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Naveenkumar S, Kamaraj C, Kumarasamy V, Jayaseelan C, Prem P, Boomija RV, Suseem SR, Subramaniyan V, Barasarathi J, Wong LS. Isolation and validation of antimalarial compounds from Phyllanthus emblica leaves for new antimalarial drug development. Sci Rep 2025; 15:17452. [PMID: 40394223 PMCID: PMC12092577 DOI: 10.1038/s41598-025-99998-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Accepted: 04/24/2025] [Indexed: 05/22/2025] Open
Abstract
Natural products can serve as an alternative source of novel therapies that are required to address the problem of malarial infection resistance. Indian gooseberry (Phyllanthus emblica L.) leaves are often used in traditional medicine to treat fevers, but there isn't enough scientific proof that they contain antimalarial and effective phytochemicals. This study's primary goal was to investigate the antimalarial efficacy of P. emblica leaf ethyl acetate extract against Plasmodium falciparum (3D7) and its cytotoxicity against the HeLa cell line. The active compounds from P. emblica were isolated using a bioassay-guided fractionation of column chromatography technique, and NMR spectroscopy was employed to identify their structures. The drug's anti-malarial efficacy was assessed by estimating its growth-inhibitory activities employing the SYBR Green I asexual parasite drug assay. The cytotoxic effect was evaluated using the MTT assay. P. falciparum dihydroorotate dehydrogenase protein (Pf-DDP) was used as a drug target to investigate molecular docking. P. emblica crude extract and two fractions exhibited > 90% inhibition of 3D7 parasite proliferation, indicating good antimalarial activity at 100 and 10 µg/mL, respectively. Subsequently, the column chromatography study of each fraction, a targeted purification, contributed to the separation of six active compounds designated as 9-hydroxy isolongifolene (C1), Hexadecanoic acid (C2), Phenol, 2,6-Bis(1,1-Dimethylethyl) (C3), Furan, tetrahydro-3-methyl-4-methylene (C4), Octadecanoic acid (C5), and Beta-Sitosterol (C6). Compound C4 showed stronger bioactivity against P. falciparum (3D7) (IC50 4.32 µg/mL) parasites than other constituents, equivalent to the drug-sensitive strains (100 µg/mL). Considering the IC50 levels of the two compounds, 90.56 and > 100 µg/mL, respectively, both demonstrated low cytotoxicity against HeLa cell lines. This research offers scientific support for the historical application of P. emblica in combating malaria. Building on existing knowledge, this study represents a groundbreaking effort to isolate and identify antimalarial compounds from P. emblica leaves for the first time. Moreover, our research underscores the potential of P. emblica in the development of antimalarial agents, encouraging further investigation of different species to suppress the growth of P. falciparum. This plant species could be a valuable source for developing new anti-malarial drugs.
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Affiliation(s)
- Selvam Naveenkumar
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology (SRMIST), Kattankulatur, Chennai, Tamil Nadu, 603203, India
| | - Chinnaperumal Kamaraj
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology (SRMIST), Kattankulatur, Chennai, Tamil Nadu, 603203, India.
- Interdisciplinary Institute of Indian System of Medicine, Directorate of Research, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, 603203, India.
| | - Vinoth Kumarasamy
- Department of Parasitology, Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000, Cheras, Kuala Lumpur, Malaysia.
| | - Chidambaram Jayaseelan
- Centre for Laboratory Animal Technology and Research, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, 600119, India
| | - Pradisha Prem
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology (SRMIST), Kattankulatur, Chennai, Tamil Nadu, 603203, India
| | - Rajagopalan Vijayalakshmi Boomija
- Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology (SRMIST), Kattankulatur, Chennai, Tamil Nadu, 603203, India
| | - S R Suseem
- Department of Chemistry, School of Advanced Sciences, VIT University, Vellore, Tamil Nadu, 632014, India
| | - Vetriselvan Subramaniyan
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, No. 5, Jalan Universiti, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Jayanthi Barasarathi
- Faculty of Health and Life Sciences, INTI International University, 71800, Nilai, Malaysia
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, 71800, Nilai, Malaysia
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Zhou S, Yu L, Liang J, Xie W, Li G, Deng C, Song J, Zou G, Chen Y. Changes in Malaria Patterns in Comoros from 2010 to 2021: A Comparative Study with Sub-Saharan Africa. Trop Med Infect Dis 2025; 10:138. [PMID: 40423367 DOI: 10.3390/tropicalmed10050138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2025] [Revised: 05/13/2025] [Accepted: 05/14/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Recent setbacks in malaria control in Comoros demand a reassessment of its evolving epidemiology. METHODS Using the Global Burden of Disease (GBD) Study 2021 data, we analyzed malaria trends from 2010 to 2021, stratified by sex. We quantified the contributions of demographic and epidemiological factors to these trends and identified risk factors for malaria-related disability-adjusted life years (DALYs). RESULTS From 2010 to 2021, malaria cases, deaths, and DALYs in Comoros fell by -90.22%, -94.44%, and -94.88%; and the corresponding age-standardized rates declined with EAPCs of -18.70% (95% CI: -33.77 to -0.20), -23.89% (95% CI: -36.58 to -8.66), and -24.49% (95% CI: -36.88 to -9.66), with steeper declines in males. Nevertheless, all indicators increased in 2018 and again in 2021. In sub-Saharan Africa, only cases increased, while other metrics declined slightly. In Comoros, incidence shifted mainly to adults ≥25 years, unlike sub-Saharan Africa, where children < 5 years were most affected. Population growth drove increases in cases, deaths and DALYs, whereas epidemiological shifts had the opposite effect. Child underweight was the leading risk factor for malaria DALYs. CONCLUSIONS Existing interventions can achieve malaria control in Comoros; however, rebounds in 2018 and 2021 highlight the need to identify and address drivers of resurgence.
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Affiliation(s)
- Sheng Zhou
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Linxin Yu
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
| | - Jianming Liang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
| | - Wei Xie
- Institute of Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510540, China
| | - Guoming Li
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
| | - Changsheng Deng
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
| | - Jianping Song
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Yinhuan Chen
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 501405, China
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Donacho DO, Korsa Tura S, Tefera Kefeni B. Determinants of Long-Lasting Insecticide-Treated Bed Net Utilization Among Pregnant Women in Gechi District, Buno Bedele Zone South West Ethiopia: A Community-Based Cross-Sectional Study. ENVIRONMENTAL HEALTH INSIGHTS 2025; 19:11786302251335135. [PMID: 40356943 PMCID: PMC12066862 DOI: 10.1177/11786302251335135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 03/29/2025] [Indexed: 05/15/2025]
Abstract
Background Long-lasting insecticide-treated bed nets (LLITNs) are a key malaria prevention method, but their consistent use in Ethiopia, particularly among rural mothers, remains challenging. Information on LLITN usage among pregnant women in resource-limited settings is especially scarce. This study investigated LLITN utilization and the factors influencing its use among pregnant women in the Gechi district, Southwest Ethiopia, in 2024. Methods A community-based cross-sectional study was conducted from June to July 2024, including 422 randomly selected pregnant women. Data collection employed a pretested questionnaire, and logistic regression analysis was utilized to identify factors influencing LLITN usage. Variables with a P-value < .25 in univariable analysis were incorporated into the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was set at P ⩽ .05. The model's performance was assessed using the Hosmer-Lemeshow goodness-of-fit test. Results The finding of this study revealed that 93.9% of the respondents had LLITN, and the current utilization status of pregnant women was 46.5% [41.7%-51.3%]. The low level of utilization was significantly associated with women' education, parity, antenatal care (ANC) attendance, and family size. Accordingly, women without formal education were 52% less likely [AOR: 0.48, 95% CI: 0.28-0.81]; those with primipara were 1.98 times more likely [AOR: 1.98, 95% CI: 1.30-3.03]; a family size of less than 5 was 2.53 times [AOR: 2.53, 95% CI: 1.61-3.87] more likely, and women who attended at least 1 ANC visit were 2.08 times more likely [AOR: 2.08, 95% CI: 1.21-2.58] to use LLITN. Conclusion The pregnant women's LITN utilization in settings was low, associated with women's education, parity, antenatal care attendance, and family size. Key players should focus on awareness creation and ANC follow-up to reduce illness during pregnancy, particularly in rural, hard-to-reach settings.
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Affiliation(s)
| | - Sisay Korsa Tura
- Gechi Woreda Health Office, Bunno Bedele Zonal Health Office, Oromia Regional Health Bureau, Addis Ababa, Ethiopia
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Bushi G, Khatib MN, S RJ, Kaur I, Sharma A, Iqbal S, Kumar MR, Chauhan AS, Vishwakarma T, Malik P, Zahiruddin QS, Singh MP, Shabil M, Mehta R, Sah S, Albayat H, Sulaiman T, Al bshabshe A, Al Kaabi NA, Alrasheed HA, Alfaresi M, Sabour AA, Alamri E, Al‐Subaie MF, Rabaan AA. Determinants of Malaria Vaccine Acceptance: A Systematic Review and Meta-Analysis of Awareness, Acceptance, Hesitancy, and Willingness to Pay. Immun Inflamm Dis 2025; 13:e70205. [PMID: 40365988 PMCID: PMC12076350 DOI: 10.1002/iid3.70205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 03/09/2025] [Accepted: 05/05/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND Malaria is a life-threatening disease caused by Plasmodium parasites, transmitted through the bites of infected female Anopheles mosquitoes. It remains a major global health issue, with 263 million cases and 597,000 deaths in 2023, primarily affecting young children and pregnant women. This review evaluates awareness, acceptance, hesitancy, and willingness to pay (WTP) for the RTS,S/AS01 malaria vaccine, along with the key factors influencing these outcomes. METHODS A comprehensive literature search was conducted in Web of Science, PubMed, and Embase, covering publications up to 18 June 2024. Observational studies assessing awareness, acceptance, hesitancy, and WTP for the malaria vaccine in endemic regions were included. Two independent reviewers screened the studies. Data extraction was performed using Nested Knowledge software and analyzed with R v.4.4. Pooled prevalences were estimated using random-effects models, and heterogeneity was assessed with the I² statistic. RESULTS Eighteen studies with 21,975 participants provided insights into malaria vaccine dynamics: 32% awareness (95% CI, 18%-50%), 83% acceptance (95% CI, 75%-89%), 14% hesitancy (95% CI, 7%-26%), and 58% WTP (95% CI, 34%-79%). Key determinants of acceptance included age, where younger adults (18-24 years) showed lower acceptance (OR = 0.64, 95% CI, 0.35-0.93). Employment, particularly farmers, had higher acceptance rates (OR = 3.20, 95% CI, 1.00-7.40). Lower socioeconomic status and larger family sizes were associated with decreased acceptance (OR = 0.18, 95% CI, 0.02-0.38). CONCLUSION This review revealed an 83% acceptance rate for the malaria vaccine, with variability in awareness (32%), hesitancy (14%), and willingness to pay (58%). Age, employment, and socioeconomic status were significant determinants of acceptance. However, due to potential publication bias and high heterogeneity, these findings should be cautiously interpreted. The results highlight the necessity for targeted interventions to enhance vaccine acceptance. Further research is required to elucidate factors that influence vaccine acceptance.
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Affiliation(s)
- Ganesh Bushi
- School of Pharmaceutical SciencesLovely Professional UniversityPhagwaraPunjabIndia
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthessis, Global Consortium of Public Health and ResearchDatta Meghe Institute of Higher EducationWardhaMaharashtraIndia
| | - Renuka Jyothi. S
- Department of Biotechnology and GeneticsSchool of Sciences, JAIN (Deemed to be University)BangaloreKarnatakaIndia
| | - Irwanjot Kaur
- Department of Allied Healthcare and SciencesVivekananda Global UniversityJaipurRajasthanIndia
| | | | - Suhaib Iqbal
- Chandigarh Pharmacy College, Chandigarh Group of College, JhanjeriMohaliPunjabIndia
| | - M. Ravi Kumar
- Department of ChemistryRaghu Engineering CollegeVisakhapatnamAndhra PradeshIndia
| | - Ashish Singh Chauhan
- Division of Research and InnovationUttaranchal Institute of Pharmaceutical Sciences, Uttaranchal UniversityDehradunUttarakhandIndia
| | | | | | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network, Division of Evidence Synthesis, Global Consortium of Public Health and ResearchDatta Meghe Institute of Higher EducationWardhaMaharashtraIndia
| | - Mahendra Pratap Singh
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical SciencesSaveetha UniversityChennaiTamil NaduIndia
| | - Muhammed Shabil
- University Center for Research and Development, Chandigarh UniversityMohaliPunjabIndia
- Medical Laboratories Techniques DepartmentAL‐Mustaqbal UniversityHillahBabilIraq
| | - Rachana Mehta
- Clinical Microbiology, RDCManav Rachna International Institute of Research and StudiesFaridabadHaryanaIndia
- Dr Lal PathLabs ‐ NepalMaharajgunjKathmanduNepal
| | - Sanjit Sah
- Department of Pediatrics, Dr. D. Y. Patil Medical College, Hospital and Research CentreDr. D. Y. Patil Vidyapeeth (Deemed‐to‐be‐University), PimpriPuneIndia
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and HospitalDr. D. Y. Patil Vidyapeeth (Deemed‐to‐be‐University), PimpriPuneMaharashtraIndia
- SR Sanjeevani HospitalKalyanpurSirahaNepal
| | - Hawra Albayat
- Infectious Disease DepartmentKing Saud Medical CityRiyadhSaudi Arabia
| | - Tarek Sulaiman
- Infectious Diseases Section, Medical Specialties DepartmentKing Fahad Medical CityRiyadhSaudi Arabia
| | - Ali Al bshabshe
- Adult critical care Department of medicine, Division of adult critical care, College of medicineKing Khalid UniversityAbhaSaudi Arabia
| | - Nawal A. Al Kaabi
- College of Medicine and Health ScienceKhalifa UniversityAbu DhabiUnited Arab Emirates
- Sheikh Khalifa Medical CityAbu Dhabi Health Services Company (SEHA)Abu DhabiUnited Arab Emirates
| | - Hayam A Alrasheed
- Department of Pharmacy Practice, College of PharmacyPrincess Nourah bint Abdulrahman UniversityRiyadhSaudi Arabia
| | - Mubarak Alfaresi
- Department of MicrobiologyNational Reference Laboratory, Cleveland Clinic Abu DhabiAbu DhabiUnited Arab Emirates
- Department of Pathology, College of MedicineMohammed Bin Rashid University of Medicine and Health SciencesDubaiUnited Arab Emirates
| | - Amal A. Sabour
- Department of Botany and Microbiology, College of ScienceKing Saud UniversityRiyadhSaudi Arabia
| | - Eman Alamri
- Food Science and Nutrition, Faculty of ScienceUniversity of TabukTabukSaudi Arabia
| | - Maha F. Al‐Subaie
- Research CenterDr. Sulaiman Alhabib Medical GroupRiyadhSaudi Arabia
- College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
| | - Ali A. Rabaan
- College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco HealthcareDhahranSaudi Arabia
- Department of Public Health and NutritionThe University of HaripurHaripurPakistan
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Mfangnia CNT, Tonnang HEZ, Tsanou B, Keith Herren J. An eco-epidemiological model for malaria with Microsporidia MB as bio-control agent. MODELING EARTH SYSTEMS AND ENVIRONMENT 2025; 11:221. [PMID: 40255466 PMCID: PMC12003625 DOI: 10.1007/s40808-025-02322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Accepted: 01/30/2025] [Indexed: 04/22/2025]
Abstract
Microsporidia MB is an endosymbiont which naturally infects Anopheles mosquitoes. Due to its ability to block Plasmodium transmission, it shows potential as a bio-based agent for the control of malaria. Its self-sustainability is promising, as it can spread through both vertical and horizontal transmissions. However, its low prevalence in mosquito populations remains a challenge. We develop an eco-epidemiological mathematical model describing the co-dynamics of Microsporidia MB (within mosquito population) and malaria (within human population). The model is used to assess the potential of Microsporidia MB-infected mosquitoes on the control of malaria infection. The results on the basic reproduction numbers, the stability of the equilibria, and the existence of bifurcations are obtained, providing conditions for the extinction and persistence of MB-infected mosquitoes. We highlight relevant threshold parameters for the elimination and persistence of MB-infected mosquitoes and malaria-infected individuals. Using real data from Kenya, we found that, given a horizontal transmission rate between 0 and 0.5, a minimum vertical rate of 0.55 is required to avoid extinction of MB-infected mosquitoes. The predicted prevalence of MB-infected mosquitoes using transmission rates reported from lab experiments align with the observed low prevalence of MB-infected mosquitoes in the field, thereby validating our model and results. Finally, predictions indicate that increasing MB mosquito infection could effectively control malaria, with target prevalence varying by region: 15% in Highland, 40% on the coast, and 70% in the Lake region. This study offers insights into the use of bio-based vector population replacement solutions to reduce malaria incidence in regions where Microsporidia MB is prevalent.
