving the consent of each patient, clinical and sociodemographic information were collected using a pretested semistructured questionnaire. Thereafter, blood samples were collected and subjected to (i) blood film examination for malaria detection and (ii) qualitative and semiquantitative Widal assay for typhoid fever detection. Plasmodium falciparum was the only species identified, and the prevalence of malaria was 50.0% (n = 104). The seroprevalence of typhoid fever was 64.3% (n = 133). The malaria and typhoid fever coinfection was 30.3% (n = 63). The coinfection between S. paratyphi (A, B, and C) and malaria was also observed with the prevalence ranging from 32.2 to 63.9%. Female group and children from 2 to 10 years old were the most affected groups by the two infectious agents. Typhoid fever and malaria were more prevalent in Ngaoundéré City, particularly in children and women. Further studies should be done on the risk factors of malaria and typhoid fever coinfection in different study areas.

Risk factors of malaria transmission in mining workers in Muara Enim, South Sumatra, Indonesia

Eliminating malaria by 2030 is stated as goal three in the UN’s Sustainable Development Goals (SDGs). However, malaria still remains a significant public health problem. This study aims to identify the factors determining malaria transmission in artisanal or small-scale miner (ASM) communities in three villages: Tanjung Agung, Tanjung Lalang, and Penyandingan, located in the Tanjung Enim District, Muara Enim, South Sumatra, Indonesia. Researchers conducted a cross-sectional study involving 92 participants from the study area. They used a logistic regression model to investigate the risk factors related to malaria occurrence. The multivariable analysis revealed that age (Adjusted Prevalence Ratio (APR) = 7.989 with 95% CI 1.724–37.002) and mosquito breeding (APR = 7.685 with 95% CI 1.502–39.309) were risk factors for malaria. On the other hand, higher education (APR = 0.104 with 95% CI 0.027–0.403), the use of mosquito repellent (APR = 0.138 with 95% CI 0.035–0.549), and the condition of house walls (APR = 0.145 with 95% CI 0.0414–0.511) were identified as protective factors. The current study highlights age and mosquito breeding sites as risk factors for malaria. Additionally, higher education, insect repellent use, and the condition of house walls are protective factors against malaria. Therefore, reducing risk factors and increasing protective measures through effective communication, information, and education are highly recommended to eliminate malaria in mining areas.

A malaria risk model for the Mediterranean in antiquity based on the historical Carta della Malaria dell’Italia

ABSTRACT Growing interest in the health burden of malaria in ancient times is complimented by recent DNA confirmation of its presence at several archaeological sites in the Mediterranean. This study presents a model of ancient malaria risk for the region with utility for synthesis and application. The GIS-based model combines malaria risk factors that can be reasonably known for pre-modern times. Calibration, verification, and validation of the model is possible through use of a detailed map of pre-eradication malaria endemicity in Italy, the 1882 Carta della Malaria dell’Italia. The model provides a cross-disciplinary tool by bringing technical GIS capabilities to the evaluation of textual sources having potential malarial connections. The study’s main product is an open access relative malaria risk layer for GIS use and application to historical reconstruction. Example maps using model output and potential use are presented.

Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design.

Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.

Spatial Clustering and Risk Factors for Malaria Infections and Marker of Recent Exposure to Plasmodium falciparum from a Household Survey in Artibonite, Haiti.

Targeting malaria interventions in elimination settings where transmission is heterogeneous is essential to ensure the efficient use of resources. Identifying the most important risk factors among persons experiencing a range of exposure can facilitate such targeting. A cross-sectional household survey was conducted in Artibonite, Haiti, to identify and characterize spatial clustering of malaria infections. Household members (N = 21,813) from 6,962 households were surveyed and tested for malaria. An infection was defined as testing positive for Plasmodium falciparum by either a conventional or novel highly sensitive rapid diagnostic test. Seropositivity to the early transcribed membrane protein 5 antigen 1 represented recent exposure to P. falciparum. Clusters were identified using SaTScan. Associations among individual, household, and environmental risk factors for malaria, recent exposure, and living in spatial clusters of these outcomes were evaluated. Malaria infection was detected in 161 individuals (median age: 15 years). Weighted malaria prevalence was low (0.56%; 95% CI: 0.45-0.70%). Serological evidence of recent exposure was detected in 1,134 individuals. Bed net use, household wealth, and elevation were protective, whereas being febrile, over age 5 years, and living in either households with rudimentary wall material or farther from the road increased the odds of malaria. Two predominant overlapping spatial clusters of infection and recent exposure were identified. Individual, household, and environmental risk factors are associated with the odds of individual risk and recent exposure in Artibonite; spatial clusters are primarily associated with household-level risk factors. Findings from serology testing can further strengthen the targeting of interventions.

Malaria Risk Drivers in the Brazilian Amazon: Land Use-Land Cover Interactions and Biological Diversity.

