Slide Positivity Rate Research Articles

Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan.

Cutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks. To comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK. Microscopy and internal transcribed spacer-1 PCR-restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco. Urgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.'s genetic diversity and curtail its cross-border spread.

Strengthening Malaria Migration Surveillance at Village Level in Tanah Bumbu Regency, South Borneo, Indonesia

Tanah Bumbu Regency had implemented malaria migration surveillance in illegal mining areas. This study aimed to describe the implementation of malaria migration surveillance. The study conducted in five villages with high case incidence (HCI) i.e., Gunung Raya, Temunih, Mangkal Api, Guntung, and Teluk Kepayang, from March to October 2018. The study used an observational design with a cross-sectional approach, descriptive analysis for quantitative data, and thematic content for qualitative data. The research activity included a mass blood survey, malaria vector species, environmental survey, focus group discussion with mining workers, and in-depth interviews about the implementation of malaria migration surveillance. Socialization of malaria migration surveillance in 5 HCI villages has been carried out to the wider community. The slide positivity rate of malaria was 1.45% of 1996 participants and positive cases of malaria were detected in 75 subjects. Anopheles sp and potential larvae in swamps, rivers, ponds, and wells. Mine workers consider malaria as an occupational risk of working in forests. The workers are unwilling to get checked for blood examination or to report to the local Primary Health Centers (Puskesmas) before and after traveling to endemic areas. Cross-sectoral collaboration is carried out by community empowerment through village malaria posts

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.

India may need an additional metric to assess the endemicity of malaria in low surveillance districts.

India's National Framework for malaria elimination is essentially dependent on Annual Parasite Incidence (API). API is the primary criterion for classifying states and districts into different categories: intensified control, pre-elimination, elimination, prevention and re-establishment of malaria. However, API's validity is critically dependent on multiple factors, one such important factor is Annual Blood Examination Rate (ABER) and is often considered as indicator of operational efficiency. Therefore, the present study aimed to determine whether the API is a sufficiently good malaria index to assess malaria endemicity in India. An in-depth analysis of malaria data (2017-19) was done to determine the appropriateness of API as a sole indicator of malaria endemicity. We stratified the Indian districts into three strata based on Annual Blood Examination Rate (ABER): <5, 5.0-5.0, >15, further APIs was compared with Slide Positivity Rates (SPRs) using sign rank test, independently in each stratum. API and SPR were found comparable (p-value 0.323) in stratum 2 only. However, in the case of lower ABER (<5%, strata 1), the API was significantly lower than the SPR, and higher ABER (>15%), the API was found substantially higher than the SPR. Thus, ABER tunes the validity of API and should avoid to use as a single indicator of malaria endemicity. API is an appropriate measure of malaria endemicity in high and moderate transmission areas where surveillance is good (ABER≥5%). However, it is vitally dependent upon surveillance rate and other factors such as population size, the selection of individuals for malaria testing. Therefore, where surveillance is poor (<5%), we propose that API should be complemented with SPR and the number of cases. It will significantly aid the design and deployment of interventions in India.

Assessment of malaria prevalence in Boset District, East Shawa Zone, Oromia Regional State, Ethiopia: a retrospective study

ObjectiveIn this study, we aimed to assess the epidemiological profile and associated risk factors of malaria in Boset District using clinical records from the Boset District Health Office Central Surveillance Unit, East Shawa Zone, Oromia, Ethiopia.MethodsThis health facility-based retrospective cross-sectional study included clinical malaria data for 5 years (2016–2020) recorded at all public and private health facilities in the district.ResultsThe present study revealed an overall malaria slide positivity rate of 12.4% (21,059/169,986), ranging from 23.3% to 5.3% during 2016–2020 in Boset District. Malaria cases were recorded in all age groups, but individuals aged 15 years and above accounted for a higher (56.2%) average proportion of malaria cases. Concerning the relative proportion of malaria parasite species, Plasmodium falciparum was slightly predominant (58%) over P. vivax (42%).ConclusionThe present study revealed a declining trend in malaria cases over the 5-year study period in Boset District. Scaling up the available malaria prevention strategies and control measures is recommended to achieve malaria pre-elimination.