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Affiliation(s)
- Charlène N. T. Mfangnia
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box : 30772, Nairobi 00100, Kenya
- Department of Mathematics and Computer Science, Faculty of Science, University of Dschang, P.O. Box : 67, Dschang, Cameroon
| | - Henri E. Z. Tonnang
- School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa
- International Institute of Tropical Agriculture (IITA), PMB, 5320 Oyo Road, Idi-Oshe Ibadan, Nigeria
| | - Berge Tsanou
- Department of Mathematics and Computer Science, Faculty of Science, University of Dschang, P.O. Box : 67, Dschang, Cameroon
- Department of Mathematics and Applied Mathematics, University of Pretoria, Pretoria 0002, South Africa
| | - Jeremy Keith Herren
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box : 30772, Nairobi 00100, Kenya
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Chivasa T, Dhlamini M, Maviza A, Nunu WN, Tsoka-Gwegweni J. Modelling an Optimal Climate-Driven Malaria Transmission Control Strategy to Optimise the Management of Malaria in Mberengwa District, Zimbabwe: A Multi-Method Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:591. [PMID: 40283815 PMCID: PMC12027159 DOI: 10.3390/ijerph22040591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 03/17/2025] [Accepted: 03/29/2025] [Indexed: 04/29/2025]
Abstract
Malaria is a persistent public health problem, particularly in sub-Saharan Africa where its transmission is intricately linked to climatic factors. Climate change threatens malaria elimination efforts in limited resource settings, such as in the Mberengwa district. However, the role of climate change in malaria transmission and management has not been adequately quantified to inform interventions. This protocol employs a multi-method quantitative study design in four steps, starting with a scoping review of the literature, followed by a multi-method quantitative approach using geospatial analysis, a quantitative survey, and the development of a predictive Susceptible-Exposed-Infected-Recovered-Susceptible-Geographic Information System model to explore the link between climate change and malaria transmission in the Mberengwa district. Geospatial overlay, Getis-Ord Gi* spatial autocorrelation, and spatial linear regression will be applied to climate (temperature, rainfall, and humidity), environmental (Land Use-Land Cover, elevations, proximity to water bodies, and Normalised Difference Vegetation Index), and socio-economic (Poverty Levels and Population Density) data to provide a comprehensive understanding of the spatial distribution of malaria in Mberengwa District. The predictive model will utilise historical data from two decades (2003-2023) to simulate near- and mid-century malaria transmission patterns. The findings of this study will be used to inform policies and optimise the management of malaria in the context of climate change.
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Affiliation(s)
- Tafadzwa Chivasa
- Department of Environmental Health, Faculty of Environmental Science, National University of Science and Technology, Bulawayo 00263, Zimbabwe;
- Department of Environmental Health Services, Mberengwa District Hospital, Ministry of Health and Child Care, Mberengwa 00263, Zimbabwe
| | - Mlamuli Dhlamini
- Department of Applied Mathematics, Faculty of Applied Science, National University of Science and Technology, Bulawayo 00263, Zimbabwe;
| | - Auther Maviza
- Department of Environmental Science, Faculty of Environmental Science, National University of Science and Technology, Bulawayo 00263, Zimbabwe;
- Global Change Institute, Faculty of Science, University of Witwatersrand, Johannesburg 2050, South Africa
| | - Wilfred Njabulo Nunu
- Department of Environmental Health, Faculty of Environmental Science, National University of Science and Technology, Bulawayo 00263, Zimbabwe;
- Department of Environmental Health, School of Public Health, Faculty of Health Sciences, University of Botswana, Gaborone 00267, Botswana
- Department of Public Health, Faculty of Health Sciences, University of the Free State, Bloemfontein 0027, South Africa;
| | - Joyce Tsoka-Gwegweni
- Department of Public Health, Faculty of Health Sciences, University of the Free State, Bloemfontein 0027, South Africa;
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Sallam M, Al-Khatib AO, Al-Mahzoum KS, Abdelaziz DH, Sallam M. Current Developments in Malaria Vaccination: A Concise Review on Implementation, Challenges, and Future Directions. Clin Pharmacol 2025; 17:29-47. [PMID: 40191019 PMCID: PMC11971972 DOI: 10.2147/cpaa.s513282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 03/25/2025] [Indexed: 04/09/2025] Open
Abstract
Introduction Malaria remains a persistent challenge in global health, disproportionately affecting populations in endemic regions (eg, sub-Saharan Africa). Despite decades of international collaborative efforts, malaria continues to claim hundreds of thousands of lives each year, with young children and pregnant women enduring the heaviest burden. This concise review aimed to provide an up-to-date assessment of malaria vaccines progress, challenges, and future directions. Methods A PubMed/MEDLINE search (2015-2024) was conducted to identify studies on malaria vaccine development, implementation barriers, efficacy, and vaccination hesitancy. Clinical trials, reviews, and global health reports were included based on relevance to the review aims. No strict inclusion criteria were applied, and selection was guided by key review themes and policy relevance. Results The introduction of pre-erythrocytic malaria vaccines (RTS,S/AS01 and R21/Matrix-M), represents an important milestone in malaria control efforts with promising results from the erythrocytic vaccine RH5.1/Matrix-M in recent clinical trials. However, the approval of these vaccines is accompanied by significant challenges such as the limited efficacy, the complexity of multi-dose regimens, and numerous barriers to widespread implementation in resource-limited settings. The review identified the complex challenges to broad malaria vaccination coverage, including logistical barriers, healthcare infrastructure effect, financial limitations, malaria vaccine hesitancy, among other obstacles in malaria-endemic regions. Promising developments in malaria vaccination, such as next-generation candidates (eg, mRNA-based vaccines), hold the potential to offer improved efficacy, longer-lasting protection, and greater scalability. There is a critical need to integrate malaria vaccination efforts with established malaria control interventions (eg, insecticide-treated bed nets, vector control strategies, and anti-malarial drugs). Conclusion Achieving sustained control of malaria morbidity and mortality will require strong global collaboration, sufficient funding, and continuous efforts to address inequities in access and delivery of malaria control measures including the malaria vaccines.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Arwa Omar Al-Khatib
- Faculty of Pharmacy, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Doaa H Abdelaziz
- Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Baha University, Al-Baha, Saudi Arabia
- Department of Clinical Pharmacy, the National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mohammed Sallam
- Department of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai, United Arab Emirates
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Abebe ED, Huang S, Baker K, Awokou F, Zelalem M, Chekol TS, Weldemichael AT, Richardson S. Determinants of access to health facilities among under-five children with caregiver-reported fever in the context of seasonal malaria chemoprevention in Togo, 2020-2022. Trop Med Health 2025; 53:38. [PMID: 40069866 PMCID: PMC11895289 DOI: 10.1186/s41182-025-00717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 02/26/2025] [Indexed: 03/15/2025] Open
Abstract
BACKGROUND Malaria is responsible for 580,000 deaths among children under 5, or 95% of all malaria deaths per year globally. Seasonal Malaria Chemoprevention (SMC) is a malaria control intervention in Togo and other African countries targeting children under 5 years old during the peak malaria transmission season. Delaying access to healthcare for children with malaria can result in serious health problems, including heightened morbidity and mortality, complications related to cerebral malaria and anemia, as well as impaired cognitive development. This study aimed to identify determinants of access to health facilities for children with caregiver-reported fever, in the context of SMC campaigns in Togo. METHODOLOGY We analyzed data from three representative annual end-of-round SMC surveys on SMC-eligible children aged 3-59 months residing in the provinces of Savanes, Central and Kara in Togo, conducted during 2020-2022. We performed a descriptive analysis and fitted logistic regression models to assess predictors of health facility access. Our sample included all children with a caregiver-reported fever in the month before the survey. Model variables included household distance to their local health facility, quintiles of household wealth, household visit by SMC distributors in the previous month, household nomad status, literacy of primary caregivers, and the age and sex of both eligible children and their primary caregivers. RESULTS Our analytic sample included 6,252 SMC-eligible children, including 1,418 experiencing fevers. Most children with fever (62.6%, 95% CI 60.0-65.0%) accessed health facilities. Adjusted odds ratios and 95% confidence intervals obtained from the logistic regression analysis found a statistically significant linear relationship between children's adjusted odds of access to health facilities and their distance from the nearest facility, with 2% lower odds of access for each additional kilometer of distance (AOR = 0.98, 95% CI 0.97-0.99). Households with SMC distributor visits were significantly more likely to access health facilities (AOR = 2.20, 95% CI 1.22-3.96). Children of female primary caregivers had higher odds of access (AOR = 1.42, 95% CI 1.05-1.93). CONCLUSION Febrile children's access to malaria testing and treatment in Northern Togo requires further improvement, particularly among those further from health facilities and with lower household wealth.
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Affiliation(s)
- Endeshaw Degie Abebe
- Vanke School of Public Health, Tsinghua University, Beijing, 100083, China
- Ministry of Health, 2P8W+GP6, Sudan St, Addis Ababa, Ethiopia
| | - Sikai Huang
- Vanke School of Public Health, Tsinghua University, Beijing, 100083, China
| | - Kevin Baker
- Malaria Consortium UK, the Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Fantche Awokou
- Malaria Consortium Togo, Malaria Consortium, Quartier Administratif, Rue Adamé, Lomé, Togo
| | - Meseret Zelalem
- Addis ECD Centre for Excellence, Learning and Innovation, Addis Ababa, Ethiopia
| | | | | | - Sol Richardson
- Vanke School of Public Health, Tsinghua University, Beijing, 100083, China.
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Ramaita E, Agumba S, Mwangangi J, Kitur S, Wachira L, Otieno S, Mburu D, Matoke-Muhia D, Juma E, Mbogo C, Ochomo E, Kamau L. Insecticide resistance intensity in Anopheles gambiae ( s.l.) from five malaria epidemiological zones in Kenya. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2025; 7:100252. [PMID: 40206848 PMCID: PMC11981760 DOI: 10.1016/j.crpvbd.2025.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 10/13/2024] [Accepted: 03/03/2025] [Indexed: 04/11/2025]
Abstract
Insecticide-based malaria vector-control interventions have been economically important in reducing malaria prevalence. However, insecticide resistance now threatens the continued efficacy of insecticides in malaria vector control. Monitoring insecticide resistance in mosquito populations is needed to guide the implementation of effective insecticide resistance management (IRM) strategies. Thus the study assessed the levels and intensity of insecticide resistance in Anopheles gambiae (sensu lato) in five malaria epidemiological zones of Kenya, which are subjected to different vector control interventions. Anopheles gambiae (s.l.) mosquito larvae were sampled from Teso in Busia County in the lake malaria-endemic zone, Kwale in Kwale County in the coastal malaria-endemic zone, Kakuma in Turkana County, a malaria epidemic zone, Mwea in Kirinyaga County in the seasonal malaria transmission zone of Central Kenya and Thika in Kiambu County in the low-risk malaria zones. The mosquito larvae were reared into adults, and the Centre for Disease Control (CDC) bottle DD intensity of resistance assays were conducted at 2× , 5× , and 10× the discriminating doses (DD); the WHO guidelines were used to evaluate the percentage knockdown or mortality of the adult vectors. Anopheles gambiae (s.l.) mosquitoes from all the malaria epidemiological zones showed resistance to deltamethrin and pirimiphos-methyl, while mosquitoes from most of the zones were resistant to alpha-cypermethrin. However, the mosquitoes were susceptible to the other insecticides tested, i.e. chlorfenapyr and clothianidin. In cases where resistance was found, the resistance intensity ranged from low to moderate levels. Anopheles arabiensis was the most prevalent species in all the sites except in Busia County, where An. gambiae (sensu stricto) was the majority. The results of this study showed widespread insecticide resistance in An. gambiae (s.l.) to commonly used insecticides in different malaria epidemiological zones in Kenya. Routine surveillance of insecticide resistance through monitoring and subsequent management in the zones of occurrence is a reliable component of evidence-based policy decision-making for mitigating malaria transmission using insecticide-based vector control interventions.
