Background:Globally, malaria cases increased from 228 million in 2018 to 282 million in 2024, with the African region accounting for 95% of the cases. Nigeria bears the highest malaria burden in the world, and pregnant women carry a significant number of the cases. Malaria in pregnancy (MiP) may have negative implications for maternal and neonatal health. The WHO-recommended intermittent preventive treatment using sulphadoxine-pyrimethamine (IPTp-SP) helps to prevent MiP, but its uptake is low in Nigeria. Using the theory of reasoned action (TRA), this study investigated the attitudes and intentions of pregnant women in Bayelsa State towards the use of IPTp-SP. Methods:The study adopted qualitative methods, including focus group discussions with pregnant women and key informant interviews with relevant community stakeholders. Six focus group discussions and seventeen key informant interviews were conducted with pregnant women and stakeholders, respectively. Data were managed using NVivo (version 12) and analysed thematically and deductively in line with the TRA. Results:Pregnant women had limited knowledge of preventing MiP and specifically IPTp-SP use. This resulted in a negative attitude towards the preventive technique. Interestingly, while the role of significant others, such as traditional birth attendants (TBAs), husbands and mothers-in-law, was acknowledged, many pregnant women did not succumb to the social pressure to use IPTp-SP when they did not think it was best for them. Many women intended to use IPTp-SP but had not done so at the time of the study due to structural barriers, poor access to facilities, and the unavailability of IPTp-SP. Conclusions:The use of IPTp-SP is poor among pregnant women in the sample. These women have their own will and are not necessarily pressured by social norms. Intentions may not translate to actual practice or use if structural barriers are not eliminated.
Background:Malaria transmission in the Sahel persists during the dry season despite low microscopic parasite prevalence, maintaining reservoirs that hinder elimination efforts. Understanding serological markers of Plasmodium falciparum gametocyte exposure may help identify hidden transmission reservoirs during low‑transmission periods. Materials and Methods:We conducted a cross‑sectional survey in Kéniéroba, Mali, at three time points representing key seasonal periods: December 2024 (end of rainy season), May 2025 (dry season), and August 2025 (rainy season). A total of 356 participants were enrolled across three age groups (5-8, 9-17, and ≥18 yrs). Parasitaemia and gametocytaemia were assessed by microscopy. IgG and IgM responses to clinically isolated late-stage gametocytes were quantified by ELISA, and seropositivity thresholds defined using malaria‑naïve controls. Results:Microscopic P. falciparum infection prevalence remained stable across surveys (~13%), but gametocyte carriage declined from 5.7% in December to ~2% in May and August, whereas gametocyte density was higher in the latter months. IgG/IgM seropositivity exceeded 95% throughout, with IgM peaking in May, consistent with recent antigenic stimulation. Age‑stratified analyses revealed weak but statistically significant associations between antibody levels and gametocyte carriage restricted to children aged 5-8 yrs, while no associations were observed in older children or adults. Conclusions:In conclusion, serological analyses indicate widespread and seasonally variable exposure to P. falciparum in Kéniéroba, with consistently high IgG and IgM responses to gametocytes reflecting intense background malaria exposure and cross‑reactive immunity from asexual stages. Seasonal and age‑stratified patterns identify school‑aged children as an important reservoir sustaining transmission. Although overall correlations with gametocyte carriage were weak, age‑specific associations suggest an age‑dependent relationship between antibody responses and carriage.
Until recently, the main cause of concern for those involved with malaria elimination was the emergence of insecticide and drug resistance. However, since the withdrawal of USA funding for malaria control, as well as dwindling foreign aid budgets of European countries, the additional concern that now exists is of a lack of finance in support of that work. This paper sets out to remind that with only limited finance and without reliance on insecticides, drugs or bednets, the launch took place of successful sustainable malaria control as far back as 1922, and the principles which were then applied are available for use elsewhere.