Trend of Malaria Burden Among Residents of Kisii County, Kenya After More Than a Decade Usage of Artemisinin Combined Therapies, 11-Year Laboratory Based Retrospective Study.

BackgroundMalaria remains a major vector borne disease globally, with the majority of the casualties reported in Africa. Despite this fact, there is drastic reduction in malaria infection using Artemisinin combined therapies (ACTs). Malaria is characterized by significant inconsistency in different geographical locations due to different confounding factors. There is need to identify zone-specific malaria trends and interventions to completely eliminate the disease. Thus the study was aimed at assessing the 11-year trend of microscopically confirmed malaria cases in Kisii County, Kenya, so as to devise area-specific evidence-based interventions, informed decisions, and to track the effectiveness of malaria control programs.MethodsThis was a retrospective study carried out to determine 11-year malaria trend rates centered on the admission and laboratory records from health facilities located at four Sub-Counties in Kisii County, Kenya. Parasitological positivity rates of malaria were determined by comparing with the register records in health facilities which recorded confirmed malaria cases with the total number of monthly admissions over the entire year. Data was analyzed by using descriptive tools and chi-square test.ResultsThere were 36,946 suspect cases, with 8449 (22.8%) confirmed malaria cases reported in this study. The overall malaria slide positivity rate over the last 11 years in the study area was 22.6%. The months of April and August showed the largest number of malaria cases (63%). The age group of ≥18 years contained the most positive confirmed cases, having a prevalence rate of 2953 (35.45%). Out of the confirmed malaria cases, 2379 (28.1%) were males and 6070 (71.9%) were females The highest malaria prevalence rate was recorded in 2014, with Marani Sub-County recording the highest positivity rate of 37.94%.ConclusionFrom the observed trends, malaria prevalence and transmission still remains stable in the study area. Thus more interventions need to be scaled up.

Moderate Rainfall and High Humidity During the Monsoon Season, Negligence in Using Malaria Protection Methods and High Proportion of Mild Symptomatic Patients Were the Driving Forces for Upsurge of Malaria Cases in 2018 Among Tea Tribe Populations in Endemic Dolonibasti Health Sub-center, Udalguri District, Assam State, North-East India.

Malaria elimination is a global priority, which India has also adopted as a target. Despite the malaria control efforts like long-lasting insecticidal nets distribution, rounds of indoor residual spray, the introduction of bi-valent rapid diagnostic tests and artemisinin combination therapy, malaria remained consistent in Dolonibasti sub-center of Orang block primary health center (BPHC) under the district Udalguri, Assam state followed by abrupt rise in cases in 2018. Therefore, we aimed to investigate the factors driving the malaria transmission in the outbreak area of Dolonibasti sub-center. Malaria epidemiological data (2008–2018) of Udalguri district and Orang BPHC was collected. The annual (2011-2018) and monthly (2013–2018) malaria and meteorological data of Dolonibasti sub-center was collected. An entomological survey, Knowledge, Attitude and Practices study among malaria cases (n = 120) from Dolonibasti was conducted. In 2018, 26.1 % (2136/ 8188) of the population of Dolonibasti were found to be malaria positive, of which 55% were adults (n = 1176). Majority of cases were from tea tribe populations (90%), either asymptomatic or with fever only, 67.5 % (81/120) had experienced malaria infection during past years. The outbreak was characterized by a strong increase in cases in June 2018, high proportion of slide falciparum rate of 26.1% (other years average, 15.8%) and high proportion of P. falciparum of 81.2 % (other years average, 84.3%). Anopheles minimus s.l. was the major vector with 28.6% positivity and high larval density in paddy fields/ drainage area. Annual relative humidity was associated with rise in malaria cases, annual parasite incidence (rs = 0.69, 90%CI; p = 0.06) and slide positivity rate (rs = 0.83, 95%CI; p = 0.01). Older people were less educated (rs = −0.66; p < 0.001), had lesser knowledge about malaria cause (rs = −0.42; χ2=21.80; p < 0.001) and prevention (rs = −0.18; p = 0.04). Malaria control practices were followed by those having knowledge about cause of malaria (rs = 0.36; χ2 = 13.50; p < 0.001) and prevention (rs = 0.40; χ2 = 17.71; p < 0.001). Altogether, 84.6% (44/52) of the respondents did not use protective measures. We described a sudden increase in malaria incidence in a rural, predominantly tea tribe population group with high illiteracy rate and ignorance on protective measures against malaria. More efforts that are concerted needed to educate the community about malaria control practices.