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Affiliation(s)
- Edith Ramaita
- Ministry of Health - National Malaria Control Programme (NMCP), Nairobi, Kenya
| | - Silas Agumba
- Centre for Global Health Research (CGHR), Kenya Medical Research Institute, Kisumu, Kenya
| | - Joseph Mwangangi
- Centre for Geographic Medicine Research-Coast (CGMR-C), Kenya Medical Research Institute, Mombasa, Kenya
| | - Stanley Kitur
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute, Nairobi, Kenya
| | - Lucy Wachira
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute, Nairobi, Kenya
| | - Samson Otieno
- Centre for Global Health Research (CGHR), Kenya Medical Research Institute, Kisumu, Kenya
| | - David Mburu
- Pwani University Biosciences Research Centre (PUBReC), Mombasa, Kenya
| | - Damaris Matoke-Muhia
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute, Nairobi, Kenya
- Pan African Mosquito Control Association (PAMCA), Nairobi, Kenya
| | - Elijah Juma
- Pan African Mosquito Control Association (PAMCA), Nairobi, Kenya
| | - Charles Mbogo
- Pan African Mosquito Control Association (PAMCA), Nairobi, Kenya
| | - Eric Ochomo
- Centre for Global Health Research (CGHR), Kenya Medical Research Institute, Kisumu, Kenya
| | - Luna Kamau
- Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute, Nairobi, Kenya
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Abdulzeid A, Bosson-Amedenu S, Gmayinaam VU, Enock A, Ocloo S, Acquah J. Evaluating malaria burden in children under-five and intervention outcomes in Tarkwa-Nsuaem municipality. BMC Infect Dis 2025; 25:294. [PMID: 40021974 PMCID: PMC11871811 DOI: 10.1186/s12879-025-10705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Accepted: 02/21/2025] [Indexed: 03/03/2025] Open
Abstract
BACKGROUND Malaria is a significant public health burden, particularly in sub-Saharan Africa. Despite global efforts to reduce malaria incidence, various challenges, including socio-economic disparities, insecticide resistance, and climatic factors, continue to hamper malaria elimination in Ghana. Over the years, several interventions have been implemented to combat malaria. However, the implementation of these malaria interventions and their association with the malaria burden remains unclear. AIM This study evaluated the epidemiological behaviour of malaria in Tarkwa-Nsuaem Municipality from 2013 to 2023. MATERIALS AND METHODS Malaria incidence, severe cases, and mortality among children under five from 2013 to 2023 were obtained from the Tarkwa-Nsuaem Health Directorate. Meteorological data were sourced from the Global Climate Monitor, while intervention coverage data were extracted from the Malaria Atlas Project. The study employed the Mann-Kendall test to assess trends and applied Joinpoint regression to detect significant shifts in malaria incidence, severe cases, and mortality. Additionally, data on insecticide-treated net coverage and case management treatment were analyzed to evaluate intervention effectiveness. To further assess the influence of climate factors on malaria incidence, a Seasonal AutoRegressive Integrated Moving Average with Exogenous Variables model was applied. The best-fitting model, SARIMAX(1,1,1)x(1,1,1,12), incorporated rainfall and temperature as exogenous predictors to capture the temporal dynamics and seasonal variations in malaria incidence. RESULTS Over the study period, 110,737 malaria cases were reported, with an annual mean incidence rate of 242.37 cases per 1,000 population. Malaria incidence increased significantly by 12.48% from 109.63 cases per 1,000 in 2013 to 234.41 in 2023 (p = 0.02). ITN coverage fluctuated between 27.21% and 51.82%, and treatment coverage improved steadily to 62.08%. Malaria-related deaths decreased significantly, with zero deaths reported since 2020. However, severe malaria cases showed a fluctuating trend, decreasing by 80.6% from 2013 to 2018, followed by a 110.3% increase from 2018 to 2023. The AutoRegressive Integrated Moving Average with Exogenous Variables model results indicated that rainfall was a significant predictor of malaria incidence (p = 0.032), while temperature did not show a statistically significant impact (p = 0.927). The model successfully captured historical trends and seasonal variations. CONCLUSIONS The study showed a significant reduction in malaria-related mortality in Tarkwa-Nsuaem, likely attributable to improved case management and treatment coverage. However, the fluctuating ITN coverage and the recent rise in severe cases warrant further investigation. Targeted interventions, especially in mining areas, and more consistent vector control measures are needed to sustain progress and further reduce malaria incidence.
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Affiliation(s)
- Anafo Abdulzeid
- Department of Mathematical Sciences, University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana.
| | - Senyefia Bosson-Amedenu
- Department of Mathematics, Statistics and Actuarial Science, Takoradi Technical University, Takoradi, Ghana
| | | | - Appiah Enock
- Department of Mathematical Sciences, University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana
| | - Selasi Ocloo
- Department of Engineering, Ashesi University, Brekuso, Ghana
| | - Joseph Acquah
- Department of Mathematical Sciences, University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana
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Namayanja C, Paasi G, Alunyo JP, Amorut D, Okalebo CB, Okiror W, Ongodia P, Abongo G, Muhindo R, Lubaale YAM, Olupot-Olupot P. Epidemiology, clinical spectrum, and outcomes of severe malaria in Eastern Uganda: a prospective study. Malar J 2025; 24:37. [PMID: 39920795 PMCID: PMC11806871 DOI: 10.1186/s12936-024-05221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 12/11/2024] [Indexed: 02/09/2025] Open
Abstract
BACKGROUND In sub-Saharan Africa, malaria remains a public health problem despite some reports of declining incidence in the period 2000-2018. Since 2019, there have been some reports of disease epidemics and resurgences in areas that had registered steep declines and unusual clinical presentations. This study aimed to describe the epidemiology, clinical spectrum, and outcomes of severe malaria in children among malaria-endemic Eastern Uganda, a region that has recently experienced disease epidemics. METHODS This prospective study was conducted at Mbale Regional Referral Hospital, Uganda, from 08th May 2019 to August 15, 2023, as part of the Malaria Epidemiological, Pathophysiological and Intervention studies in Highly Endemic Eastern Uganda (EDCTP-TMA2016SF-1514-MEPIE Study). Children aged 60 days to 12 years who at admission tested positive for malaria and fulfilled the clinical World Health Organization criteria for surveillance of severe malaria were enrolled into the study following appropriate informed consent. Data were collected using a customized proforma on social demographic characteristics, clinical presentation, treatment, and outcomes. Laboratory analyses included complete blood counts, lactate, glucose, blood gases, electrolytes, metabolites, and coagulation markers. In addition, urinalysis using dipsticks was done. Data were analysed using STATA V15. The study had ethical and regulatory approval before data collection commenced. RESULTS A total of 1,379 participants were recruited. The median age was 4 years (2 months-12 years). Most children 757/1379 (54.9%) were under 5 years, and 825/1379 (59.8%) were males. The common symptoms were fever 1368 (99.2%), poor appetite 1095 (79.5%), inability to sit upright 1051 (76.2%), vomiting 944 (68.4%) and yellow eyes 833 (60.4%). The common signs included prostration, haemoglobinuria and jaundice. Prolonged hospitalization was found in 284/1339 (21.2%) and was associated with impaired consciousness 116/166 (30.1%), P = 0.003; haemoglobinuria 514/705 (27.1%), P < 0.001 and jaundice 505/690 (26.8%) P < 0.001. The overall mortality was 40/1347 (3.0%). Children who had > 1 severity feature were at a higher risk of mortality. CONCLUSION In this prospective study of children with severe malaria in Eastern Uganda, the overall mortality was 3.0% and the more the disease clinical syndromes the higher the risk of death.
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Affiliation(s)
| | - George Paasi
- Mbale Clinical Research Institute, Mbale, Uganda
- Department of Public Health, Busitema University Faculty of Health Sciences, P.O. Box 1966, Mbale, Uganda
| | - Jimmy Patrick Alunyo
- Mbale Clinical Research Institute, Mbale, Uganda
- Department of Public Health, Busitema University Faculty of Health Sciences, P.O. Box 1966, Mbale, Uganda
| | - Denis Amorut
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Charles Benard Okalebo
- Mbale Clinical Research Institute, Mbale, Uganda
- Department of Public Health, Busitema University Faculty of Health Sciences, P.O. Box 1966, Mbale, Uganda
| | | | - Paul Ongodia
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Grace Abongo
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Rita Muhindo
- Mbale Clinical Research Institute, Mbale, Uganda
| | - Yovani A M Lubaale
- Department of Public Health, Busitema University Faculty of Health Sciences, P.O. Box 1966, Mbale, Uganda
| | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Mbale, Uganda.
- Department of Public Health, Busitema University Faculty of Health Sciences, P.O. Box 1966, Mbale, Uganda.
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Mwesigwa A, Golumbeanu M, Jones S, Cantoreggi SL, Musinguzi B, Nankabirwa JI, Bikaitwoha EM, Kalyango JN, Karamagi C, Plucinski M, Nsobya SL, Nsanzabana C, Byakika-Kibwika P. Assessment of different genotyping markers and algorithms for distinguishing Plasmodium falciparum recrudescence from reinfection in Uganda. Sci Rep 2025; 15:4375. [PMID: 39910229 PMCID: PMC11799330 DOI: 10.1038/s41598-025-88892-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Accepted: 01/31/2025] [Indexed: 02/07/2025] Open
Abstract
Antimalarial therapeutic efficacy studies are vital for monitoring drug efficacy in malaria-endemic regions. The WHO recommends genotyping polymorphic markers including msp-1, msp-2, and glurp for distinguishing recrudescences from reinfections. Recently, WHO proposed replacing glurp with microsatellites (Poly-α, PfPK2, TA1). However, suitable combinations with msp-1 and msp-2, as well as the performance of different algorithms for classifying recrudescence, have not been systematically assessed. This study investigated various microsatellites alongside msp-1 and msp-2 for molecular correction and compared different genotyping algorithms across three sites in Uganda. Microsatellites 313, Poly-α, and 383 exhibited the highest diversity, while PfPK2 and Poly-α revealed elevated multiplicity of infection (MOI) across all sites. The 3/3 match-counting algorithm classified significantly fewer recrudescences than both the ≥ 2/3 and Bayesian algorithms at probability cutoffs of ≥ 0.7 and ≥ 0.8 (P < 0.05). The msp-1/msp-2/2490 combination identified more recrudescences using the ≥ 2/3 and 3/3 algorithms in the artemether-lumefantrine (AL) treatment arm, while msp-1/msp-2/glurp combination classified more cases of recrudescence using the ≥ 2/3 in the dihydroartemisinin-piperaquine (DP) arm. Microsatellites PfPK2 and Poly-α, potentially sensitive to detecting minority clones, are promising replacements for glurp. Discrepancies in recrudescence classification between match-counting and Bayesian algorithms highlight the need for standardized PCR correction practices.
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Affiliation(s)
- Alex Mwesigwa
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.
- Department of Microbiology and Immunology, School of Medicine, Kabale University, P. O Box 314, Kabale, Uganda.
| | - Monica Golumbeanu
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sam Jones
- MMV Medicines for Malaria Venture, Geneva, Switzerland
| | - Sara L Cantoreggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Benson Musinguzi
- Departent of Medical Laboratory Science, Faculty of Health Sciences, Muni University, P.O Box 725, Arua, Uganda
| | - Joaniter I Nankabirwa
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Infectious Diseases Research Collaboration, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Everd Maniple Bikaitwoha
- Department of Community Health, School of Medicine, Kabale University, P. O Box 314, Kabale, Uganda
| | - Joan N Kalyango
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Charles Karamagi
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Mateusz Plucinski
- U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, 30345, USA
| | - Samuel L Nsobya
- Infectious Diseases Research Collaboration, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Christian Nsanzabana
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Mabeya H, Aluku C, Crosby CD, Spivak AR, Haruethaivijitchock P, Rojanasakul A, Dhir M, Abbas MA. Complex Pelvic Fistulas in African Women: The Challenges and Opportunities of an Ongoing Epidemic. Dis Colon Rectum 2025; 68:144-153. [PMID: 39508473 DOI: 10.1097/dcr.0000000000003548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2024]
Affiliation(s)
| | | | - Claud D Crosby
- Memorial Health University Medical Center, Miami, Florida
| | | | | | | | - Meena Dhir
- Mercer University School of Medicine, Macon, Georgia
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Kisambale AJ, Pereus D, Mandai SS, Lyimo BM, Bakari C, Chacha GA, Mbwambo RB, Moshi R, Petro DA, Challe DP, Seth MD, Madebe RA, Budodo R, Aaron S, Mbwambo D, Lusasi A, Kajange S, Lazaro S, Kapologwe N, Mandara CI, Ishengoma DS. Genetic diversity of Plasmodium falciparum reticulocyte binding protein homologue-5, which is a potential malaria vaccine candidate: baseline data from areas of varying malaria endemicity in Mainland Tanzania. Malar J 2025; 24:29. [PMID: 39871346 PMCID: PMC11773767 DOI: 10.1186/s12936-025-05269-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 01/21/2025] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND The limited efficacy of the two recently approved malaria vaccines, RTS,S/AS01 and R21/Matrix- M™, highlights the need for alternative vaccine candidate genes. Plasmodium falciparum Reticulocyte Binding Protein Homologue 5 (Pfrh5) is a promising malaria vaccine candidate, given its limited polymorphism, its essential role in parasite survival, a lack of immune selection pressure and higher efficacy against multiple parasites strains. This study evaluated the genetic diversity of Pfrh5 gene among parasites from regions with varying malaria transmission intensities in Mainland Tanzania, to generate baseline data for this potential malaria vaccine candidate. METHODS This study utilized secondary data of 697 whole-genome sequences which were generated by the MalariaGEN Community Network. The samples which were sequenced to generated the data were collected between 2010 and 2015 from five districts within five regions of Mainland Tanzania, with varying endemicities (Morogoro-urban district in Morogoro region, Muheza in Tanga, Kigoma-Ujiji in Kigoma, Muleba in Kagera, and Nachingwea district in Lindi region). Wright's fixation index (FST), Wright's inbreeding coefficient (Fws), Principal component analysis (PCA), nucleotide diversity (π), haplotype network, haplotype diversity (Hd), Tajima's D, and Linkage disequilibrium (LD) were used to assess the diversity of the gene. RESULTS Of the sequences used in this study, 84.5% (n = 589/697) passed quality control and 313 (53.1%) were monoclonal (contained infections from a single strain of P. falciparum) and were used for haplotype diversity and haplotype network analysis. High within-host diversity (Fws < 0.95) was reported in Kigoma-Ujiji (60.7%), Morogoro-urban (53.1%), and Nachingwea (50.8%), while Muleba (53.9%) and Muheza (61.6%) had low within-host diversity (Fws ≥ 0.95). PCA did not show any population structure and the mean FST value was 0.015. Low nucleotide diversity values were observed across the study sites (mean π = 0.00056). A total of 27 haplotypes were observed among the 313 monoclonal samples and under-fives exhibited higher haplotype counts. The Pf3D7 was detected as Hap_1, which occurred in 16/313 (5.1%) monoclonal sequences. Negative Tajima's D values were observed among the parasite populations in all the study sites. CONCLUSION Low levels of polymorphism in the pfrh5 gene were observed based on low nucleotide and haplotype diversity, a lack of population structure and negative Tajima's D values. This study provides essential data on the diversity of the Pfrh5 gene indicating that it can be considered in the development of the next generation malaria vaccines. Robust and intensive studies of this and other candidate genes are crucial to support the prioritization of the Pfrh5 gene for potential inclusion in a broadly cross-protective malaria vaccine.
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Affiliation(s)
| | - Dativa Pereus
- National Institute for Medical Research, Dar Es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Salehe S Mandai
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Beatus M Lyimo
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Catherine Bakari
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Gervas A Chacha
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Ruth B Mbwambo
- National Institute for Medical Research, Dar Es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Ramadhan Moshi
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | | | - Daniel P Challe
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Misago D Seth
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Rashid A Madebe
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Rule Budodo
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | | | | | | | - Stella Kajange
- President's Office, Regional Administration and Local Government, Dodoma, Tanzania
| | - Samwel Lazaro
- National Malaria Control Programme, Dodoma, Tanzania
| | - Ntuli Kapologwe
- Directorate of Preventive Services, Ministry of Health, Dodoma, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Deus S Ishengoma
- National Institute for Medical Research, Dar Es Salaam, Tanzania.