The work of Francesco Torti (1658-1741), who developed the use of cinchona bark, the source of quinine, to treat malaria, is examined in this paper. Torti was notable for his meticulous patient care and clinical observation during a period when humoral theories still influenced medical practice. He introduced the famous "fever tree" in his 1712 book, which detailed several forms of intermittent fevers and looked at how they responded to therapy. His efforts contributed to the growth of cinchona throughout Europe and is indicative of a larger trend in medicine toward a more patient-centred and experience-based approach.
Background:Despite ongoing efforts by both Guinean authorities and international stakeholders, malaria remains the leading public health challenge in Guinea, contributing to significant morbidity and mortality, especially among children under five. This study aimed to evaluate the effectiveness of distribution campaigns in increasing ownership and utilisation of long-lasting insecticide-treated nets (LLINs), to improve coverage among this high-risk population. Materials and Methods:A cross-sectional, community-based survey of 34 villages in Guinea (May-August 2025) assessed household LLIN ownership and use. A total of 316 household data records were collected door-to-door by Peace Corps Volunteers and trained local health workers using Google Forms or printed surveys in local languages. Households with and without recent LLIN distribution campaigns were compared using non-parametric Mann-Whitney U tests. Results:Campaign presence was associated with increased household ownership of at least one LLIN, from 45.8% to 94.5% (p < 0.0001). Mean population access to LLINs saw a three-fold increase from 20.8% to 72.9% (p < 0.001). LLIN use among children under five doubled from 24.8% to 50.0% (p < 0.001), while adult use rose from 28.3% to 42.0% (p = 0.052) in campaign-exposed areas. At the household level, net density reached the target of 1.00 net per sleeping space (up from 0.00; p < 0.001). While median ownership reached 1.00 net per bed, the median number of nets actually hung was only 0.55, indicating that logistical success has not yet translated into universal deployment. Conclusions:The LLIN distribution campaign was associated with substantially increased bednet ownership, population access, and use in Guinea, underscoring the critical role of such efforts by the Ministry of Health and international partners. However, underutilisation persists due to social, cultural, and practical barriers. Strengthening post-distribution support and targeted sensitisation campaigns is essential to ensure proper use and maximise protection for vulnerable populations.
Background:Malaria is highly prevalent in Gabon. The objective of this study was to assess adherence to WHO recommendations in the management of paediatric malaria in Franceville, south-east Gabon, and to identify factors influencing clinical decision making. Materials and Methods:This was a prospective observational study conducted from January 2021 to July 2023. Information regarding clinical examination, thick blood smear results, and the prescription of antimalarial drugs of paediatric children were collected anonymously following informed consent from parents or legal guardians. Data were analysed using R software (version 4.0.5), with descriptive statistics, Chi-square tests, and binary logistic regression to estimate crude and adjusted odds ratios with 95% confidence intervals at a significance level of p < 0.05. Results:A total of 3,195 children aged 0-16 years presenting with fever or a history of fever were included. Overall, 41.6% of patients tested positive by thick blood smear, and 21.4% of them had severe malaria. Despite negative thick blood smear results, 86.7% of patients received a presumptive diagnosis and 98.8% of them were treated with antimalarials. Symptoms significantly associated with a presumptive diagnosis were asthenia (aOR = 1.41; 95% CI [1.01-2.00]), headache (aOR = 1.71; 95% CI [1.02-3.03]), and nausea-vomiting (aOR = 1.95, 95% CI [1.20-3.31]). Conclusions:Despite access to parasitological testing, presumptive diagnosis remains common, exposing patients to potential overprescription and increased risk of drug resistance. Strengthening diagnostic capacity and continuous training of healthcare providers are essential to improve case management.