Spatiotemporal distribution of malaria prevalence in the district Anuppur, central India

Background: In the current study, 2013±16 medical data were examined to evaluate intervention effects on malaria prevalence in central India. Spatiotemporal variation in the distribution of malaria types (PV, PF, and PV-PF) was also investigated and geographical distribution of malaria prevalence in central India first time.Methods: The data was collected from the primary health centers, sub health centers, community health centers, and district hospital. The data was used for the calculation of annual blood examination rate, annual parasite incidence, blood slide positive rate, blood slide falciparum rate, % PF, % PV, and % PV-PF types of malaria. The rate of malaria was transformed ( ) for carrying out statistical analyses. ANOVA models were considered for analysis of the data. The minimum deviation informatics statistic has been used to compare the spatiotemporal distribution of malaria types. The spatiotemporal distribution maps of malaria prevalence and mosquito breeding sites were generated using the geographic component software ArcGIS 10.3.Results: The results display that space was an important significant factor for malaria prevalence. Kotma, one of the blocks of the study region displayed varying geographic patterns of dominance. The analysis for the presence of malaria types indicated that space was an important source of variation for the rate of malaria due to Plasmodium falciparum. The distributional patterns of the malaria types, as observed in the empirical data were tested using the MDIS statistic and findings indicate that the distributions of malaria types for the spatial points, namely Pushparajgarh, Kotma, and Anuppur were not the same over the selected time points. The geographical maps mainly displayed the active mosquito breeding sites in river areas and handpump areas namely Karpa, Laidara, Khamraudh, Rajendragram, Sivarichndas, Basaniha, Soniyamar, Kiragi. The maps also displayed 46% high risk, 34% moderate risk, and 20% low-risk area.Conclusions: The prevalence of malaria in this tribal-dominated area shows that was governed by mosquitogenic factors and their transmission.

Five-Year Trend Analysis of Malaria Cases in East Shawa Zone, Ethiopia

Malaria is an infectious disease caused by Plasmodium parasites. Of the five human malaria parasites Plasmodium falciparum and Plasmodium vivax are the two co-endemic predominant and widely distributed species in Ethiopia, with major public health importance. Even though enormous effort has been made countrywide to reduce the disease burden little was reported about trends of malaria transmission in the several localities of malarious areas like East Shawa Zone, Ethiopia. Thus, the present study was aimed at assessing fiveyear (2016-2020) trends of malaria transmission at Adama, Boset and Lume districts of East Shawa Zone of Oromia Regional State, Ethiopia. Retrospective data was extracted from the central surveillance database of East Shawa Zone Health Office. The data collected was analyzed from September 2020 to December 2020 to examine trends of malaria epidemiology in three malarious districts in the Zone. The results of the present study showed a remarkable decrease in slide positivity rate (SPR) from 16.3 to 1.4% from 2016 to 2018 in the areas. However, a recent slight increase of malaria SPR was observed. On the other hand, as age increases more male individuals were infected with malaria compared to female of similar age groups. Falciparum, vivax and mixed malaria infection accounted for 53%, 41% and 6% respectively. Even though, an overall reduction of malaria incidence was revealed in the study areas, an increase in malaria SPR was observed in 2019 and 2020. Such inconsistency in reduction of malaria cases in the study area demands due attention of health planners.