- Department of Biochemistry, Kampala International University in Tanzania, Dar Es Salaam, Tanzania.
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Alemu AA, Welsh A, Getachew T, Khajehei M. Assessment of antenatal care quality in Ethiopia: Facility-based study using service provision assessment data. PLoS One 2025; 20:e0313527. [PMID: 39820615 PMCID: PMC11737742 DOI: 10.1371/journal.pone.0313527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 10/27/2024] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Antenatal care (ANC) coverage in low- and middle-income countries has increased in the past few decades. However, merely increasing care coverage may not enhance maternal and newborn health unless the recommended service components are also provided. Our aim was to assess the quality of ANC and its associated factors in Ethiopia. METHODS We used data from 2,042 pregnant women whose first ANC consultation was observed. Data were obtained from the 2021-2022 Ethiopian Service Provision Assessment survey conducted among a nationally representative sample of 1,158 healthcare facilities. Twenty-four components of ANC were assessed, and their values were summed to generate a total ANC quality score (range: 0-24). A higher score indicated a superior ANC quality. A multiple generalized Poisson regression model was fitted to identify factors influencing the quality of ANC. All statistical analyses were performed using STATA version 16. RESULTS The mean ANC quality score was 11 (standard deviation [SD]: 3.8). Blood pressure measurement was the most commonly performed ANC component, at 79.5%, and breast examination for cancer screening was the most neglected component of ANC, at 3.3%. ANC quality was higher in the Amhara region (incidence rate ratio [IRR]: 1.088; 95% confidence interval [CI]: 1.0-1.171) and Southern Nations, Nationalities, and Peoples' Region (IRR: 1.081; 95% CI: 1.002-1.166), and when the care was provided by a female healthcare worker (IRR: 1.054; 95% CI: 1.021-1.088). On the other hand, ANC quality decreased in rural healthcare facilities (IRR: 0.964; 95% CI: 0.932-0.998), clinics (IRR: 0.666; 95% CI: 0.581-0.764), and health posts (IRR: 0.817; 95% CI: 0.732-0.91). Similarly, ANC quality decreased when gestational age at the first antenatal visit increased (IRR: 0.994; 95% CI: 0.992-0.996) and when care was received from a non-nearby healthcare facility (IRR: 0.956; 95% CI: 0.923-0.990). CONCLUSION Overall, the quality of ANC in Ethiopia is suboptimal. Encouraging women to initiate ANC early and utilize nearby facilities, assisting providers in delivering standardized services through preservice training, supervision, and continuous education, and ensuring the availability and proper use of necessary resources at all facilities are important to improve ANC quality.
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Affiliation(s)
- Addisu Alehegn Alemu
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Alec Welsh
- Discipline of Women’s Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Department of Maternal-Fetal Medicine, Royal Hospital for Women, Sydney, Australia
| | - Theodros Getachew
- Health System Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Takemi Program in International Health, Boston, Massachusetts, United States of America
| | - Marjan Khajehei
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
- Women’s and Newborn Health, Westmead Hospital, Sydney, Australia
- The University of Sydney, Sydney, Australia
- Western Sydney University, Sydney, Australia
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Nishan MDNH. AI-powered drug discovery for neglected diseases: accelerating public health solutions in the developing world. J Glob Health 2025; 15:03002. [PMID: 39791403 PMCID: PMC11719738 DOI: 10.7189/jogh.15.03002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2025] Open
Abstract
The emergence of artificial intelligence (AI) in drug discovery represents a transformative development in addressing neglected diseases, particularly in the context of the developing world. Neglected diseases, often overlooked by traditional pharmaceutical research due to limited commercial profitability, pose significant public health challenges in low- and middle-income countries. AI-powered drug discovery offers a promising solution by accelerating the identification of potential drug candidates, optimising the drug development process, and reducing the time and cost associated with bringing new treatments to market. However, while AI shows promise, many of its applications are still in their early stages and require human validation to ensure the accuracy and reliability of predictions. Additionally, AI models are limited by the availability of high-quality data, which is often sparse in regions where neglected diseases are most prevalent. This viewpoint explores the application of AI in drug discovery for neglected diseases, examining its current impact, related ethical considerations, and the broader implications for public health in the developing world. It also highlights the challenges and opportunities presented by AI in this context, emphasising the need for ongoing research, ethical oversight, and collaboration between public health stakeholders to fully realise its potential in transforming global health outcomes.
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Adegbola AJ, Ogboye RM, Ijarotimi OA, Ubom AE, Adesoji BA, Bolaji OO. Assessment of uptake of sulphadoxine-pyrimethamine for intermittent preventive treatment among pregnant women in Osun State, Nigeria. Trans R Soc Trop Med Hyg 2025; 119:77-84. [PMID: 39397751 DOI: 10.1093/trstmh/trae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/13/2024] [Accepted: 09/19/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND About 32 million pregnant women are at the risk of malaria infection yearly in malaria-endemic sub-Saharan Africa. To mitigate the risks associated with malaria in pregnancy, the WHO recommends ≥3 doses of intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP), covering from the second trimester of pregnancy until delivery. METHODS This cross-sectional study assessed the uptake and extent of adherence with IPTp-SP among pregnant women in Osun State, Nigeria, from October 2020 to March 2021. Assessment of the uptake was done by extracting information from the validated case report forms. Venous blood samples were obtained to assess the levels of sulphadoxine in plasma through HPLC-UV. RESULTS In total, 49.24%, 38.17% and 12.58% of the study participants obtained 1, 2 and ≥3 doses of IPTp-SP, respectively. In assessing the extent of adherence, 46.67% obtained their last dose within 28 d before sample collection. Uptake of IPTp-SP is not associated with gravidity (p=0.603), but is weakly associated with the age of the study participants (p=0.04). The median (IQR) plasma sulphadoxine concentration was 10.6248 (2.8124-27.1242) ug/mL. CONCLUSIONS Utilisation of the intervention is still very low and adherence appears to be inadequate among the study population, suggesting that more advocacy on the IPTp-SP strategy and the implementation of directly observed therapy is necessary.
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Affiliation(s)
- Adebanjo J Adegbola
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile Ife, Nigeria
| | - Ruth M Ogboye
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile Ife, Nigeria
| | - Omotade A Ijarotimi
- Department of Obstetrics, Gynaecology and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Akaninyene E Ubom
- Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Bukola A Adesoji
- Department of Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Oluseye O Bolaji
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile Ife, Nigeria
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Funwei RI, Olaleye A, Uyaiabasi GN, Hammed W, Obadimeji MM, Elikwu CJ, Adepoju A, Okangba C, Akinyede A, Ojurongbe O, Falade C, Walker O. Genetic profiling of Plasmodium falciparum antigenic biomarkers among asymptomatic pregnant women on intermittent preventive treatment with sulfadoxine-pyrimethamine from southwest Nigeria. Placenta 2025; 159:161-169. [PMID: 39731848 DOI: 10.1016/j.placenta.2024.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 12/09/2024] [Accepted: 12/20/2024] [Indexed: 12/30/2024]
Abstract
INTRODUCTION The genetic complexity of Plasmodium falciparum is contributory to the emergence of drug resistant-parasites. Intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in malaria endemic settings is recommended by WHO. This study evaluated the prevalence of Plasmodium falciparum multidrug resistance-1 gene (Pfmdr-1), genetic diversity of merozoite surface proteins (msp-1, msp-2) and glutamate-rich protein (glurp) among pregnant women with sub-patent parasitaemia from southwest Nigeria. METHODS One hundred PCR-confirmed Plasmodium falciparum isolates, collected at first visit-V-1 (n = 52), delivery (n = 31) and cord blood (n = 17), were selected for analysis. The Pfmdr-1 alleles was evaluated using restriction fragment length polymorphism (RLFP), while msp-1, msp-2 and glurp genes were genotyped. Allelic frequency distribution and multiplicity of infection were calculated at p-value ≤0.05. RESULTS The Pfmdr-1 (N86/N86Y) combination was detected in 11.8 %, 61.3 % and 58.8 % (p ≤ 0.05) in V-1, Delivery and Cord isolates respectively. The N86Y haplotype was detected only in cord (5.9 %). The allelic frequency distribution for msp-1 was 244 (K1 = 81, MAD20 = 84 and RO33 = 79), and msp-2; 110 alleles, representing 43.6 % (FC27) and 56.4 % (3D7). While glurp expressed 25 alleles, 84 % (V-1), 12 % (delivery) and 4 % (cord), respectively (p ≤ 0.05). The msp-1 and msp-2 recorded higher MOIs than glurp. DISCUSSION Genetically diverse P. falciparum strains with Pfmdr-1 mutant alleles were detected in pregnant women with sub-patent parasitaemia in southwest Nigeria, which may reduce IPTp-SP effectiveness. Thus, continuous molecular surveillance of resistant-parasites to sulphadoxine-pyrimethamine and ACTs is essential.
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Affiliation(s)
- R I Funwei
- Department of Pharmacology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria.
| | - A Olaleye
- Two Hills Medical Clinic, Two Hills, Alberta, Canada; Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - G N Uyaiabasi
- Department of Pharmacology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - W Hammed
- Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Department of Pharmacology, Therapeutics and Toxicology, University of Lagos, Idiaraba, Nigeria
| | - M M Obadimeji
- Research Innovation and International Cooperation (RIIC) Unit, Babcock University, Ogun State, Nigeria
| | - C J Elikwu
- Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Department of Medical Microbiology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - A Adepoju
- Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Centre for Research, Innovation and Development, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - C Okangba
- Department of Medical Microbiology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - A Akinyede
- Department of Pharmacology, Therapeutics and Toxicology, University of Lagos, Idiaraba, Nigeria
| | - O Ojurongbe
- Department of Medical Microbiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo, Nigeria
| | - C Falade
- Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O Walker
- Department of Pharmacology, Babcock University, Ilishan-Remo, Ogun, Nigeria; Centre for Advanced Medical Research and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
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Bhargava S, Deshmukh R, Dewangan HK. Recent Advancement in Drug Development for Treating Malaria using Herbal Medicine and Nanotechnological Approach. Curr Pharm Des 2025; 31:203-218. [PMID: 39279710 DOI: 10.2174/0113816128321468240828103439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 09/18/2024]
Abstract
More than two hundred million people around the world are infected with malaria, a blood-borne disease that poses a significant risk to human life. Single medications, such as lumefantrine, primaquine, and chloroquine, as well as combinations of these medications with artemisinin or its derivatives, are currently being used as therapies. In addition, due to rising antimalarial drug resistance, other therapeutic options are needed immediately. Furthermore, due to anti-malarial medication failures, a new drug is required. Medication discovery and development are costly and time-consuming. Many malaria treatments have been developed however, most treatments have low water solubility and bioavailability. They may also cause drugresistant parasites, which would increase malaria cases and fatalities. Nanotechnology may offer a safer, more effective malaria therapy and control option. Nanoparticles' high loading capacity, concentrated drug delivery, biocompatibility, and low toxicity make them an attractive alternative to traditional therapy. Nanotechnologybased anti-malarial chemotherapeutic medications outperform conventional therapies in therapeutic benefits, safety, and cost. This improves patient treatment compliance. The limitations of malaria treatments and the importance of nanotechnological approaches to the treatment of malaria were also topics that were covered in this review. The most recent advancements in nanomaterials and the advantages they offer in terms of medication delivery are discussed in this article. The prospective therapy for malaria is also discussed. Additionally, the limitations of malaria therapies and the importance of nanotechnology-based approaches to the treatment of malaria were explored.
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Affiliation(s)
- Sarvesh Bhargava
- Institute of Pharmaceutical Research, GLA University, Mathura, U.P., India
| | - Rohitas Deshmukh
- Institute of Pharmaceutical Research, GLA University, Mathura, U.P., India
| | - Hitesh Kumar Dewangan
- University Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, India
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Chaves CRS, da Silva C, Salamandane A, Nogueira F. Mapping Antimalarial Drug Resistance in Mozambique: A Systematic Review of Plasmodium falciparum Genetic Markers Post-ACT Implementation. Int J Mol Sci 2024; 25:13645. [PMID: 39769406 PMCID: PMC11728251 DOI: 10.3390/ijms252413645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/07/2024] [Accepted: 12/09/2024] [Indexed: 01/16/2025] Open
Abstract
Malaria continues to be a significant public health burden in many tropical and subtropical regions. Mozambique ranks among the top countries affected by malaria, where it is a leading cause of morbidity and mortality, accounting for 29% of all hospital deaths in the general population and 42% of deaths amongst children under five. This review presents a comparative analysis of data on five critical genes associated with antimalarial drug resistance: pfmdr1, pfcrt, pfk13, pfdhfr, and pfdhps, along with the copy number variation (CNV) in genes pfmdr1 and pfpm2/3. These are genes associated with parasite response to antimalarials currently used to treat uncomplicated P. falciparum malaria in Mozambique. The review synthesizes data collected from published studies conducted in Mozambique after the introduction of artemisinin-based combination therapies (ACTs) (2006) up to June 2024, highlighting the presence or absence of mutations in these genes across Mozambique. We aimed at mapping the prevalence and distribution of these molecular markers across the country in order to contribute to the development of targeted interventions to sustain the efficacy of malaria treatments in Mozambique. Four databases were used to access the articles: PubMed, Science Direct, Scopus, and Google scholar. The search strategy identified 132 studies addressing malaria and antimalarial resistance. Of these, 112 were excluded for various reasons, leaving 20 studies to be included in this review. Children and pregnant women represent the majority of target groups in studies on all types of antimalarials. Most studies (87.5%) were conducted in the provinces of Maputo and Gaza. The primary alleles reported were pfcrt CVMNK, and in the most recent data, its wild-type form was found in the majority of patients. A low prevalence of mutations in the pfk13 gene was identified reflecting the effectiveness of ACTs. In pfk13, only mutation A578S was reported in Niassa and Tete. CNVs were observed in studies carried out in the south of Mozambique, with a frequency of 1.1-5.1% for pfmdr1 and a frequency of 1.1-3.4% for pfpm2. This review indicates that molecular markers linked to malaria resistance show considerable variation across provinces in Mozambique, with most up-to-date data accessible for Maputo and Gaza. In contrast, provinces such as Zambezia and Inhambane have limited data on several genes, while Nampula lacks data on all drug resistance markers.
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Affiliation(s)
- Celso Raul Silambo Chaves
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (C.R.S.C.); (C.d.S.)
| | - Clemente da Silva
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (C.R.S.C.); (C.d.S.)
| | - Acácio Salamandane
- Faculdade de Ciências de Saúde, Universidade Lúrio, Campus Universitário de Marrere, Nampula 4250, Mozambique;
| | - Fatima Nogueira
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (C.R.S.C.); (C.d.S.)