Background:Currently, the widely used antigen-based malaria rapid diagnostic tests (RDTs) in sub-Saharan Africa primarily detect Plasmodium falciparum histidine-rich protein 2 (PfHRP2). However, their diagnostic accuracy is being compromised by the increasing report of evolving parasite strains with deletion of pfhrp2 and pfhrp3 genes in malaria endemic regions. Therefore, elucidating local heterogeneity and addressing methodological variability are critical for guiding diagnostic strategies. Materials and Methods:We systematically searched PubMed and Google Scholar for studies published between 2015 to 2024 reporting the prevalence of pfhrp2 and/or pfhrp3 gene deletions. Eligible studies utilised molecular confirmation methods and provided regional or national prevalence estimates. A random-effects meta-analysis was conducted to estimate pooled prevalence and evaluate heterogeneity. Additionally, study methodologies and compliance with World Health Organization (WHO) guidelines were evaluated. Results:Forty-three studies from 60 sampling sites across Africa, the Americas, and Asia were included. The highest pooled prevalence of pfhrp2 deletion was observed in the Americas (35%, 95% CI: 17-55%), followed by Africa (9%, 95% CI: 4-17%) and Asia (3%, 95% CI: 2-4%). Markedly elevated high local deletion rates (>80%) were reported in specific areas of Ethiopia, Eritrea, Peru, and Colombia. Notably, substantial intra-national variability was evident, particularly within Central Africa and South America. Most studies (81%) complied with WHO-recommended protocols for deletion surveillance. Delays of 5-10 yrs between sample collection and publication were common, raising concerns about data timeliness although methodological heterogeneity in sampling strategies, molecular detection methods, and study design contributed to variability in reported estimates. Conclusions:High prevalence of pfhrp2/3 gene deletions compromises the effectiveness of PfHRP2-based RDTs in several regions. Countries with a prevalence rate of 5% and above are strongly encouraged to transition to alternative antigen-based RDTs, such as pLDH-based or combination tests. Standardising molecular surveillance methods, expediting data reporting and ensuring alignment with WHO protocols are critical to inform and sustain an evidence-based diagnostic framework tailored to region-specific malaria control policies.
In 1918, the British Army, having just defeated the Turkish Army in Palestine, intimated that the future of Palestine was considered hopeless due to the severity of malaria in the country. The British Army's victory was partially attributable to its employment for six months of thousands of mainly Egyptian labourers to control the disease in the country through destruction of mosquito breeding sites. When the control ceased on 19th September 1918, the disease returned shortly thereafter. Due to the disease, the country was desolate and was either almost empty or uninhabitable in many rural areas. With the dream of a Jewish Homeland somewhere in Palestine, the Zionists were obliged to view malaria control as a priority. But the Zionists were unable to conduct malaria control in the same manner as that carried out by the British Army due to lack of finances and manpower that were available to the British Army. The Zionists were obliged, therefore, to think creatively and set about launching the first start of a sustainable malaria control programme for the whole country, of which it is only now realised that it was also the first step anywhere in the decolonisation of malaria control, an approach that was conducted by all the inhabitants for all the inhabitants.
Background:Glucose-6-phosphate dehydrogenase (G6PD) deficiency, prevalent in malaria-endemic regions, has been associated with a reduced risk of severe malaria due to impaired parasite growth in deficient erythrocytes. The G6PD gene, located on the X chromosome, harbours various mutations associated with differing enzyme activity levels. This study investigates the prevalence of G6PD deficiency variants and their impact on parasite density and haemoglobin levels among malaria-positive patients in Awka, Anambra State, Nigeria. Materials and Methods:Blood samples were collected from 100 malaria positive participants; 64 participants with complete genotyping and clinical data were included in the analysis and screened for the A376G and G202A variants using PCR and Sanger sequencing. Results:Molecular analysis indicated that the B variant (normal) was predominant, with 83% of the participants possessing this variant. None of the participants tested had the A- variant, associated with G6PD defciency, suggesting no evidence of the G202A (A-) variant in this hospital-based sample. The B variant and the A+ variant showed no significant impact on the haemoglobin and parasitaemia levels of the study participants. Conclusions:The findings support the absence of the G202A (A-) variant in this cohort and show no detectable differences in parasitaemia or haemoglobin between A+ and B genotypes. Broader genotyping and/or G6PD enzyme activity testing in community representative samples is recommended before drawing population-level conclusions or informing treatment policy.