Prevalence of Malaria from Blood Smears: A Four-Year Retrospective Study from the Jean Claude Handrault Hospital, Southern Gabon

Background: Malaria remains a public health concern in developing nations despite the reduction of its burden worldwide. In Gabon, the prevalence of malaria has declined in major urban cities due to the implementation of the preventive strategies recommended by the World Health Organization. However, the few studies conducted in rural areas have revealed that malaria still poses threats. The scarcity of data on rural areas of Gabon in general, and the Haut-Ogooué province, in particular, has led us to conduct the present study. The main objective of this four-year retrospective study was to determine the slide positivity rate of malaria at JC ANDRAULT hospital of Mounana, Southern Gabon.&#x0D; Methods: Sociodemographic and clinical data from malaria suspected patients were collected from laboratory annual reports and analyzed.&#x0D; Results: The results revealed a mean annual prevalence of 67.43%, no statistical difference was recorded among the years. The mean malaria cases of female (896) patients were nearly double of that of male patients (467), and patients aged 5-18, and older than 18 were the most affected; both results were found to be statistically significant. Although two peaks malaria cases were recorded during the great rainy season (482) and small dry season (476), the difference among seasons was not statistically significant.&#x0D; Conclusion: The results of this study revealed that malaria transmission is high in the study area and thus preventive measures should be strengthen and extended to the older patients. This study is the first one to ever report the prevalence of malaria in a rural area of the Haut-Ogooué province.

A Retrospective Study of Malaria Trend in Libokemkem District Over the Last Five Years: North West Ethiopia.

BackgroundMalaria is a vector-borne disease caused by public health important Plasmodium species. Despite the fact that Ethiopia has implemented several malaria prevention and control techniques aimed at reducing its morbidity and death, it continues as major cause of morbidity and mortality in Ethiopia. Transmission dynamics are really critical for guiding the selection of the appropriate intervention in a given area. As a result, the goal of this study was to analyze the trend of malaria prevalence over the last five years in the Addis Zemen health center.MethodsAn institutional-based retrospective analysis on malaria data from 2015/16 to 2019/20 was undertaken in Addis Zemen health center of Libokemkem district. The data collectors thoroughly and systematically collected the results of 15,452 blood films performed over a five-year period from the malaria registration book in the health center. Any data missing species and stage of the parasite, as well as sociodemographic characteristics, date, month, and year of blood film performed, were omitted from the study. Finally, data were entered and analyzed using SPSS version 25, with P-values of less than or equal to 0.05 deemed statistically significant variables.ResultsThe overall malaria slide positivity rate over the last five years in the study area was 10.9%. From 2015/16 to 2018/19, the positive rate fell, then it spiked in 2019/20. Plasmodium falciparum was the most common parasite found, accounting for 72.6% of the total. The months of October, November, May, June, August, and September showed the largest number of malaria cases. Males, rural residents, and adult population groups were more affected by malaria, according to multivariate logistic regression (P ≤0.05).ConclusionThere was high malaria morbidity case in 2019/20 as compared to the remaining years. Therefore, malaria control, prevention, and intervention programs in the district should be strengthened.

Modeling Annual Parasite Incidence of Malaria in Indonesia of 2017 using Spatial Regime

Malaria is an infectious disease caused by the Plasmodium parasite and transmitted through infected female Anopheles mosquitoes. The morbidity of malaria is determined by Annual Parasite Incidence (API) per year. A region with high malaria cases can spread malaria to other regions. Therefore, the purpose of this study is to determine the spatial regimes and factors that significantly influence the spread of malaria in Indonesia of 2017. Spatial regime is a method obtained by clustering the coefficient values from the well-known method in modeling spatial varying relationship namely geographically weighted regression (GWR). The data used in this study are malaria Passive Case Detection (PCD) from Puskesmas throughout Indonesia in 2017. The results show three groups which can be classified as regencies/cities with low, medium moderate and high API, while slide positivity rate and annual blood examination are predictors who influent API numbers in Indonesia significantly.