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Kumah E. The influence of caregiver's malaria-related knowledge on the use of insecticide-treated net among children under-five: a cross-sectional study. Malar J 2024; 23:374. [PMID: 39696443 DOI: 10.1186/s12936-024-05203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 11/28/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Malaria remains a critical public health challenge globally, particularly in sub-Saharan Africa where it significantly contributes to morbidity and mortality among children under-five. In Ghana, efforts to promote the use of insecticide-treated nets (ITNs) as a preventive measure have been substantial but utilization rates remain suboptimal. This study examines the influence of caregivers' malaria-related knowledge on ITN use among children under the age of five years in a rural district of Ghana. METHODS A community-based cross-sectional study was conducted in the Ahafo Ano South West District, Ghana, between June and October 2023. A total of 442 caregivers (mothers) of children under-five were selected using a two-stage sampling process. Data were collected through structured interviews and analysed using bivariate and multivariable logistic regression models to determine the association between caregivers' malaria-related knowledge and ITN use among children. RESULTS Out of 442 caregivers, 436 (98.6%) completed the survey. ITN use among children under-five the night before the survey was reported by 73.8% of caregivers. Overall, 36.8% of caregivers had good malaria-related knowledge, 41.2% had satisfactory knowledge, and 21.9% had poor knowledge. Multivariable analysis showed that caregivers with good malaria-related knowledge were 12 times more likely to use ITNs for their children (AOR = 12.06, 95% CI 2.30-53.20) compared to those with poor knowledge. Other significant predictors included education on ITN use, ITN ownership, child's age, and use of alternative malaria prevention methods. CONCLUSION This study highlights the critical role of caregiver malaria-related knowledge in promoting ITN use among children under-five in rural Ghana. Caregivers with better knowledge were significantly more likely to use ITNs, emphasizing the need for targeted health education programs. Such interventions should enhance awareness of malaria risks and ITN benefits, empower caregivers to use ITNs effectively, and reduce barriers to ITN access. These findings provide valuable insights for policymakers aiming to improve ITN utilization and reduce malaria morbidity and mortality in vulnerable populations.
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Affiliation(s)
- Emmanuel Kumah
- Department of Health Administration and Education, Faculty of Health, Allied Sciences and Home Economics Education, University of Education, Winneba, Ghana.
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Alghamdi JM, Al-Qahtani AA, Alhamlan FS, Al-Qahtani AA. Recent Advances in the Treatment of Malaria. Pharmaceutics 2024; 16:1416. [PMID: 39598540 PMCID: PMC11597227 DOI: 10.3390/pharmaceutics16111416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 10/25/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024] Open
Abstract
Malaria is still one of the major global health challenges affecting millions annually, particularly in non-Mediterranean Africa and Southeast Asia. Over the past two decades, substantial progress has been made in reducing malaria-related morbidity and mortality, primarily due to advancements in antimalarial therapeutics. This review provides a comprehensive overview of recent developments in malaria treatment, focusing on the evolution of drug therapies, mechanisms of action, and emerging resistance patterns. The cornerstone of current treatment strategies is artemisinin-based combination therapies (ACTs), which have proven highly effective against P. falciparum and P. vivax, the most prevalent malaria-causing parasites. However, the onset of artemisinin resistance, particularly in Southeast Asian countries, poses a significant threat to these gains. Additionally, other antimalarial classes, including quinine derivatives, 8-aminoquinolines, and antifolate drugs, are examined for their efficacy, resistance mechanisms, and future potential. This review also discusses the challenges associated with drug resistance, the genetic underpinnings of resistance in malaria parasites, and the implications for future treatment protocols. Furthermore, the review examines combinational therapies, such as triple artemisinin combination therapies (TACTs), and vaccines that are approved or in development to circumvent resistance issues. The need for continuous surveillance, innovative therapeutic strategies, and advances in novel antimalarial therapeutic agents is emphasized to sustain and further progress in the control of malaria and its eventual eradication.
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Affiliation(s)
- Jawaher M. Alghamdi
- Department of Zoology, College of Science, King Saud University, Riyadh 13242, Saudi Arabia;
| | - Arwa A. Al-Qahtani
- Department of Family Medicine, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia;
| | - Fatimah S. Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital & Research Center, Riyadh 11211, Saudi Arabia;
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia
| | - Ahmed A. Al-Qahtani
- Department of Infection and Immunity, King Faisal Specialist Hospital & Research Center, Riyadh 11211, Saudi Arabia;
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh 11211, Saudi Arabia
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Obeagu EI, Obeagu GU. Emerging public health strategies in malaria control: innovations and implications. Ann Med Surg (Lond) 2024; 86:6576-6584. [PMID: 39525724 PMCID: PMC11543165 DOI: 10.1097/ms9.0000000000002578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 09/06/2024] [Indexed: 11/16/2024] Open
Abstract
Malaria remains a significant global health challenge, particularly in regions with limited resources and tropical climates. Despite extensive efforts, the disease continues to cause significant morbidity and mortality, with ~229 million cases and 409 000 deaths reported in 2020. However, recent years have seen promising advancements in public health strategies aimed at malaria control and elimination. Technological advancements have played a crucial role in improving malaria control efforts. Genomic surveillance techniques enable the monitoring of malaria parasite populations, aiding in the detection of drug resistance and informing targeted interventions. Additionally, innovative diagnostic technologies, such as rapid diagnostic tests (RDTs) and molecular assays, have enhanced the speed and accuracy of malaria diagnosis, facilitated prompt treatment and reduced transmission. These tools are instrumental in achieving the WHO goals of reducing malaria cases and deaths by at least 90% by 2030. Novel vector control methods offer innovative approaches to reduce malaria transmission. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) remain foundational strategies, with advancements including the development of next-generation insecticides and long-lasting insecticidal nets (LLINs). Furthermore, genetic modification of mosquitoes, such as gene drive technology, holds promise for reducing mosquito populations and interrupting malaria transmission. These vector control innovations complement other strategies, contributing to comprehensive malaria control efforts aimed at achieving sustainable disease reduction and eventual elimination.
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Tadege G, Dagne A, Bizuneh GK, Abebe D, Nureye D. Efficacy of Albizia malacophylla (A.Rich.) Walp. (Leguminosae) methanol (80%) leaf extract and solvent fractions against Plasmodium berghei-induced malaria in mice model. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118413. [PMID: 38824975 DOI: 10.1016/j.jep.2024.118413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Novel drugs are needed to address the issue of malarial infection resistance; natural items can be a different source of these medications. Albizia malacophylla (A. Rich.) Walp. (Leguminosae) is listed as one of the antimalarial medicinal plants in Ethiopian folk medicine. However, there are no reports regarding the biological activity or phytochemistry of the plant. AIM OF THE STUDY Thus, this study aimed to evaluate the A. malacophylla crude extract and solvent fractions' in vivo antimalarial activity utilizing 4-day suppressive, preventative, and curative tests in mice infected with P. berghei. MATERIALS AND METHODS The parasite Plasmodium berghei, which causes rodent malaria, was used to infect healthy male Swiss Albino mice, weighing 23-28 g and aged 6-8 weeks. Solvent fractions such as methanol, water, and chloroform were given in addition to an 80% methanolic extract at 100, 200, and 400 mg/kg doses. A Conventional test such as parasitemia, survival time, body weight, temperature, and packed cell capacity were employed to ascertain factors such as the suppressive, curative, and preventive tests. RESULTS Every test substance dramatically reduced the number of parasites in every experiment. Crude extract (with the highest percentage suppression of 67.78%) performs better antimalarial effect than the methanol fraction, which is the most efficient solvent fraction with a percentage suppression of 55.74%. With a suppression value of 64.83% parasitemia level, the therapeutic effects of 80% methanolic crude extract were greater than its curative and preventative effects in a four-day suppressive test. The survival period (17 days) was longer with the hydroalcoholic crude extract dose of 400 mg/kg than with other doses of the materials under investigation. CONCLUSIONS The results of this investigation validate the antimalarial characteristics of A. malacophylla leaf extract. The crude extract prevented weight loss, a decline in temperature, and a reduction in PCV. The results demonstrate that the plant has a promising antimalarial effect against P. berghei, hence supporting the traditional use of the plant. Therefore, it could serve as a foundation for the development of new antimalarial drugs.
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Affiliation(s)
- Getnet Tadege
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Northwest, Ethiopia.
| | - Abebe Dagne
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Northwest, Ethiopia
| | - Gizachew Kassahun Bizuneh
- Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Dehnnet Abebe
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Northwest, Ethiopia.
| | - Dejen Nureye
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia; School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Southwest, Ethiopia
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Makau M, Kanoi BN, Mgawe C, Maina M, Bitshi M, Too EK, Naruse TK, Abkallo HM, Waweru H, Adung'o F, Kaneko O, Gitaka J. Presence of Plasmodium falciparum strains with artemisinin-resistant K13 mutation C469Y in Busia County, Western Kenya. Trop Med Health 2024; 52:72. [PMID: 39425178 PMCID: PMC11488207 DOI: 10.1186/s41182-024-00640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 09/29/2024] [Indexed: 10/21/2024] Open
Abstract
Malaria remains a key health and economic problem, particularly in sub-Saharan Africa. The emergence of artemisinin drug resistance (ART-R) parasite strains poses a serious threat to the control and elimination of this scourge. This is because artemisinin-based combination therapies (ACTs) remain the first-line treatment in the majority of malaria-endemic regions in Sub-Saharan Africa. Certain single-nucleotide polymorphisms in the propeller domains of Plasmodium falciparum Kelch 13 protein (K13) have been associated with delayed parasite clearance in vivo and in vitro. These mutations serve as vital molecular markers for tracking the emergence and dispersion of resistance. Recently, there have been increasing reports of the emergence and spread of P. falciparum ART-R parasites in the Eastern Africa region. This necessitates continued surveillance to best inform mitigation efforts. This study investigated the presence of all reported mutations of K13 propeller domains in the parasite population in Busia County, Kenya, a known malaria-endemic region. Two hundred twenty-six participants with microscopically confirmed uncomplicated malaria were recruited for this study. They were treated with artemether-lumefantrine under observation for the first dose, and microscopic examination was repeated 1 day later after ensuring the participants had taken the second and third doses. P. falciparum DNA from all samples underwent targeted amplification of the K13 gene using a semi-nested PCR approach, followed by Sanger sequencing. The recently validated ART-R K13 mutation C469Y was identified in three samples. These three samples were among 63 samples with a low reduction in parasitemia on day 1, suggesting day 1 parasitemia reduction rate is a useful parameter to enrich the ART-R parasites for further analysis. Our findings highlight the need for continuous surveillance of ART-R in western Kenya and the region to determine the spread of ART-R and inform containment.
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Affiliation(s)
- Mark Makau
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
- Centre for Research in Infectious Diseases, Directorate of Research and Innovation, Mount Kenya University, Thika, Kenya
| | - Bernard N Kanoi
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
- Centre for Research in Infectious Diseases, Directorate of Research and Innovation, Mount Kenya University, Thika, Kenya
| | - Calvin Mgawe
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | - Michael Maina
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | - Mimie Bitshi
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Edwin K Too
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taeko K Naruse
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Hussein M Abkallo
- Animal and Human Health Program, International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Harrison Waweru
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | - Ferdinand Adung'o
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
| | - Osamu Kaneko
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Jesse Gitaka
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya.
- Centre for Research in Infectious Diseases, Directorate of Research and Innovation, Mount Kenya University, Thika, Kenya.
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
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Mandai SS, Francis F, Challe DP, Seth MD, Madebe RA, Petro DA, Budodo R, Kisambale AJ, Chacha GA, Moshi R, Mbwambo RB, Pereus D, Bakari C, Aaron S, Mbwambo D, Lusasi A, Kajange S, Lazaro S, Kapologwe N, Mandara CI, Ishengoma DS. High prevalence and risk of malaria among asymptomatic individuals from villages with high prevalence of artemisinin partial resistance in Kyerwa district of Kagera region, north-western Tanzania. Malar J 2024; 23:197. [PMID: 38926854 PMCID: PMC11201325 DOI: 10.1186/s12936-024-05019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Although Tanzania adopted and has been implementing effective interventions to control and eventually eliminate malaria, the disease is still a leading public health problem, and the country experiences heterogeneous transmission. Recent studies reported the emergence of parasites with artemisinin partial resistance (ART-R) in Kagera region with high prevalence (> 10.0%) in two districts of Karagwe and Kyerwa. This study assessed the prevalence and predictors/risk of malaria infections among asymptomatic individuals living in a hyperendemic area where ART-R has emerged in Kyerwa District of Kagera region, north-western Tanzania. METHODS This was a community-based cross-sectional survey which was conducted in July and August 2023 and involved individuals aged ≥ 6 months from five villages in Kyerwa district. Demographic, anthropometric, clinical, parasitological, type of house inhabited and socio-economic status (SES) data were collected using electronic capture tools run on Open Data Kit (ODK) software. Predictors/risks of malaria infections were determined by univariate and multivariate logistic regression, and the results were presented as crude (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs). RESULTS Overall, 4454 individuals were tested using rapid diagnostic tests (RDTs), and 1979 (44.4%) had positive results. The prevalence of malaria infections ranged from 14.4% to 68.5% and varied significantly among the villages (p < 0.001). The prevalence and odds of infections were significantly higher in males (aOR = 1.28, 95% CI 1.08 -1.51, p = 0.003), school children (aged 5-≤10 years (aOR = 3.88, 95% CI 3.07-4.91, p < 0.001) and 10-≤15 years (aOR = 4.06, 95% CI 3.22-5.13, p < 0.001)) and among individuals who were not using bed nets (aOR = 1.22, 95% CI 1.03-1.46, p = 0.024). The odds of malaria infections were also higher in individuals with lower SES (aOR = 1.42, 95% CI 1.17-1.72, p < 0.001), and living in houses without windows (aOR = 2.08, 95% CI 1.46-2.96, p < 0.001), partially open (aOR = 1.33, 95% CI 1.11-1.58, p = 0.002) or fully open windows (aOR = 1.30, 95%CI 1.05-1.61, p = 0.015). CONCLUSION The five villages had a high prevalence of malaria infections and heterogeneity at micro-geographic levels. Groups with higher odds of malaria infections included school children, males, and individuals with low SES, living in poorly constructed houses or non-bed net users. These are important baseline data from an area with high prevalence of parasites with ART-R and will be useful in planning interventions for these groups, and in future studies to monitor the trends and potential spread of such parasites, and in designing a response to ART-R.
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Affiliation(s)
- Salehe S Mandai
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Daniel P Challe
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Misago D Seth
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Rashid A Madebe
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Rule Budodo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Gervas A Chacha
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Ramadhan Moshi
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Ruth B Mbwambo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Dativa Pereus
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Catherine Bakari
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | | | | | - Stella Kajange
- President's Office, Regional Administration and Local Government, Dodoma, Tanzania
| | - Samuel Lazaro
- National Malaria Control Programme, Dodoma, Tanzania
| | - Ntuli Kapologwe
- Directorate of Preventive Services, Ministry of Health, Dodoma, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Deus S Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania.
- Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
- Harvard T.H Chan School of Public Health, Harvard University, Boston, MA, USA.
- Department of Biochemistry, Kampala International University in Tanzania, Dar es Salaam, Tanzania.