Background:Insecticide-treated nets (ITNs) are a core malaria vector control intervention recommended by the World Health Organization (WHO). To obtain WHO endorsement, ITNs must demonstrate sustained bio-efficacy after repeated washing through standardised laboratory and semi-field evaluations. Wash resistance (WR) is typically evaluated over 20 washes (WR20) to approximate three years of use. Routine WR20 testing is impractical for quality control. To address this, the Collaborative International Pesticides Analytical Council (CIPAC) introduced the Wash Retention Index (WRI), based on four consecutive daily washes. The WRI was defined as the fourth root of the ratio of insecticide content after four washes to the initial content and adopted as a quality-control specification. This article examines the WRI and the prediction of WR20 when including or excluding the first wash with the aim to define a WRI method that more accurately reflects WR20, while remaining practical. Because surface insecticide may increase during storage due to diffusion from the polymer, the effect of excluding the first wash from index calculations to reduce storage-related variability was assessed. Materials and Methods:WR data were extracted from WHO Pesticide Evaluation Scheme (WHOPES) reports, and WRI values calculated assuming 1-day washing intervals. Additional data were generated from polyester and polyethylene nets with insecticide content quantified. Results:When WR20 was regressed on WRI (including the first wash), the model fit was weaker and significant effects of insecticide chemistry and polymer were retained, indicating that WRI does not capture intrinsic wash-off kinetics. In contrast, new WR (excluding the first wash) explained more variance in WR20 (adjusted R2= 0.76 vs 0.71), with a slope approaching proportionality (0.66 vs 0.31) and with no residual effects of chemistry or polymer. Conclusions:Excluding the first wash from WRI improves prediction of WR20. First-wash loss reflects production and storage effects rather than intrinsic wash resistance. Wash resistance can be more intuitively expressed as the Wash-Off Rate Index (WORI), representing average wash-off between washes 1-5.
This paper examines the overlooked, forgotten or even ignored role played by malaria when considering the start of the Arab-Israel conflict in the Middle East. It would seem that anything associated with Zionism or Israel today is vilified, boycotted or shunned in certain quarters. Thus, by choosing to boycott anything that had a connection with Zionism or Israel, a study of the steps and events leading to the launch of the first start of sustainable malaria control has been missed, discouraging the malaria community of an opportunity to consider why and how certain methods were employed to achieve a desired successful outcome. In particular, there appears to be an attempt to suppress the fact that Palestine over 100 years ago was desolate, in many rural areas it was either almost empty or uninhabitable, due to the severity of the disease.
Background:Malaria remains a major public health challenge, causing high mortality and morbidity, particularly in developing countries. Microparticles (MPs), also known as plasma membrane-derived extracellular vesicles (PMEVs), are sub-cellular structures formed by budding off the plasma membrane. Although present in healthy individuals, their numbers increase during pathological conditions such as malaria. While several studies have examined proteins in cell-specific MPs, limited information exists on the protein composition of circulating MPs in malaria and their link to disease symptoms. This study aimed to perform proteomic analyses of MPs from malaria-positive samples, parasite culture supernatants, and healthy controls to elucidate their role in malaria infection. Materials and Methods:Plasma samples were obtained from forty-three (43) malaria diagnosed patients (cases) and ten (10) healthy individuals (controls). MPs were isolated from malaria parasite culture supernatant and confirmed using flow cytometry. 2D LC-MS was done to obtain their protein content. Resultant data were analysed using SPSS Ver. 21.0 statistical software, Kruskal Wallis test and Spearman's correlation coefficient r. Results:In all, 1806 proteins were isolated from the samples. The MPs from malaria-positive samples recorded 1729 proteins, those from culture supernatant 333 while the control samples recorded 234 proteins. The mean number of proteins in MPs of malaria positive samples was significantly higher than that in the control samples. Significantly, higher quantities of haemoglobin subunits were seen in MPs from malaria samples and culture supernatant compared to control samples. Conclusions:A great number of proteins were observed to be carried in the MPs from malaria samples and culture supernatant compared to controls. The greater loss of haemoglobin from erythrocytes via MPs from malaria patients could serve as the initiation and progression of anaemia in P. falciparum infection. Also while some proteins were up-regulated in circulating MPs in malaria, others were down-regulated.