Molecular characterization and genetic diversity of cutaneous leishmaniasis from North Eastern Pakistan

The genetic diversity of Leishmania spp. in North Eastern Pakistan remains undetermined despite increased cases of cutaneous leishmaniasis (CL). This study was designed to decipher the molecular characterization and genetic diversity of Leishmania spp. in North Eastern Pakistan. Out of 13761 CL suspected cases, 567 cases were microscopically positive and confirmed as Leishmania spp. by internal transcribed spacer (ITS) gene amplification through the PCR- RFLP technique. Further, isolates were directly sequenced to conduct phylogenetic analysis for genetic diversity. Among suspected CL cases, Mirpur showed the highest proportion of CL infection with 4.85% (118/2431) of the cases, while the Neelum district showed the lowest percentage at 3.29% (9/273). The slide positivity rate, annual blood examination rate, and annual parasite incidence rate were 3.84, 0.27, and 0.01% respectively, and the incidence of CL in the age group 1–20 years old was higher in males (50.92%) than females (25.75%). The RFLP analysis and sequencing confirmed the occurrence of Leishmania tropica, Leishmania major, and Leishmania infantum. Leishmania tropica (p = 0.02) confirmed significantly higher nucleotides variation than L. major (p = 0.05). Current findings confirmed the prior assumption that anthroponotic CL is the primary CL form present in North Eastern Pakistan. Moreover, this is the first report based on molecular identification of L. major, and L. infantum from North Eastern Pakistan. This remarkable heterogeneity in the Leishmania spp. is the leading cause of treatment failure and emergence of new haplotypes. Therefore more extensive investigations are recommended from all geographical regions of North Eastern Pakistan, especially those using a large sample size.

Digitized smart surveillance and micromanagement using information technology for malaria elimination in Mangaluru, India: an analysis of five-year post-digitization data

BackgroundMalaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This has facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case, data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence.MethodsIT system developed for robust malaria surveillance and field response is being continued in the sixth year. Protocol for surveillance control was followed as per the national programme guidelines mentioned in an earlier publication. Secondary data from the malaria control system was collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria maps were also analysed.ResultsSmart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitization (DY) (p < 0.001). Early reporting of new cases (within 48 h) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closures by 14 days. The best impact on reduction in incidence of malaria was recorded in the pre-monsoon months (~ 85%) compared to lower impact in July–August months (~ 40%).ConclusionMCS helped to micromanage control activities, such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.

Spatial Clustered Regression Analysis of 2017 Getis Score Indonesian Malaria Prevalence Data

Malaria is a disease that is still endemic to Indonesia. In the national scale, morbidity rate related to malaria continued to decline from 2009 to 2017. Eastern areas of Indonesia (namely Papua, West Papua, and East Nusa Tenggara) still have high endemic levels of malaria, while western areas (Islands Sumatera and Java) mostly have low endemic levels or even free of malaria. This indicates that malaria has a clustering pattern. This research used the Annual Parasite Incidence (API) data as the dependent variable and Slide Positivity Rate (SPR), Annual Blood Examination Rate (ABER), number of positive cases on children aged 1-14 years, and the number of Plasmodium falciparum cases and Plasmodium vivax cases data as the independent variables. Since they contain spatial autocorrelation, Getis Ord G_i were employed in the clustered regression analysis. Finite Mixture Model was employed as the clustering method. This study resulted in the forming of 3 clusters. Cities/regencies belonging to Cluster-1 were neither hotspots nor coldspots. Elements of Cluster-2 are SPR hotspots. Elements of Cluster-3 are hotspot areas of API, ABER, number of Plasmodium falciparum cases, number of Plasmodium vivax cases, and number of cases on children aged 1-14 years. Cluster-1 consists of 360 cities/regencies located in Islands Kalimantan, Sulawesi, Sumatera, and Java, and North Maluku Province. Cluster-2 consists of 88 cities/regencies, mostly located in provinces South Sumatera, Bengkulu, Lampung, Banten, DKI Jakarta, and West Java. Cluster-3 consists of 66 cities/regencies located in the Papua Island and East Nusa Tenggara Province.

