Climate change is recognized as a critical determinant of malaria transmission in the coming decades. This manuscript synthesizes testimonies from six African countries (Chad, Côte d’Ivoire, Democratic Republic of the Congo (DRC), Madagascar, Rwanda, and Senegal) highlighting how climate variability has recently influenced malaria epidemiology and how national malaria control programmes (NMCPs) are adapting. The correlation between changing patterns of rainfalls, floodings, and how they affect the expansion of mosquito vector habitats with malaria transmission has been reported. Adaptive strategies adopted by the NMCPs include integrating climate and health data, strengthening surveillance and establishing early warning systems, engaging and educating communities, promoting multisectoral collaboration, and leveraging technology and innovation. However, systemic barriers, such as limited data integration capacity, infrastructural deficits, behavioural factors, and financial constraints, continue to impede effective implementation of adaptive strategies. Addressing these barriers requires sustained political commitment, enhanced technical capacity, operational and implementation research, and long-term investment in climate-resilient health systems. The findings offer valuable insights for broader regional efforts to align malaria control strategies with climate change.

Mass drug administration (MDA) has emerged as a promising strategy for reducing malaria incidence in many African countries. A pilot study of MDA in the Tambacounda health district in southeastern Senegal had a significant impact on reducing the malaria burden. This led the Senegalese National Malaria Control Program (NMCP) to consider scaling up MDA to the district level. However, the infrequent use of MDA has resulted in limited knowledge of its use in the specific context of Senegal. In this work, we propose a mathematical model based on impulsive differential equations that integrates asymptomatic carriers to analyze the impact of MDA on malaria incidence in the region. To this end, we explore four different scenarios of MDA operational factors: 1) the number of MDA rounds, 2) the time interval between rounds, 3) the campaign coverage, and 4) the campaign start date. We find that MDA operational factors should not be oversimplified, as they play a critical role in the effectiveness of MDA campaigns. Our model predicts that successful MDA campaigns are obtained with high MDA coverage, multiple rounds within a year, an interval of five to six weeks between rounds, and an intervention that starts in the first month of the transmission period (mid-to-late July). In addition, we find that the starting campaign date and the interval between are highly correlated. These findings suggest that outcomes of MDA campaigns can be improved by optimizing operational factors for specific malaria-endemic settings. When implementing multiple MDA rounds, it is crucial to optimize these factors so that the intervention covers the entire period of high transmission and reaches most of the target population.

Background: Artemisinin-based combination therapies (ACTs) remain the cornerstone of malaria treatment in Africa. However, the emergence of Plasmodium falciparum artemisinin partial resistance associated with mutations in the pfk13 gene in Southeast Asia and East Africa raises concern about its potential emergence or spread to West Africa. This study aimed to investigate whether therapeutic efficacy study (TES)-defined treatment failures in Senegal are associated with pfk13 mutations using targeted amplicon deep sequencing (TADS). Methods: A total of 182 P. falciparum isolates collected during TES conducted between 2020 and 2022 in Senegal were analyzed. These included paired Day 0 (D0)/Day of Failure (DF) samples (n=112) and additional D0 samples (n=70) analyzed in pools. The pfk13 gene was sequenced using TADS, and single nucleotide polymorphisms (SNPs) were identified and compared with WHO-validated artemisinin resistance markers. Results: Among the 182 samples, 23 SNPs were identified in the pfk13 gene, including both synonymous and non-synonymous variants. Six non-synonymous mutations (D547Y, V566L, A578S, V589I, E596D, and V637I) were detected at very low within-sample allele frequencies (<1%). None corresponded to validated or candidate artemisinin resistance-associated mutations. Analysis of paired D0/DF samples showed no enrichment or selection of pfk13 mutations in post-treatment samples, indicating that observed treatment failures were not associated with pfk13 -mediated artemisinin resistance. Conclusion: This study provides no evidence of pfk13 -mediated artemisinin resistance in Senegal between 2020 and 2022. The absence of validated resistance mutations and the lack of association between pfk13 variants and treatment failure support the continued efficacy of ACTs in this setting. These findings highlight the importance of integrating TES outcomes with genomic surveillance to detect early signals of resistance and inform malaria control strategies in West Africa.

Background:Malaria remains a major cause of illness and death among children under five in Senegal, particularly in remote areas inhabited by transhumant herders who have limited access to health services. To address these gaps, the National Malaria Control Program implemented a community-based home management (CBHM) strategy in the Ferlo region of Matam, integrating One Health principles to engage animal and environmental health actors. Methods:A cross-sectional study was carried out describing the said CBHM-Ferlo strategy. Data were collected by document review and activity report exploitation on the DHIS2 platform. It focused on the IMCI target group (children under five) living in a mobile (transhumance) mode. The community-based home care providers (CBHCPs) were selected within and by their own transhumant herder's community to early detect and care of childhood illness (diarrhea, respiratory infection, malaria, etc.) on the one hand; and to reinforce vitamin A supplementation, deworming and immunization coverage on the other hand. Results:The strategy's principle was "Making the home, the first 'hospital' of communities" with a total of 2307 cases seen by CBHCPs including 1464 cases of fever. The malaria testing rate of 98.9 % with a positivity rate of 21.1 %, 96.4 % of which were on artemisinin-based combination therapies. Regarding diarrhea, 209 cases were detected with 67.9 % of treatment rate based on oral rehydration solution and zinc. In terms of respiratory infections, cough/cold occurred in 96.5 % of cases, and pneumonia cases were treated 55.6 % of cases with amoxicillin. Finally, 1156 children were supplemented with vitamin A, while 443 children were dewormed, and 129 children were raised awareness and referred for immunization. Conclusion:Thus, CBHM-Ferlo strategy improved the care of childhood illness in Matam in 2024, and above all highlights the added value of One Health and transdisciplinary approaches.