Background:Malaria remains a major cause of morbidity and mortality among children under five in Cameroon. The recent introduction of the RTS,S/AS01 malaria vaccine provides an important opportunity to reduce the disease burden. However, little is known about caregivers' awareness and perceptions during the early vaccine rollout. This study explored caregivers' understanding, attitudes, and experiences regarding the malaria vaccine in selected urban and rural communities in the South West Region of Cameroon, forming part of a broader mixed-methods project aimed at informing strategies to strengthen vaccine uptake. Methods:An exploratory qualitative design was used, involving two focus group discussions with 20 mothers and caregivers of children aged 11-30 months. Participants were purposively selected to capture diverse perspectives across settings. Discussions examined awareness, perceived benefits, misconceptions, and contextual factors shaping vaccine uptake. Data were audio-recorded, transcribed, translated, and analysed thematically using an inductive deductive coding approach. Results:Findings showed that caregivers in the urban setting had high awareness of the malaria vaccine, though understanding was often limited and sometimes confused with other malaria interventions. Rural caregivers displayed uneven awareness but strong trust in health workers, which positively influenced acceptance. Across both settings, perceived benefits such as reduced severity of malaria episodes enhanced confidence in the vaccine. Barriers included communication gaps, misinformation, gender dynamics, long waiting times, and distance to health facilities. Caregivers recommended strengthening community-based communication through churches, town criers, health talks, outreach sessions, and visual materials. Conclusion:These findings highlight the importance of clear, consistent communication and trust-building as Cameroon expands malaria vaccine implementation. Enhanced community engagement and improved service delivery may support equitable uptake. The insights from this qualitative phase offer a foundation for further research within the wider mixed-methods project.
Background:While malaria elimination efforts in West African countries focus primarily on Plasmodium falciparum, non-falciparum malaria species could replace P. falciparum if their elimination is neglected. It is within this malaria control and elimination context that this article reviews the circulation of non-falciparum malaria species in the West African region. Methods:Non-falciparum related articles with a focus on the West African sub-region, published between 2000 and 2024, were selected using internet search engines Google Search, PubMed Central®, and the National Library of Medicine. The methodologies, including the study type, period, population, clinical symptoms, and diagnostic techniques used, plus the frequency of non-falciparum species, were reviewed. Results:A total of 31 articles about non-falciparum malaria were reviewed, including 2 (6.5%) each from Benin, Burkina Faso, and Ivory Coast, 4 (12.9%) each from Ghana and Nigeria, 5 (16.1%) from Mali, 3 (9.7%) from Niger, and 9 (29.0%) from Senegal. Of the 31 reviewed papers, P. falciparum was reported in 29 (93.5%), P. malariae in 25 (80.6%), P. ovale in 24 (77.4%), P. vivax in 11 (35.5%). Overall, 17 (54.8%) of the review papers used RDTs including 12 (70.6%) PfHRP2-based RDTs, and 5 (29.4%) of the malaria Ag P.f/Pan-based RDTs. Conclusion:This review describes and provides a better understanding of the circulation of non-falciparum malaria species in West Africa. In addition, it underscores the need to adapt malaria diagnostics by using more sensitive techniques, and to modify control strategies to investigate asymptomatic Plasmodium infections.