Prevalence and associated factors of malaria in Pushparajgarh block of district Anuppur, Madhya Pradesh, India

Background: The current study aimed to determine the prevalence of malaria and its association with seasonality of malaria and socio-demographic variables in a tribal dominated district Anuppur (Madhya Pradesh).Methods: This cross-sectional study was based on blood films for malaria parasites (BFMP) data obtained from primary health centers, sub-health centers, community health centers and district hospital. This study was also based on household survey for information on malaria awareness and type of treatment preferred for malaria. From 2014-2016, a household survey was conducted regarding the type of treatment available, assessment of the influence of demographic factors, knowledge, awareness and education on malaria occurrence. Odds ratio were used to analyse the association between the gender, age group, season and types of malaria infection.Results: Annual blood examination rate (11.81%) and slide vivax rate (0.66%) was highest in 2016. There was decrease in slide falciparum rate in 2016 (1.52%). Slide positivity rate was 3.78%, 3.73% and 2.74% in the years 2014-16. Annual parasite incidence rate was 3.20%, 3.82% and 3.07% in the years 2014-16. Plasmodium falciparum positivity rate was 78.13%, 78.17% and 54.49% in the study years and was highest among the females and in the age group of 26 years and above. Distinct seasonality was observed correlating with population dynamics of the vector and climatic and socio-demographic conditions.Conclusions: The prevalence of malaria in tribal dominated Pushparajgarh area showed seasonality that was governed by mosquitogenic factors, their transmission and socio-demographic status of the population.

A report on incidence of COVID-19 among febrile patients attending a malaria clinic.

Context:Screening for malaria and coronavirus disease (COVID-19) in all patients with acute febrile illness is necessary in malaria-endemic areas to reduce malaria-related mortality and to prevent the transmission of COVID-19 by isolation.Aims:A pilot study was undertaken to determine the incidence of SARS-CoV-2 infection among febrile patients attending a malaria clinic.Subjects and Methods:All patients were tested for malaria parasite by examining thick and thin blood smears as well as by rapid malaria antigen tests. COVID-19 was detected by rapid antigen test and reverse transcriptase–polymerase chain reaction in patients agreeing to undergo the test.Results:Out of 262 patients examined, 66 (25.19%) were positive for Plasmodium vivax, 45 (17.17%) for Plasmodium falciparum (Pf) with a slide positivity rate of 42.40%, and Pf% of 40.50%. Only 29 patients consented for COVID-19 testing along with malaria; of them, 3 (10.34%) were positive for COVID-19 alone and 2 (6.89%) were positive for both COVID-19 and P. vivax with an incidence of 17.24%. A maximum number of patients (196) did not examine for COVID-19 as they did not agree to do the test.Conclusion:Diagnosis of COVID-19 among three patients (10.34%) is significant both in terms of identification of cases and to isolate them for preventing transmission in the community. Detection of COVID-19 along with malaria is equally important for their proper management.

Identification of Mutations in Antimalarial Resistance Gene Kelch13 from plasmodium falciparum Isolates in Kano, Nigeria.

Malaria control relies on first-line treatments that use artemisinin-combination therapies (ACT). Unfortunately, mutations in the plasmodium falciparum kelch13 gene result in delayed parasite clearance. Research on what is causing ACT failure is non-existent in northwestern Nigeria. Thus, the presence of mutations in kelch13 in P. falciparum isolates from Kano, Nigeria was investigated in this study. Microscopic examination of 154 blood samples obtained from patients revealed a high prevalence of P. falciparum infection (114 positive individuals, slide positivity rate = 74.03%). The 114 patients were administered Cartef® (ACT) and out of the 50 patients that returned for the 14-day follow up, 11 were positive for P. falciparum (slide positivity rate = 22%). On day 0, 80 samples out of 114 and 11 samples on day 14 (91 out of 125 microscopy-positive samples) were positive with Plasmodium according to the PCR of cytochrome oxidase I, which corresponds to 72.8%. A fragment of the kelch13 gene encompassing the propeller domains was sequenced in 49 samples, alongside samples of the susceptible strain pf_3D7. Low polymorphism was observed, suggesting a lack of selection on this gene, and only six mutations (Glu433Gly, Phe434Ile, Phe434Ser, Ile684Asn, Ile684Thr and Glu688Lys) were found. The epidemiologic impact of these mutations and their potential role in ACT resistance needs to be investigated further.