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Moltot T, Bekele G, Gebreegziabher ZA, Lemma T, Sisay M, Silesh M, Mulugeta M, Demissie L, Kebede TN, Taye BT. A five years malaria surveillance data analysis of North Shewa zone, Amhara region, Ethiopia: July 2018 to June 2023. Malar J 2024; 23:187. [PMID: 38879484 PMCID: PMC11179369 DOI: 10.1186/s12936-024-05006-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/29/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Malaria is a critical public health concern in Ethiopia, with significant socioeconomic consequences. Malaria data trend analysis is essential for understanding transmission patterns and adopting evidence-based malaria control measures. The purpose of this study was to determine the 5 year distribution of malaria in North Shewa zone, Amhara region, Ethiopia, in 2023. METHODS A descriptive cross-sectional study design was employed to analyse the 5 year trend of malaria surveillance data in the North Shewa zone of the Amhara regional, Ethiopia, spanning from July 2018 to June 2023. The malaria indicator data were gathered from the zone's public health emergency management database. Malaria data from the previous 5 years was collected, compiled, processed, and analysed using Microsoft Excel 2019. RESULTS Among a total of 434,110 suspected cases 47,889 (11.03%) cases were confirmed as malaria, with an average annual malaria incidence rate of 4.4 per 1000 population in the Zone. Malaria cases exhibited an increase from Epidemiological Week (Epi week) 37 to Epi week 49 (September to November) and again from Epi week 22 to week 30 (May to July). Individuals aged 15 and above, and all districts in the Zone except Angolela were notably affected by malaria. CONCLUSION Despite implementing various measures to reduce malaria incidence, the disease continues to persist in the zone. Therefore, the Zone Health Department should intensify its preventive and control efforts.
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Affiliation(s)
- Tebabere Moltot
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia.
| | - Girma Bekele
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre University, Debre Birhan, Ethiopia
| | | | - Tesfansh Lemma
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Moges Sisay
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Mulualem Silesh
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Melkam Mulugeta
- School of Medicine, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Legesse Demissie
- School of Medicine, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Tirusew Nigussie Kebede
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia
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Kigongo E, Kabunga A, Opollo MS, Tumwesigye R, Musinguzi M, Akello AR, Nabaziwa J, Hardido TG, Puleh SS. Community readiness and acceptance for the implementation of a novel malaria vaccine among at-risk children in sub-saharan Africa: a systematic review protocol. Malar J 2024; 23:182. [PMID: 38858779 PMCID: PMC11165811 DOI: 10.1186/s12936-024-04995-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/22/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND The World Health Organization novel malaria vaccine for at-risk children has the potential to greatly reduce the current malaria burden in sub-Saharan Africa. However, most studies have reported contradictory findings regarding community willingness for the vaccine, which could easily undermine the expected benefits of the vaccine. This study aims to ascertain the current state of community readiness and acceptance for the implementation of a novel malaria vaccine (RTS,S/ASO1) among at-risk children in sub-Saharan Africa, based on available evidence. METHODS This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol (PRISMA-P) guidelines. Relevant studies will be comprehensively searched from PubMed, ScienceDirect, Web of Science, Google Scholar, and African journals online, in accordance with the Cochrane search guidelines. Two independent reviewers will screen titles, abstracts and full texts of eligible studies based on some specified eligibility criteria. When it is feasible to conduct a meta-analysis, a random effects model will be employed to estimate the common effect due to anticipated high heterogeneity of the data. The effect measure for readiness or acceptance will be reported as a pooled proportion with corresponding 95% confidence interval. Additionally, odds ratios with 95% confidence interval will be estimated to assess factors associated with readiness. These will be presented on a forest plot. DISSEMINATION PLANS The findings of the study will be peer-reviewed and published in a scientific journal. Conference presentations will also be made to the different stakeholders in the malaria vaccination campaigns. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered with PROSPERO Registration Number: CRD42023480528.
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Affiliation(s)
- Eustes Kigongo
- Faculty of Public Health, Lira University, Lira, Uganda.
| | - Amir Kabunga
- Faculty of Medicine, Lira University, Lira, Uganda
| | | | - Raymond Tumwesigye
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Tia JPB, Tchicaya ESF, Zahouli JZB, Ouattara AF, Vavassori L, Assamoi JB, Small G, Koudou BG. Combined use of long-lasting insecticidal nets and Bacillus thuringiensis israelensis larviciding, a promising integrated approach against malaria transmission in northern Côte d'Ivoire. Malar J 2024; 23:168. [PMID: 38812003 PMCID: PMC11137964 DOI: 10.1186/s12936-024-04953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND The recent reduction in malaria burden in Côte d'Ivoire is largely attributable to the use of long-lasting insecticidal nets (LLINs). However, this progress is threatened by insecticide resistance and behavioral changes in Anopheles gambiae sensu lato (s.l.) populations and residual malaria transmission, and complementary tools are required. Thus, this study aimed to assess the efficacy of the combined use of LLINs and Bacillus thuringiensis israelensis (Bti), in comparison with LLINs. METHODS This study was conducted in the health district of Korhogo, northern Côte d'Ivoire, within two study arms (LLIN + Bti arm and LLIN-only arm) from March 2019 to February 2020. In the LLIN + Bti arm, Anopheles larval habitats were treated every fortnight with Bti in addition to the use of LLINs. Mosquito larvae and adults were sampled and identified morphologically to genus and species using standard methods. The members of the An. gambiae complex were determined using a polymerase chain reaction technique. Plasmodium infection in An. gambiae s.l. and malaria incidence in local people was also assessed. RESULTS Overall, Anopheles spp. larval density was lower in the LLIN + Bti arm 0.61 [95% CI 0.41-0.81] larva/dip (l/dip) compared with the LLIN-only arm 3.97 [95% CI 3.56-4.38] l/dip (RR = 6.50; 95% CI 5.81-7.29; P < 0.001). The overall biting rate of An. gambiae s.l. was 0.59 [95% CI 0.43-0.75] biting/person/night in the LLIN + Bti arm against 2.97 [95% CI 2.02-3.93] biting/person/night in LLIN-only arm (P < 0.001). Anopheles gambiae s.l. was predominantly identified as An. gambiae sensu stricto (s.s.) (95.1%, n = 293), followed by Anopheles coluzzii (4.9%; n = 15). The human-blood index was 80.5% (n = 389) in study area. EIR was 1.36 infected bites/person/year (ib/p/y) in the LLIN + Bti arm against 47.71 ib/p/y in the LLIN-only arm. Malaria incidence dramatically declined from 291.8‰ (n = 765) to 111.4‰ (n = 292) in LLIN + Bti arm (P < 0.001). CONCLUSIONS The combined use of LLINs with Bti significantly reduced the incidence of malaria. The LLINs and Bti duo could be a promising integrated approach for effective vector control of An. gambiae for elimination of malaria.
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Affiliation(s)
- Jean-Philippe B Tia
- Université Nangui Abrogoua, Abidjan, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Emile S F Tchicaya
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Péléforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Julien Z B Zahouli
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Allassane F Ouattara
- Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Laura Vavassori
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | | | - Graham Small
- Innovative Vector Control Consortium, Pembroke Place, Liverpool, L3 5QA, UK
| | - Benjamin G Koudou
- Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Dapari R, Mohd Yusop MZF, Chinnasamy D, Zakaria NI, Mohd Shoaib SM, Edros ME. A systematic review of the factors associated with malaria infection among forest rangers. PLoS One 2024; 19:e0303406. [PMID: 38748721 PMCID: PMC11095669 DOI: 10.1371/journal.pone.0303406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Malaria is a vector-borne disease that initially manifests as fever, headache, and chills. The illness could progress to more severe conditions, including lethargy, impaired consciousness, convulsions, shortness of breath, blood in urine, jaundice, and haemorrhage if left untreated. The risk of contracting malaria is considerably heightened in specific occupational settings, particularly among forest rangers, following frequent exposure to natural habitats. Consequently, advancing the understanding of malaria and emphasising how specific occupational environments (including those of forest rangers) contribute to disease risk and management is imperative. OBJECTIVE The present study aims to determine the factors associated with malaria infection among forest rangers by systematically reviewing electronic articles from three databases (EBSCOhost, ScienceDirect, and ResearchGate). METHODS The current review was prepared based on the updated preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. First, three independent reviewers screened the titles and abstracts of the data collected. The information was then stored in Endnote20 based on the inclusion and exclusion criteria. The articles were critically appraised with the mixed methods appraisal tool (MMAT) to assess their quality. RESULT A total of 103, 31, and 51 articles from EBSCOhost, ScienceDirect, and ResearchGate, respectively, were selected, resulting in 185 unique hits. Nevertheless, only 63 full-text publications were assessed following a rigorous selection screening, from which only five were included in the final review. The studies revealed that several factors contribute to malaria infection among forest rangers. The parameters were classified into sociodemographic, individual, and living condition-related. CONCLUSION A better understanding of malaria progresses and identifying its potential risk factors is essential to impact worker well-being. The findings might be utilised to improve malaria infection prevention programme implementations, hence maximising their success. Pre-employment and regular health screenings could also aid in evaluating and identifying potential risks for malaria infection among forest rangers.
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Affiliation(s)
- Rahmat Dapari
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - Muhamad Zazali Fikri Mohd Yusop
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - Dharsshini Chinnasamy
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - Nurul Izati Zakaria
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - Siti Munisah Mohd Shoaib
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - Mohd Erfan Edros
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
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Thomford NE, Kellermann T, Biney RP, Dixon C, Nyarko SB, Ateko RO, Ekor M, Kyei GB. Therapeutic efficacy of generic artemether-lumefantrine in the treatment of uncomplicated malaria in Ghana: assessing anti-malarial efficacy amidst pharmacogenetic variations. Malar J 2024; 23:125. [PMID: 38685044 PMCID: PMC11059713 DOI: 10.1186/s12936-024-04930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite efforts made to reduce morbidity and mortality associated with malaria, especially in sub-Saharan Africa, malaria continues to be a public health concern that requires innovative efforts to reach the WHO-set zero malaria agenda. Among the innovations is the use of artemisinin-based combination therapy (ACT) that is effective against Plasmodium falciparum. Generic artemether-lumefantrine (AL) is used to treat uncomplicated malaria after appropriate diagnosis. AL is metabolized by the cytochrome P450 family of enzymes, such as CYP2B6, CYP3A4 and CYP3A5, which can be under pharmacogenetic influence. Pharmacogenetics affecting AL metabolism, significantly influence the overall anti-malarial activity leading to variable therapeutic efficacy. This study focused on generic AL drugs used in malarial treatment as prescribed at health facilities and evaluated pharmacogenomic influences on their efficacy. METHODS Patients who have been diagnosed with malaria and confirmed through RDT and microscopy were recruited in this study. Blood samples were taken on days 1, 2, 3 and 7 for parasite count and blood levels of lumefantrine, artemisinin, desbutyl-lumefantrine (DBL), and dihydroartemisinin (DHA), the active metabolites of lumefantrine and artemether, respectively, were analysed using established methods. Pharmacogene variation analysis was undertaken using iPLEX microarray and PCR-RFLP. RESULTS A total of 52 patients completed the study. Median parasite density from day 1 to 7 ranged from 0-2666/μL of blood, with days 3 and 7 recording 0 parasite density. Highest median plasma concentration for lumefantrine and desbutyl lumefantrine, which are the long-acting components of artemisinin-based combinations, was 4123.75 ng/mL and 35.87 ng/mL, respectively. Day 7 plasma lumefantrine concentration across all generic ACT brands was ≥ 200 ng/mL which potentially accounted for the parasitaemia profile observed. Monomorphism was observed for CYP3A4 variants, while there were observed variations in CYP2B6 and CYP3A5 alleles. Among the CYP3A5 genotypes, significant differences in genotypes and plasma concentration for DBL were seen on day 3 between 1/*1 versus *1/*6 (p = 0.002), *1/*3 versus *1/*6 (p = 0.006) and *1/*7 versus *1/*6 (p = 0.008). Day 7 plasma DBL concentrations showed a significant difference between *1/*6 and *1/*3 (p = 0.026) expressors. CONCLUSIONS The study findings show that CYP2B6 and CYP3A5 pharmacogenetic variations may lead to higher plasma exposure of AL metabolites.
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Affiliation(s)
- Nicholas Ekow Thomford
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
| | - Tracy Kellermann
- Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert Peter Biney
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Pharmacotherpaeutics and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Charné Dixon
- Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Samuel Badu Nyarko
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richmond Owusu Ateko
- Department of Chemical Pathology, University of Ghana Medical School, University of Ghana, Legon, Accra, Ghana
- Division of Chemical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Martins Ekor
- Department of Pharmacology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - George B Kyei
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Ajibaye O, Olukosi YA, Oriero EC, Oboh MA, Iwalokun B, Nwankwo IC, Nnam CF, Adaramoye OV, Chukwemeka S, Okanazu J, Gabriel E, Balogun EO, Amambua-Ngwa A. Detection of novel Plasmodium falciparum coronin gene mutations in a recrudescent ACT-treated patient in South-Western Nigeria. Front Cell Infect Microbiol 2024; 14:1366563. [PMID: 38716192 PMCID: PMC11074373 DOI: 10.3389/fcimb.2024.1366563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
Background Routine surveillance for antimalarial drug resistance is critical to sustaining the efficacy of artemisinin-based Combination Therapies (ACTs). Plasmodium falciparum kelch-13 (Pfkelch-13) and non-Pfkelch-13 artemisinin (ART) resistance-associated mutations are uncommon in Africa. We investigated polymorphisms in Plasmodium falciparum actin-binding protein (Pfcoronin) associated with in vivo reduced sensitivity to ART in Nigeria. Methods Fifty-two P. falciparum malaria subjects who met the inclusion criteria were followed up in a 28-day therapeutic efficacy study of artemether-lumefantrine in Lagos, Nigeria. Parasite detection was done by microscopy and molecular diagnostic approaches involving PCR amplification of genes for Pf18S rRNA, varATS, telomere-associated repetitive elements-2 (TARE-2). Pfcoronin and Pfkelch-13 genes were sequenced bi-directionally while clonality of infections was determined using 12 neutral P. falciparum microsatellite loci and msp2 analyses. Antimalarial drugs (sulfadoxine-pyrimethamine, amodiaquine, chloroquine and some quinolones) resistance variants (DHFR_51, DHFR_59, DHFR_108, DHFR_164, MDR1_86, MDR1_184, DHPS_581 and DHPS_613) were genotyped by high-resolution melting (HRM) analysis. Results A total of 7 (26.92%) cases were identified either as early treatment failure, late parasitological failure or late clinical failure. Of the four post-treatment infections identified as recrudescence by msp2 genotypes, only one was classified as recrudescence by multilocus microsatellites genotyping. Microsatellite analysis revealed no significant difference in the mean allelic diversity, He, (P = 0.19, Mann-Whitney test). Allele sizes and frequency per locus implicated one isolate. Genetic analysis of this isolate identified two new Pfcoronin SNVs (I68G and L173F) in addition to the P76S earlier reported. Linkage-Disequilibrium as a standardized association index, IAS, between multiple P. falciparum loci revealed significant LD (IAS = 0.2865, P=0.02, Monte-Carlo simulation) around the neutral microsatellite loci. The pfdhfr/pfdhps/pfmdr1 drug resistance-associated haplotypes combinations, (108T/N/51I/164L/59R/581G/86Y/184F), were observed in two samples. Conclusion Pfcoronin mutations identified in this study, with potential to impact parasite clearance, may guide investigations on emerging ART tolerance in Nigeria, and West African endemic countries.