Background:Malaria remains a significant public health challenge in sub-Saharan Africa, disproportionately affecting children under five years of age. Understanding the spatial distribution of malaria and its associated risk factors is essential for implementing effective, targeted control strategies. In this study, we investigated spatial variation and key determinants of malaria prevalence among children under five in eight West African countries. Methods:The study used the most recent Demographic and Health Surveys Data from eight West African countries where malaria infection status was determined by microscopy. Generalised Linear Mixed Models were first used to explore associations between malaria infection and sociodemographic predictors, accounting for survey design. These models were extended into Generalised Linear Geostatistical Models to incorporate spatial random effects. Malaria prevalence was predicted at a 10 x 10 km resolution, and exceedance probability maps were generated to identify high-burden areas with prevalence exceeding 30%. Model validation was done using empirical variograms, PIT histograms, and residual spatial analyses. Results:The use of insecticide-treated mosquito nets was significantly associated with reduced odds of malaria infection in four of the eight countries included in the study, while younger child age (<2 years) was consistently associated with lower risk across all countries. In addition, marked spatial heterogeneity in malaria prevalence was observed, with high predicted prevalence in Benin and Cote d'Ivoire and lower prevalence in Ghana and Liberia. Conclusion:This study highlights the importance of geospatial approaches for understanding malaria transmission dynamics in order to tailor malaria control measures to local context. The findings underscore the need to strengthen the effective use of insecticide-treated nets and community-level vector control, while improving spatial surveillance and data integration to support context-specific malaria interventions.
Recent events, i.e., the demise of USAID, recognition of a State of Palestine, and the massacre of 7th October 2023 by Hamas, have seemingly come together to remind of the obstacles the Zionists had to overcome in Palestine more than 100 years ago when launching the start of the first sustainable rural malaria control programme. Here, I examine how the Zionists dealt with situations of a similar nature to these events all that time ago.
Background:Plasmodium vivax malaria, traditionally regarded as benign, is now recognised to cause severe illness. India bears a high burden of P. vivax malaria, yet data on its clinical spectrum and severity predictors remain limited. This study aimed to describe the clinical and laboratory profile of P. vivax malaria and identify risk factors for severe disease in a tertiary care setting. Materials and Methods:A retrospective study of 361 patients diagnosed with P. vivax malaria between June 2020 and May 2024 was conducted at a tertiary hospital in South Delhi, India. Diagnosis was confirmed by peripheral smear and/or rapid diagnostic tests. Patients were categorised into complicated and uncomplicated groups using WHO criteria. Demographic, clinical, and laboratory data were analysed with chi-square test, odds ratios, correlation analysis, and logistic regression. Results:Of 361 patients, 167 (46.3%) had complications. Mean age was 31 years with male predominance (64.6%), though complications were more frequent in females (42% vs. 32%, P=0.039). Anaemia (73.4%), thrombocytopenia (57.9%), and leucocytosis were common. Thrombocytopenia (OR 3.20, P<0.001) and leucocytosis (OR 2.37, P<0.05) were significantly linked to severity. Elevated creatinine (OR=6.07, P 0.001) and hyperbilirubinemia (OR=3.71, P<0.001) strongly correlated with complications. Breathlessness and pleural effusion were also more common in severe cases. Strong associations were observed between anaemia and hyperbilirubinemia (r 0.75), bleeding and ARDS (r 0.82), and mortality with shock (r=0.74). Conclusion:Nearly half of P. vivax cases developed severe complications, challenging its benign perception. Anaemia, thrombocytopenia, leucocytosis, and organ dysfunction were key severity markers. Higher complication rates in females and afebrile cases highlight diagnostic and social challenges. Early recognition of atypical features and vigilant monitoring are crucial to improve outcomes in endemic regions.