A twenty-eight-year laboratory-based retrospective trend analysis of malaria in Dakar, Senegal.

IntroductionHealth facility-based records offer a rich source of information to understand trends and changes in malaria cases over time. This study is aimed at determining the changes in malaria occurrence over the last 28 years, from 1989 to 2016 in Dakar, Senegal.MethodsLaboratory suspected and confirmed malaria records from 1989 to 2016 were reviewed from the laboratory registers of the Laboratory of Parasitology and Mycology of Aristide Le Dantec Hospital. Interrupted time series (ITS) analysis was used to estimate the changes by comparing malaria cases post-intervention (2006–2016) with that of the pre-intervention (1989–2005) period.ResultsA total of 5,876 laboratory confirmed malaria cases were reported out of 29,852 tested cases, with total slide positivity rate (SPR) of 19.7%. Malaria case counts exhibited a fluctuating trend with major peaks occurring in the years 1995 and 2003 with SPR of 42.3% and 42.5%, respectively. Overall, a remarkable decline in the total number of laboratory confirmed malaria cases was observed over the last 28 years. P. falciparum was almost the only reported species, accounting for 99.98% of cases. The highest SPR was observed in the age group of under five years during the pre-intervention period while this shifted to the age group of 6–15 years old for the subsequent years. Two major malaria peak seasons were observed: one in September during the pre-intervention period and the other in November for the post-intervention period. The ITS analysis showed a dramatic decline of 83.6% in SPR following the scale-up of interventions in 2006.ConclusionA remarkable decline in laboratory confirmed malaria cases in Dakar over 28 years was observed. The period of rapid decline in malaria SPR coincided with the scale-up in interventions beginning in 2006 with the introduction of ACTs, followed by the widespread introduction in 2008 of bed nets treated with insecticides. Robust surveillance data should be maintained in the context of malaria elimination efforts.

Molecular epidemiological survey of cutaneous leishmaniasis from Azad Jammu and Kashmir, Pakistan.

Cutaneous leishmaniasis (CL) is an emerging neglected tropical disease in Azad Jammu and Kashmir which is an underdeveloped area. Prevalence and parasite species identification are the key factors to control disease in a particular population, which were the objectives of the present study. Due to a lack of previous data, we performed a district-based active CL surveillance in 2018. The data of CL, suspected (n = 20,000) cases were analyzed statistically and identified the parasite species in microscopic positive cases by ITS1-PCR RFLP and also obtained accession numbers MN891719-28 from gene Bank. The phylogenetic tree was constructed using MEGA6 software. Out of 20,000 CL, suspected cases the highest rate of 4.02% (135/3360) of CL in Mirpur and the lowest 1.58% (8/505) in Neelum was reported. The slide positivity rate, annual parasite incidence rate and annual blood examination rate were 2.27 per 1000 population, 0.08 and 0.34%. The males were more infected 58.12% (297/511) than females 41.88% (214/511) and the age group of 1–20 years were found highly infected 82.78% (423/511) than 21–40 years 13.89% (71/511) and 41–60 years 3.33% (17/511) in the studied population. The patients 56.36% (288/511) had a single lesion whereas 29.35% (150/511) had two, only 10.76% (31/288) and 8% (12/150) were using bed nets. The patients 14.29% (73/511) had three or more lesions were not using bed nets. Only 27.98% (143/511) patients had received treatment, while 72.02% (368/511) didn't. Microscopically positive cases were found to be 2.56% (511/20,000) and ITS1-PCR positive cases were found to be 91.39% (467/511). The RFLP assay confirmed the presence of Leishmania tropica in 467 samples.