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Affiliation(s)
- Olusola Ajibaye
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Medical Research Council Unit, the Gambia – The London School of Hygiene and Tropical Medicine, Fajara, Banjul, Gambia
| | - Yetunde Adeola Olukosi
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Eniyou C. Oriero
- Medical Research Council Unit, the Gambia – The London School of Hygiene and Tropical Medicine, Fajara, Banjul, Gambia
| | - Mary Aigbiremo Oboh
- Medical Research Council Unit, the Gambia – The London School of Hygiene and Tropical Medicine, Fajara, Banjul, Gambia
| | - Bamidele Iwalokun
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ikechukwu Chidiebere Nwankwo
- Center for Molecular Parasitology, Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Chinaza Favour Nnam
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Olawunmi Victoria Adaramoye
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-araba, Surulere, Lagos, Nigeria
| | - Somadina Chukwemeka
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Judith Okanazu
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Eniafe Gabriel
- Malaria Genomics Research and Training Centre, Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Emmanuel Oluwadare Balogun
- Department of Biochemistry, Ahmadu Bello University, Zaria, Nigeria
- Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, Gilman Drive, La Jolla, CA, United States
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit, the Gambia – The London School of Hygiene and Tropical Medicine, Fajara, Banjul, Gambia
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Ibrahim EA, Wamalwa M, Odindi J, Tonnang HEZ. Insights and challenges of insecticide resistance modelling in malaria vectors: a review. Parasit Vectors 2024; 17:174. [PMID: 38570854 PMCID: PMC10993508 DOI: 10.1186/s13071-024-06237-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Malaria is one of the most devastating tropical diseases, resulting in loss of lives each year, especially in children under the age of 5 years. Malaria burden, related deaths and stall in the progress against malaria transmission is evident, particularly in countries that have moderate or high malaria transmission. Hence, mitigating malaria spread requires information on the distribution of vectors and the drivers of insecticide resistance (IR). However, owing to the impracticality in establishing the critical need for real-world information at every location, modelling provides an informed best guess for such information. Therefore, this review examines the various methodologies used to model spatial, temporal and spatio-temporal patterns of IR within populations of malaria vectors, incorporating pest-biology parameters, adopted ecological principles, and the associated modelling challenges. METHODS The review focused on the period ending March 2023 without imposing restrictions on the initial year of publication, and included articles sourced from PubMed, Web of Science, and Scopus. It was also limited to publications that deal with modelling of IR distribution across spatial and temporal dimensions and excluded articles solely focusing on insecticide susceptibility tests or articles not published in English. After rigorous selection, 33 articles met the review's elibility criteria and were subjected to full-text screening. RESULTS Results show the popularity of Bayesian geostatistical approaches, and logistic and static models, with limited adoption of dynamic modelling approaches for spatial and temporal IR modelling. Furthermore, our review identifies the availability of surveillance data and scarcity of comprehensive information on the potential drivers of IR as major impediments to developing holistic models of IR evolution. CONCLUSIONS The review notes that incorporating pest-biology parameters, and ecological principles into IR models, in tandem with fundamental ecological concepts, potentially offers crucial insights into the evolution of IR. The results extend our knowledge of IR models that provide potentially accurate results, which can be translated into policy recommendations to combat the challenge of IR in malaria control.
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Affiliation(s)
- Eric Ali Ibrahim
- International Centre of Insect Physiology and Ecology (Icipe), PO box 30772, Nairobi, Kenya
- School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, 3209, South Africa
| | - Mark Wamalwa
- International Centre of Insect Physiology and Ecology (Icipe), PO box 30772, Nairobi, Kenya
| | - John Odindi
- School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, 3209, South Africa
| | - Henri Edouard Zefack Tonnang
- International Centre of Insect Physiology and Ecology (Icipe), PO box 30772, Nairobi, Kenya.
- School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, 3209, South Africa.
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Memariani H, Memariani M, Ghasemian A. Quercetin as a Promising Antiprotozoan Phytochemical: Current Knowledge and Future Research Avenues. BIOMED RESEARCH INTERNATIONAL 2024; 2024:7632408. [PMID: 38456097 PMCID: PMC10919984 DOI: 10.1155/2024/7632408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/20/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Abstract
Despite tremendous advances in the prevention and treatment of infectious diseases, only few antiparasitic drugs have been developed to date. Protozoan infections such as malaria, leishmaniasis, and trypanosomiasis continue to exact an enormous toll on public health worldwide, underscoring the need to discover novel antiprotozoan drugs. Recently, there has been an explosion of research into the antiprotozoan properties of quercetin, one of the most abundant flavonoids in the human diet. In this review, we tried to consolidate the current knowledge on the antiprotozoal effects of quercetin and to provide the most fruitful avenues for future research. Quercetin exerts potent antiprotozoan activity against a broad spectrum of pathogens such as Leishmania spp., Trypanosoma spp., Plasmodium spp., Cryptosporidium spp., Trichomonas spp., and Toxoplasma gondii. In addition to its immunomodulatory roles, quercetin disrupts mitochondrial function, induces apoptotic/necrotic cell death, impairs iron uptake, inhibits multiple enzymes involved in fatty acid synthesis and the glycolytic pathways, suppresses the activity of DNA topoisomerases, and downregulates the expression of various heat shock proteins in these pathogens. In vivo studies also show that quercetin is effective in reducing parasitic loads, histopathological damage, and mortality in animals. Future research should focus on designing effective drug delivery systems to increase the oral bioavailability of quercetin. Incorporating quercetin into various nanocarrier systems would be a promising approach to manage localized cutaneous infections. Nevertheless, clinical trials are needed to validate the efficacy of quercetin in treating various protozoan infections.
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Affiliation(s)
- Hamed Memariani
- Department of Medical Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Memariani
- Department of Medical Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolmajid Ghasemian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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David A, Swalehe O, Habagusenga JDA, Banzimana S, Asingizwe D, Chacky F, Molteni F. Accessibility of malaria commodities in Geita District Council, mainland Tanzania: the experiences from healthcare providers and clients. J Pharm Policy Pract 2024; 17:2308611. [PMID: 38333577 PMCID: PMC10851820 DOI: 10.1080/20523211.2024.2308611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background Access to essential malaria commodities is a cornerstone in malaria control. However optimal availability and access to essential malaria commodities remain a challenge in Tanzania. Therefore, this study aimed to explore the factors affecting the accessibility of malaria commodities in Tanzania. Methods This was a mixed-method cross-sectional study using both quantitative and qualitative approaches. Data were collected between February and March 2023 from health facilities, health facility staff, and patients. Results Availability of malaria commodities in government health facilities was 100% for all items while in the private and faith-based facilities, this ranged from 10% to 80%. The reasons for stockouts in Government facilities were related to delayed and inadequate quantity delivery while in private facilities the main reason was the lack of cash for procurement. Both private facilities' clients and healthcare providers concurred that most people do not access complete treatment due to the high costs of prescribed medicines and poor stocking levels. Conclusion The availability, hence the accessibility, of malaria commodities in private and faith-based health facilities is still sub-optimal. Logistic management needs to be improved to eliminate stockouts and malaria commodities high costs need a permanent solution.
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Affiliation(s)
- Anna David
- EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Omary Swalehe
- Department of Business Studies, Mzumbe University, Dar es salaam, Tanzania
| | - Jean D’ Amour Habagusenga
- EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Stany Banzimana
- EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Domina Asingizwe
- EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Frank Chacky
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
| | - Fabrizio Molteni
- National Malaria Control Programme, Ministry of Health, Dodoma, Tanzania
- Swiss Tropical and Public Health Institute, Dar es Salaam, Tanzania
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Zeleke G, Duchateau L, Yewhalaw D, Suleman S, Devreese M. In-vitro susceptibility and ex-vivo evaluation of macrocyclic lactone endectocides sub-lethal concentrations against Plasmodium vivax oocyst development in Anopheles arabiensis. Malar J 2024; 23:26. [PMID: 38238768 PMCID: PMC10797976 DOI: 10.1186/s12936-024-04845-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Asymptomatic malaria transmission has become a public health concern across malaria-endemic Africa including Ethiopia. Specifically, Plasmodium vivax is more efficient at transmitting earlier in the infection and at lower densities than Plasmodium falciparum. Consequently, a greater proportion of individuals infected with P. vivax can transmit without detectable gametocytaemia. Mass treatment of livestock with macrocyclic lactones (MLs), e.g., ivermectin and doramectin, was suggested as a complementary malaria vector tool because of their insecticidal effects. However, the effects of MLs on P. vivax in Anopheles arabiensis has not yet been fully explored. Hence, comparative in-vitro susceptibility and ex-vivo studies were conducted to evaluate the effects of ivermectin, doramectin and moxidectin sub-lethal concentrations on P. vivax oocyst development in An. arabiensis. METHODS The 7-day sub-lethal concentrations of 25% (LC25) and 5% (LC5) were determined from in-vitro susceptibility tests on female An. arabiensis in Hemotek® membrane feeding assay. Next, an ex-vivo study was conducted using P. vivax gametocytes infected patient's blood spiked with the LC25 and LC5 of the MLs. At 7-days post-feeding, each mosquito was dissected under a dissection stereo microscope, stained with 0.5% (w/v) mercurochrome solution, and examined for the presence of P. vivax oocysts. Statistical analysis was based on a generalized mixed model with binomially distributed error terms. RESULTS A 7-day lethal concentration of 25% (LC25, in ng/mL) of 7.1 (95% CI: [6.3;8.0]), 20.0 (95%CI:[17.8;22.5]) and 794.3 (95%CI:[716.4;1516.3]) were obtained for ivermectin, doramectin and moxidectin, respectively. Similarly, a lethal concentration of 5% (LC5, in ng/mL) of 0.6 (95% CI: [0.5;0.7]), 1.8 (95% CI:[1.6;2.0]) and 53.7 (95% CI:[ 48.4;102.5]) were obtained respectively for ivermectin, doramectin and moxidectin. The oocyst prevalence in treatment and control groups did not differ significantly (p > 0.05) from each other. Therefore, no direct effect of ML endectocides on P. vivax infection in An. arabiensis mosquitoes was observed at the sub-lethal concentration (LC25 and LC5). CONCLUSIONS The effects of ivermectin and doramectin on malaria parasite is more likely via indirect effects, particularly by reducing the vectors lifespan and causing mortality before completing the parasite's sporogony cycle or reducing their vector capacity as it affects the locomotor activity of the mosquito.
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Affiliation(s)
- Gemechu Zeleke
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
- Jimma University Laboratory of Drug Quality (JuLaDQ), and School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Luc Duchateau
- Biometrics Research Center, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sultan Suleman
- Jimma University Laboratory of Drug Quality (JuLaDQ), and School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mathias Devreese
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium.
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Tajudeen YA, Oladipo HJ, Oladunjoye IO, Oladipo MK, Shittu HD, Abdulmumeen IF, Afolabi AO, El-Sherbini MS. Transforming malaria prevention and control: the prospects and challenges of gene drive technology for mosquito management. Ann Med 2024; 55:2302504. [PMID: 38232762 PMCID: PMC10795774 DOI: 10.1080/07853890.2024.2302504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024] Open
Abstract
Background: In the era of insecticides and anti-malarial drug resistance, gene drive technology holds considerable promise for malaria control. Gene drive technology deploys genetic modifications into mosquito populations to impede their ability to transmit the malaria parasite. This can be either through the disruption of an essential mosquito gene or the association of gene drive with a desirable effector gene. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) is a gene editing tool that precisely modifies mosquito vector DNA sequences and curtails the rate of pathogen transmission.Methods: A comprehensive search was conducted in the SCOPUS and MEDLINE databases (via PubMed) until October 2023. The keywords used were related to the principles and mechanisms of gene drive technology, its advantages, and disadvantages, and its ethical and regulatory considerations in sustainable malaria eradication.Results: The development of gene drive enables the preferential inheritance of specific genes in targeted mosquitoes, potentially obstructing the transmission of the Plasmodium parasite. This technology was also studied for the control of other vector-borne diseases such as dengue and chikungunya viruses. Despite its experimental superiority over other traditional methods such as insecticide-treated nets and insecticide sprays, the long-term dynamic interplay of mutation and resistance poses challenges for gene drive efficiency in sustainable malaria control.Conclusions: This commentary elucidates the underlying mechanisms and principles of gene drive technology, underscoring its promise and challenges as a novel strategy to curtail malaria prevalence. Although the release of such genetically modified mosquitoes into the natural environment would result in the eradication of the locally targeted species of mosquitoes, the complete eradication of the entire species remains questionable. Thus, the practical application raises significant ethical and regulatory concerns for further research and risk assessment, including the risk of gene drive spreading to nontarget species in the wider theatre of biodiverse species.
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Affiliation(s)
- Yusuf Amuda Tajudeen
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Microbiology, Faculty of Life Sciences, University of Ilorin, Ilorin, Nigeria
| | - Habeebullah Jayeola Oladipo
- Department of Microbiology, Faculty of Life Sciences, University of Ilorin, Ilorin, Nigeria
- Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria
| | | | | | | | - Imam-Fulani Abdulmumeen
- Faculty of health science, Department of Public health, Alhikmah University Ilorin, Ilorin, Nigeria
| | - Abdullateef Opeyemi Afolabi
- Faculty of Biomedical Sciences, Department of Microbiology and Immunology, Kampala International University, Bushenyi, Uganda
| | - Mona Said El-Sherbini
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Ojurongbe TA, Afolabi HA, Bashiru KA, Sule WF, Akinde SB, Ojurongbe O, Adegoke NA. Prediction of malaria positivity using patients' demographic and environmental features and clinical symptoms to complement parasitological confirmation before treatment. Trop Dis Travel Med Vaccines 2023; 9:24. [PMID: 38098124 PMCID: PMC10722830 DOI: 10.1186/s40794-023-00208-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Current malaria diagnosis methods that rely on microscopy and Histidine Rich Protein-2 (HRP2)-based rapid diagnostic tests (RDT) have drawbacks that necessitate the development of improved and complementary malaria diagnostic methods to overcome some or all these limitations. Consequently, the addition of automated detection and classification of malaria using laboratory methods can provide patients with more accurate and faster diagnosis. Therefore, this study used a machine-learning model to predict Plasmodium falciparum (Pf) antigen positivity (presence of malaria) based on sociodemographic behaviour, environment, and clinical features. METHOD Data from 200 Nigerian patients were used to develop predictive models using nested cross-validation and sequential backward feature selection (SBFS), with 80% of the dataset randomly selected for training and optimisation and the remaining 20% for testing the models. Outcomes were classified as Pf-positive or Pf-negative, corresponding to the presence or absence of malaria, respectively. RESULTS Among the three machine learning models examined, the penalised logistic regression model had the best area under the receiver operating characteristic curve for the training set (AUC = 84%; 95% confidence interval [CI]: 75-93%) and test set (AUC = 83%; 95% CI: 63-100%). Increased odds of malaria were associated with higher body weight (adjusted odds ratio (AOR) = 4.50, 95% CI: 2.27 to 8.01, p < 0.0001). Even though the association between the odds of having malaria and body temperature was not significant, patients with high body temperature had higher odds of testing positive for the Pf antigen than those who did not have high body temperature (AOR = 1.40, 95% CI: 0.99 to 1.91, p = 0.068). In addition, patients who had bushes in their surroundings (AOR = 2.60, 95% CI: 1.30 to 4.66, p = 0.006) or experienced fever (AOR = 2.10, 95% CI: 0.88 to 4.24, p = 0.099), headache (AOR = 2.07; 95% CI: 0.95 to 3.95, p = 0.068), muscle pain (AOR = 1.49; 95% CI: 0.66 to 3.39, p = 0.333), and vomiting (AOR = 2.32; 95% CI: 0.85 to 6.82, p = 0.097) were more likely to experience malaria. In contrast, decreased odds of malaria were associated with age (AOR = 0.62, 95% CI: 0.41 to 0.90, p = 0.012) and BMI (AOR = 0.47, 95% CI: 0.26 to 0.80, p = 0.006). CONCLUSION Newly developed routinely collected baseline sociodemographic, environmental, and clinical features to predict Pf antigen positivity may be a valuable tool for clinical decision-making.