Malaria is a prevalent disease in several tropical and subtropical regions, including Brazil, where it remains a significant public health concern. Even though there have been substantial efforts to decrease the number of cases, the reoccurrence of epidemics in regions that have been free of cases for many years presents a significant challenge. Due to the multifaceted factors that influence the spread of malaria, influencing malaria risk factors were analyzed through regional outbreak cluster analysis and spatio-temporal models in the Brazilian Amazon, incorporating climate, land use/cover interactions, species richness, and number of endemic birds and amphibians. Results showed that high amphibian and bird richness and endemism correlated with a reduction in malaria risk. The presence of forest had a risk-increasing effect, but it depended on its juxtaposition with anthropic land uses. Biodiversity and landscape composition, rather than forest formation presence alone, modulated malaria risk in the period. Areas with low endemic species diversity and high human activity, predominantly anthropogenic landscapes, posed high malaria risk. This study underscores the importance of considering the broader ecological context in malaria control efforts.

Effects of Insecticide-Treated Nets and Stagnant Water on the Risk of Malaria: A Meta-Analysis

Background: Malaria infection is a global public health problem that causes major morbidity worldwide. Stagnant water is one of the risk factors for malaria, insecticide-treated nets are one of the interventions that can prevent malaria. This study aims to estimate the magnitude of the effect of using insecticide-treated nets and stagnant water around the house on the risk of malaria. Subjects and Method: This study was conducted using a systematic review and meta-analysis with PICO, Population: children. Intervention: insecticide-treated mosquito nets and stagnant water. Comparison: without insecticide-treated nets and no stagnant water. Result: incidence of malaria. By searching for articles in 3 databases namely PubMed, Google Scholar, and Science Direct published from 2016 to 2023, by entering the following keywords insecticide-treated bed nets” OR “ITN” AND “stagnant water” OR “STAGNA” AND “Malaria” AND “Cross-sectional” AND “Multivariate Analysis”. Articles were selected using the PRISMA flow and data analysis using the Review Manager 5.3. Results: There are 13 articles using a cross-sectional study design with a total sample of 5,793 children from Indonesia, Cameroon, Nigeria, and Ethiopia which have gone through a systematic review and meta-analysis. Processed data showed that children who used insecticide-treated nets had a 0.65 times lower chance of contracting malaria compared to those who did not use insecticide-treated nets (aOR= 0.65; 95% CI= 0.41 to 1.01; p= 0.060). Children who live in an environment where there is stagnant water have a 4.10 times chance of getting malaria compared to children who live in an environment where there is no stagnant water and this is statistically significant (aOR= 4.10; 95% CI= 2.80 to 6.03; p &lt;0.001). Conclusion: Insecticidal mosquito nets reduced the incidence of malaria, and stagnant water increased the incidence of malaria. Keywords: insecticide-treated nets, stagnant water, STAGNA, children Correspondence: Atika Dwi Minawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir Sutami No.36, Kentingan, Jebres, Surakarta, 57126, Central Java. Email: dwiminawatiatika@gmail.com. Mobile: +625212613303.

Malaria surveillance, outbreak investigation, response and its determinant factors in Waghemra Zone, Northeast Ethiopia: unmatched case–control study

Malaria is a major global public health concern, with around half of the world's population at risk of infection. It is one of the most common epidemic-prone diseases, resulting in on-going epidemics and significant public health problems. On September 12, 2022, Waghemra Zone malaria monitoring data revealed that the district was suffering an unusually high number of malaria cases. Therefore, the aim of this study was to assess the occurrence of malaria outbreaks and investigate contracting factors in Waghemra Zone, Northeast Ethiopia. A community-based case–control study with a 1:1 ratio was employed at Waghemra Zone from September 14 to November 27, 2022. A total of 260 individuals (130 cases and 130 controls) were included in the study. A structured questionnaire was used to collect the data. Malaria cases were confirmed by either microscopy or malaria rapid diagnostic tests. The magnitude of the outbreak was described by place, person, and time. A multivariable logistic regression analysis was conducted to identify malaria risk factors. A total of 13,136 confirmed cases of malaria were detected in the Waghemra zone, with an overall attack rate of 26.5 per 1000 and slide positivity rate was 43.0%. The predominant species was Plasmodium falciparum accounting for 66.1%. Children under five years old (AOR = 5.1; 95% CI 2.6–23.0), the presence of artificial water-holding bodies (AOR: 2.7; 95% CI 1.340–5.420), intermittent rivers closer to the living house (AOR = 4.9; 95% CI 2.51–9.62), sleeping outside a home (AOR = 4.9; 95% CI 2.51–9.62), and a lack of knowledge about malaria transmission and prevention (AOR: 9.7; 95% CI 4.459–20.930) were factors associated with malaria contraction. The overall attack rate for malaria during this outbreak was high. Children less than five years, the presence of mosquito breeding sites, staying outdoors overnight, and a lack of knowledge on malaria transmission and prevention were predictors of malaria. Early management of local vector breeding places, as well as adequate health education on malaria transmission and prevention methods, should be provided to the community to prevent such outbreaks in the future.