BackgroundThe World Health Organization conditionally recommends reactive drug administration to reduce malaria transmission in settings approaching elimination. However, few studies have evaluated the impact of reactive focal drug administration (rFDA) in sub-Saharan Africa, and none have evaluated it under programmatic conditions. In 2016, Senegal's national malaria control programme introduced rFDA, the presumptive treatment of compound members of a person with confirmed malaria, and reactive mass focal drug administration (rMFDA), an expanded effort including neighbouring compounds during an outbreak, in 10 low transmission districts in the north of the country. This evaluation sought to measure the impact of rFDA and rMFDA on malaria incidence.MethodsAn interrupted time series analysis was conducted with routine surveillance data on health post-level monthly confirmed malaria case counts from the District Health Information Software (DHIS2). The study evaluated the change in incidence following rFDA and rMFDA rollout (level change), which ranged from August 2016 to November 2019, and monthly thereafter (trend change), using an adjusted negative binomial regression model with data from January 2015 through January 2020. The model was used to estimate the number of cases averted via a counterfactual simulation.ResultsNo incidence rate reductions were estimated immediately following rollout (level change: incidence rate ratio (IRR) = 1.00, 95% credible interval (CI) = 0.76, 1.33). However, rFDA and rMFDA were associated with a 4% monthly decline in incidence relative to the baseline trend (trend change: IRR = 0.96, 95% CI = 0.95, 0.98). Over the study period, RFDA and rMFDA were estimated to avert 2,070 (95% CI = 577, 4,367) of 4,108 (95% CI = 2,620, 6,425) malaria cases.ConclusionsRFDA and rMFDA were associated with reduced malaria incidence in northern Senegal, supporting their use in malaria control in very low transmission areas. However, additional strategies are likely needed to achieve elimination in this setting.

Background:Rapid Diagnostic Tests (RDTs) remain the frontline tool for malaria diagnosis, but their performance in detecting low-density infections is variable and poorly characterized at the population level. Objective:This study aimed to evaluate the diagnostic performance of HRP2-based RDTs by integrating high-throughput bead-based HRP2 quantification into school-based malaria surveys. Methods:A cross-sectional study was conducted in three Senegalese districts (Diourbel, Tambacounda, and Kédougou), enrolling 3,748 school-aged children. All participants were tested using RDTs, and dried blood spots were analyzed with a multiplex bead-based HRP2 assay. A Gaussian mixture model was used to classify HRP2 positivity, and logistic regression assessed the relationship between HRP2 concentration and RDT outcome. Results:The overall RDT positivity rate was 7.2%, with marked heterogeneity across districts (Diourbel: 3.0%, Kédougou: 15.9%, Tambacounda: 7.6%). HRP2 concentration was the strongest predictor of RDT positivity (aOR: 14.55 per log10 increase, 95% CI: 11.14-19.00). RDT limits of detection (LOD95) varied significantly: 3.9 ng/mL in Tambacounda, 121.2 ng/mL in Kédougou, and 204.3 ng/mL in Diourbel. Conclusion:RDTs remain a useful surveillance tool, particularly in moderate- to high-transmission settings. However, reduced sensitivity at lower antigen concentrations in hypo-endemic areas highlights the value of complementary high-sensitivity assays for elimination-focused strategies. Future research should explore the application of these integrated diagnostic approaches in regions without seasonal malaria chemoprophylaxis intervention.

Despite the World Health Organization’s recommendations, the uptake of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal remains suboptimal, with disparities observed between urban and rural areas. More remains to be known about how malaria service readiness would affect the utilization of IPTp-SP. Data were obtained from seven annual rounds of Demographic and Health Surveys (DHS) and Service Provision Assessments (SPA) in Senegal from 2012 to 2019. Using sample domain linkage to link the databases at the regional level. A malaria service readiness index was calculated to quantify the malaria service delivery capacity within the service environment where women reside. The Heckman selection model was utilized to analyze the relationship between malaria service readiness and IPTp-SP utilization. From 2012 to 2019, the average number of IPTp-SP doses received in Senegal was 1.66 (95