Background:Malaria is a leading cause of death in sub-Saharan Africa, which is home to more than 90% of both cases and deaths globally. Self-medication with antimalarials is a common practice in the region, mainly due to high malaria endemicity, poverty, and difficulty in accessing services in formal settings. Malaria self-medication is implicated in the rising trend of antimalarial drug resistance which threatens decades of gains made in controlling the disease. Previous studies have somewhat itemised the reasons for malaria self-medication and the factors driving it but have not been able to estimate the overall prevalence of the practice and its dynamics over time regarding period, region and country. Materials and Methods:Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic review of literature and meta-analysis on malaria self-medication in sub-Saharan Africa was conducted by searching PubMed, Cochrane Library, Web of Science, Scopus and Embase databases for relevant studies written in English and published up to 12th April, 2023, using a combination of different keywords derived from the main keywords ('malaria', 'self-medication' and 'sub-Saharan Africa'), broadening chances of retrieval by using Boolean operators 'OR' and 'AND'. Results:Twenty-seven studies met the inclusion criteria and were included in the review, giving rise to a pooled prevalence of 55.3% for malaria self-medication. Factors driving self-medication with antimalarials in the region include low-income level, cheap availability of non-prescription drugs, large family size, lack of health insurance, difficulty in accessing healthcare in formal settings and previous satisfactory use of specific drugs. Conclusion:Due to the underlying factors driving the practice, health authorities and regulatory agencies in sub-Saharan Africa should step up actions by incorporating stakeholders in the informal drug market into a framework that advocates for an enlightened use of antimalarial drugs in the management of the disease.
Background:The widespread use of histidine-rich protein 2 (HPR2)-based rapid diagnostic tests (RDTs), specific to Plasmodium falciparum in endemic areas may underestimate the weight of minor species such as P. malariae and P. ovale in malaria transmission. This study aimed to determine the extent of undetected P. malariae and P. ovale infections in children with positive diagnosis of uncomplicated malaria based on HRP2 RDT in the Nanoro health district, Burkina Faso. Materials and Methods:Children <5 yrs with uncomplicated malaria confirmed by HRP2 RDT were recruited from July 2021 to June 2022 in five peripheral health facilities of the Nanoro health district. Blood samples were collected from finger prick for malaria species identification by microscopy and nested PCR. The prevalence of P. malariae, P. ovale, and mixed infections was estimated as the ratio of positive cases over the total samples analysed. Binomial generalised linear models were used to assess the effect of age and sex on the positivity rate of mixed infections. Results:Over the study period, 207 children with uncomplicated malaria who tested positive for the HRP2 antigen were included. Microscopy detected 4 non-falciparum cases: 3 P. malariae and 1 P. ovale. In addition to these patent cases, sub-patent infection with P. ovale and P. malariae were detected in 6 and 5 cases, respectively. Mixed infections with non-falciparum species exhibited lower parasite densities than mono-infections with P. falciparum alone. There was no effect of gender or age on the mixed infection positivity rate (X2=0.16, p=0.683). Conclusion:The widespread use of HPR2-based RDTs underestimate the burden of non-falciparum species. In the context of eliminating malaria, new diagnostic tools allowing the detection of Plasmodium species other than P. falciparum must be deployed.
Background:Malaria is endemic in 96% of Uganda, making targeted malaria prevention programming critical to malaria elimination. In areas with low transmission rates prevention resources are limited to mass distribution of bednets every three years. Mosquito nets remain one of the most efficient and affordable malaria prevention strategies. While net distributions have increased net ownership, that has not translated to a comparable increase in net use. The Luwero District is one of two areas with increased rates of severe malaria between 2017-2021. Findings from previous studies indicate that there are a variety of factors associated with individuals choosing not to use a net even when available. Materials and Methods:This study examined community members' knowledge about malaria, their prevention methods, net ownership, net characteristics, and net use. Using a convenience sample of 106 adults, quantitative data were collected using a structured, in-person survey in four villages in central rural Uganda. Questions and response categories were read aloud; the researcher documented each response electronically. Descriptive statistics were used to characterise the sample populations. Theoretical constructs were compared between those with and without a recent diagnosis of malaria with the household. Logistic regression was used to determine the association between the theoretical constructs and recent malaria diagnosis after controlling for demographic characteristics. Results:Findings from this study indicate high rates of net ownership and self-reported use within the rural areas. Perceived susceptibility and barriers were greater among those with a recent diagnosis of malaria within the household. The positive association remained significant after controlling for household size. Conclusion:Understanding the specific factors related to individuals' knowledge and use of bednets is key to reducing rates of severe malaria.