Background In Africa, the scale-up of malaria-control interventions has reduced malaria burden, but progress towards elimination has stalled. Mass drug administration (MDA) is promising as a transmission-reducing strategy, but evidence from low-to-moderate transmission settings is needed. We aimed to assess the safety, coverage, and effect of three cycles of MDA with dihydroartemisinin-piperaquine plus single, low-dose primaquine on Plasmodium falciparum incidence and prevalence in southeast Senegal. Methods We conducted a two-arm, open-label, cluster-randomised controlled trial in villages in the Tambacounda health district of southeast Senegal. Eligible villages had a population size of 200-800, were within a health-post catchment area with an annual malaria incidence of 60-160 cases per 1000 people, and had an established or planned Prise en Charge & agrave; Domicile Plus model. We randomly assigned villages (1:1) using a stratified, constrained randomisation approach to receive either three cycles of MDA with oral dihydroartemisinin-piperaquine plus single, low-dose primaquine administered at 6-week intervals (intervention) or to standard of care, which included three cycles of seasonal malaria chemoprevention (SMC) with oral sulfadoxine-pyrimethamine plus amodiaquine administered at 4-week intervals (control). Participants, the field team, and all investigators, including those who assessed outcomes and analysed data, were unmasked to allocation assignment. Laboratory technicians were masked to intervention assignment. The primary outcome was village-level, P falciparum-confirmed malaria incidence in the post-intervention year (ie, July to December, 2022). Secondary outcomes included malaria incidence during the intervention year (ie, July to December, 2021), coverage and safety of MDA, and adverse events. We conducted analyses using an intention-to-treat approach. The trial is registered with ClinicalTrials.gov (NCT04864444) and is completed. Findings Between Sept 1 and Oct 25, 2020, 523 villages were geolocated and screened for eligibility; 111 met the inclusion criteria. Of these, 60 villages were randomly selected and assigned to the intervention arm or control arm. Distribution coverage of all three doses of dihydroartemisinin-piperaquine was 6057 (736%) of 8229 participants in the first cycle, 6836 (788%) of 8673 participants in the second cycle, and 7065 (813%) of 8690 participants in the third cycle. Distribution coverage of single, low-dose primaquine was 6286 (786%) of 7999 participants in the first cycle, 6949 (821%) of 8462 participants in the second cycle, and 7199 (840%) of 8575 participants in the third cycle. Distribution coverage of all three doses of SMC was 3187 (922%) of 3457 children aged 3-120 months in the first cycle, 3158 (918%) of 3442 children aged 3-120 months in the second cycle, and 3139 (914%) of 3434 children aged 3-120 months in the third cycle. In the intervention year (ie, July to December, 2021), the adjusted effect of MDA was 55% (95% CI 28 to 71). In the post-intervention year (ie, July to December 2022), the adjusted MDA effect was 26% (-17 to 53). Malaria incidence during the transmission season of the post-intervention year was 126 cases per 1000 population in the intervention arm and 146 cases per 1000 population in the control arm. No serious adverse events were reported. Interpretation In southeast Senegal, a low-to-moderate transmission setting where malaria-control measures have been scaled up, three cycles of MDA with dihydroartemisinin-piperaquine plus single, low-dose primaquine was safe and reduced malaria burden during the intervention year. However, its sustained effect was weak and continuation of MDA or another transmission-reducing strategy could be required. Copyright (c) 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

Introduction: The association of systemic lupus erythematosus and rheumatoid arthritis (rhupus) is a rare clinical condition. Throughout the world, 287 cases of Rhupus have been described. We report two new observations of two patients who presented predominantly distal erosive polyarthritis with positive anti-Sm antibodies in one case and SmRNP in the other case. Observations: Case 1: 37 years old patient, with a recent diagnosis of pulmonary tuberculosis. She has since 8 months an inflammatory, bilaterally and symmetrical polyarthralgia without deformation or ankylosing synovitis, associated with malar erythema without other abnormalities. Immunological tests showed: positive Rheumatoid factor at 158 IU/ml, positive Anti-CCP at 550 IU/ml, and positivity of antinuclear at 1/1280 nuclear fluorescence with a strong presence of anti-Sm >8 IU/ml. The diagnosis of rhupus was concluded, without serious visceral involvement. Case 2: A 28-year-old patient, married with 3 children, with bilateral, symmetrical, deforming and chronic polyarthritis affecting large and small joints, which had been evolving for over 5 years without cutaneous abnormality associated. Paraclinical investigations showed: a biological inflammatory syndrome. Immunology was positive, with rheumatoid factors at 78 IU/ml, anti-CCP at 561 IU/ml, antinuclear antibodies at 1/1280 with positive anti-SmRNP and anti-SSA/Ro52, and a positive direct Coombs test. Joint ultrasound revealed tenosynovitis of the extensors and common flexors of the fingers, erosions and synovitis of multiple PPIs. The diagnosis of rhupus was based on the presence of 10 ACR criteria for RA and 8 ACR/EULAR 2019 criteria for SLE. Conclusion: Rheumatoid arthritis is a rare autoimmune disease combining features of both systemic lupus erythematosus and rheumatoid arthritis in the same patient, often sequentially. Despite a growing number of case reports and series, a consensus on the classification of SLE arthritis is still lacking, and diagnostic criteria for rhupus do not exist. These cases of rhupus must be recognized, as the vital and/or functional prognosis may be different from SLE alone or isolated RA.