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Affiliation(s)
| | | | | | | | | | - Olusola Ojurongbe
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- Center for Emerging and Re-emerging Infectious Diseases, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Nurudeen A Adegoke
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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Elebiyo TC, Oluba OM, Adeyemi OS. Anti-malarial and haematological evaluation of the ethanolic, ethyl acetate and aqueous fractions of Chromolaena odorata. BMC Complement Med Ther 2023; 23:402. [PMID: 37946127 PMCID: PMC10634035 DOI: 10.1186/s12906-023-04200-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023] Open
Abstract
Malaria is a global health challenge with endemicity in sub-Saharan Africa, where there are multiple drug-resistant strains and limited access to modern health care facilities, especially in rural areas. Studies indicate that African traditional medicine could make a substantial contribution to the reduction of malaria-related deaths and achievement of universal health coverage (UHC), particularly in these regions. Thus, this study evaluated the curative antimalarial effects of Chromolaena odorata leaf extract using mouse model. Forty-five (45) albino mice weighing between 18 and 22 g were grouped into nine groups of 5 animals each. Animals in groups 2-9 were infected with the chloroquine-resistant strain of Plasmodium berghei, while animals in groups 3-9 were subsequently treated with 10 mg/kg chloroquine, a combination of 1.4 mg/kg artemether and 8.75 mg/kg lumefantrine (Coartem), and varying concentrations of the fraction from the aqueous leaf extract of C. odorata at day 3 post-infection. The findings from this study indicate that treatment with 400 mg/kg of the ethanolic fraction of the crude extract resulted in a significant decrease in parasite load (97.6%), which was comparable to the activities of the conventional drugs chloroquine (98.6%) and Coartem (98.8%). The ethyl acetate and ethanolic fractions at 400 mg/kg also ameliorated the significant alterations in the red blood cells, white blood cells, and platelets of the infected animals. The high antimalarial activity displayed by the ethanolic fraction could be due to the presence of quercetin and kaempferol, as detected by high performance liquid chromatography (HPLC) analysis. The findings suggest that the fractions from C. odorata could serve as an alternative source of malaria therapy, particularly in sub-Saharan Africa.
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Affiliation(s)
- Tobiloba Christiana Elebiyo
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria
- Department of Biochemistry, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria
| | | | - Oluyomi Stephen Adeyemi
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria.
- Department of Biochemistry, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria.
- Department of Biochemistry, Laboratory of Medicinal Biochemistry, Nanomedicine, & Toxicology, Bowen University, Iwo, Nigeria.
- Laboratory of Sustainable Animal Environment, Graduate School of Agricultural Science, Tohoku University, 232-3 Yomogida, Naruko-Onsen, Osaki, Miyagi, 989-6711, Japan.
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Mao W, Cooke R, Silimperi D, Urli Hodges E, Ortiz E, Udayakumar K. Scaling malaria interventions: bottlenecks to malaria elimination. BMJ Glob Health 2023; 8:e013378. [PMID: 37949501 PMCID: PMC10649629 DOI: 10.1136/bmjgh-2023-013378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/08/2023] [Indexed: 11/12/2023] Open
Abstract
The slow progress in malaria control efforts and increasing challenges have prompted a need to accelerate the research and development (R&D), launch and scaling of effective interventions for malaria elimination. This research, including desk research and key informant interviews, identified the following challenges along the end-to-end scale-up pathway of malaria interventions. Underinvestment in malaria R&D persists, and developers from low-resource settings are not commonly included in the R&D process. Unpredictable or unclear regulatory and policy pathways have been a hurdle. The private sector has not been fully engaged, which results in a less competitive market with few manufacturers, and consequently, a low supply of products. Persistent challenges also exist in the scaling of malaria interventions, such as the fragmentation of malaria programmes. Further efforts are needed to: (1) Strengthen coordination among stakeholders and especially the private sector to inform decisions and mobilise resources. (2) Increase engagement of national stakeholders, particularly those in low-income and middle-income countries, in planning for and implementing R&D, launching and scaling proven malaria interventions. (3) Use financial incentives and other market-shaping strategies to encourage R&D for innovative malaria products and improve existing interventions. (4) Streamline and improve transparency of WHO's prequalification and guidelines processes to provide timely technical advice and strategies for different settings. (5) Increase effort to integrate malaria services into the broader primary healthcare system. (6) Generate evidence to inform policies on improving access to malaria interventions.
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Affiliation(s)
- Wenhui Mao
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
| | - Rianna Cooke
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
| | - Diana Silimperi
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
| | - Elina Urli Hodges
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
| | - Ernesto Ortiz
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
| | - Krishna Udayakumar
- Duke Global Health Innovation Center, Duke University, Durham, North Carolina, USA
- Innovations in Healthcare, Durham, North Carolina, USA
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Gemechu T, Dedecha W, Gelchu M, Husen O, Jarso H. Asymptomatic Malaria During Pregnancy: Prevalence, Influence on Anemia and Associated Factors in West Guji Zone, Ethiopia - A Community-Based Study. Infect Drug Resist 2023; 16:6747-6755. [PMID: 37876858 PMCID: PMC10591643 DOI: 10.2147/idr.s431877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023] Open
Abstract
Background Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome. Objective This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia. Methods A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors. Results The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74-3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36-3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32-3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02-2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000). Conclusion Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.
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Affiliation(s)
- Tibeso Gemechu
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Miesa Gelchu
- Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Oliyad Husen
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Habtemu Jarso
- Department of Public Health, School of Health Science, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
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Gelband H, Carshon-Marsh R, Ansumana R, Swaray IB, Pandey A, Aimone A, Bogoch I, Eikelboom J, Jha P. Could vaccinating adults against malaria materially reduce adult mortality in high-transmission areas? Malar J 2023; 22:278. [PMID: 37726804 PMCID: PMC10507840 DOI: 10.1186/s12936-023-04714-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
After a period of unprecedented progress against malaria in the 2000s, halving the global disease burden by 2015, gains overall in sub-Saharan Africa have slowed and even reversed in some places, beginning well before the COVID-19 pandemic. The highly effective drugs, treated nets, and diagnostics that fueled the initial progress all face some threats to their effectiveness, and global funding to maintain and increase their use over the long term is not guaranteed. Malaria vaccines are among the most promising new interventions that could accelerate the elimination of malaria. Vaccines are still in early stages of rollout in children, the age group (along with pregnant women) that has been the focus of malaria strategies for a century. At the same time, over the past decade, a case has been made, based largely on evidence from verbal autopsies in at least a few high-transmission areas, that the malaria death rate among adults has been greatly underestimated. Could vaccinating adults help to bring down the adult malaria mortality rate, contribute to reduced transmission, or both? A randomized trial of a malaria vaccine is proposed in Sierra Leone, a highly endemic setting, to shed light on this proposition.
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Affiliation(s)
- Hellen Gelband
- Centre for Global Health Research, Unity Health Toronto, University of Toronto, Toronto, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | | | - Rashid Ansumana
- School of Community Health Sciences, Njala University, Bo, Sierra Leone
| | - Ibrahim Bob Swaray
- Centre for Global Health Research, Unity Health Toronto, University of Toronto, Toronto, Canada
| | - Arjun Pandey
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ashley Aimone
- Centre for Global Health Research, Unity Health Toronto, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Isaac Bogoch
- Divisions of General Internal Medicine and Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - John Eikelboom
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Akinsulie OC, Adesola RO, Aliyu VA, Oladapo IP, Hamzat A. Epidemiology and Transmission Dynamics of Viral Encephalitides in West Africa. Infect Dis Rep 2023; 15:504-517. [PMID: 37736997 PMCID: PMC10514837 DOI: 10.3390/idr15050050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
Encephalitis is an inflammation of the brain, often caused by an autoimmune reaction, or in most cases because of a direct viral, bacterial, or parasitic infection. Viral encephalitides (VE) presents a significant public health concern globally, especially in West Africa. There are more than five hundred known arthropod-borne viruses (arboviruses), with over a hundred of them identified to cause encephalitic diseases in humans and animals, giving rise to a tremendous burden of the diseases and socioeconomic strains in tropical and subtropical regions worldwide. Despite their importance, few effective preventive and control measures in the form of vaccines and therapies are available, and when they are, their use is limited. These limitations are largely hinged on the paucity of information about the molecular epidemiology and transmission patterns of VE in West Africa. Here, we reviewed the transmission dynamics, molecular epidemiology, and the ecological drivers of VE in West Africa. Collectively, timely and accurate interventions are essential for encephalitic viral disease control. Moreover, the integrated health system approach, combining surveillance, vaccination, vector control, and community engagement, could be effective in preventing viral encephalitis globally.
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Affiliation(s)
| | | | | | | | - Abdulafees Hamzat
- Faculty of Veterinary Medicine, University of Ibadan, Ibadan 200005, Nigeria
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Kotepui KU, Mahittikorn A, Wilairatana P, Masangkay FR, Kotepui M. The Association between Malaria and β-Carotene Levels: A Systematic Review and Meta-Analysis. Antioxidants (Basel) 2023; 12:1687. [PMID: 37759990 PMCID: PMC10525879 DOI: 10.3390/antiox12091687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/26/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND β-Carotene, which is a prominent carotenoid with notable antioxidant properties, may play a role in countering the oxidative stresses induced by malaria. The association between β-carotene levels and malaria is not yet fully understood, prompting this systematic review and meta-analysis. METHODS A rigorous search of databases, including Nursing and Allied Health Premium, EMBASE, MEDLINE, Ovid, PubMed, Scopus, and Google Scholar, was undertaken to collate studies that focused on β-carotene levels in malaria patients. The selected studies underwent critical appraisal, followed by data extraction for a meta-analysis. RESULTS Of the 2498 records initially identified, 10 were deemed suitable for synthesis. A considerable number of these studies indicated a pronounced reduction in β-carotene levels among malaria patients in contrast with uninfected individuals. The meta-analysis, encompassing 421 malaria patients and 240 uninfected controls, revealed a significant correlation between reduced β-carotene levels and malaria (p < 0.01, Hedges's g: -1.26, 95% CI: -2.00-(-0.53), I2: 93.86%, seven studies). CONCLUSIONS The conducted systematic review and meta-analysis corroborated the correlation between lower β-carotene levels and malaria. The intricate relationship between malaria and β-carotene merits deeper exploration. A comprehensive understanding of this association might pave the way for innovative therapeutic approaches leveraging the antioxidant attributes of β-carotene to combat malaria-induced oxidative stress.
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Affiliation(s)
- Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | | | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
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Anjuwon TM, Ehinmidu JO, Anigo KM, James DB. In Vitro Antimalarial Susceptibility of Plasmodium falciparum and Plasmodium berghei Isolates to Selected Antimalarial Agents, Column Chromatographic Subfractions of Glyphaea brevis Leaves Extract and FTIR and GCMS of SF8. Trop Life Sci Res 2023; 34:279-297. [PMID: 38144385 PMCID: PMC10735266 DOI: 10.21315/tlsr2023.34.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/02/2023] [Indexed: 12/26/2023] Open
Abstract
Malaria still remains a life-threatening parasitic disease with universal targets set for control and elimination. This study aimed to evaluate the in vitro antimalarial susceptibility of Plasmodium falciparum isolates and Plasmodium berghei to selected antimalarial agents and column chromatographic subfractions of Glyphaea brevis leaves extract and FTIR and GCMS of SF8. Trager and Jensen as well as World Health Organisation (WHO) standardised in vitro micro-test system methods were used to determine susceptibility on the patients' blood samples; Column chromatographic procedure was carried out to obtain 11 pooled fractions; FTIR and GCMS were used to determine functional groups and phytochemicals respectively. In vitro anti-plasmodial activity against P. falciparum clinical isolates had IC50 range of 1.03 μg/mL-7.63 μg/mL while their IC50 against P. berghei ranges from 4.32 μg/mL-7.89 μg/mL. Subfraction 8 (SF8) had the least IC50 of 4.32 μg/mL. The FTIR spectrum showed the presence of isoprenoid, alcohol, phenol, alkane, alkenes, ester, carboxylic acids, aromatics and nitro compounds while GCMS identified dodecanoic acid, methyl ester; carotol; hexadecanoic acid, methyl ester; 9-octadecenoic acid (Z)-, methyl ester (oleic acid); methyl stearate; heptadecanoic acid, 16-methyl-, methyl ester; all with their antimalarial reported activities. In conclusion, G. brevis has a great potential for drug development against malaria parasite since it inhibited schizont growth and possesses phytocompounds with antimalarial report.
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Affiliation(s)
- Tayo Micheal Anjuwon
- Department of Biochemistry, Ahmadu Bello University, P.M.B 1069 Zaria, Kaduna State, Nigeria
| | - Joseph Olorunmola Ehinmidu
- Department of Pharmaceutical Microbiology, Ahmadu Bello University, P.M.B 1069 Zaria, Kaduna State, Nigeria
| | | | - Dorcas Bolanle James
- Department of Biochemistry, Ahmadu Bello University, P.M.B 1069 Zaria, Kaduna State, Nigeria
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Habtamu K, Petros B, Yan G. Plasmodium vivax: the potential obstacles it presents to malaria elimination and eradication. Trop Dis Travel Med Vaccines 2022; 8:27. [PMID: 36522671 PMCID: PMC9753897 DOI: 10.1186/s40794-022-00185-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Initiatives to eradicate malaria have a good impact on P. falciparum malaria worldwide. P. vivax, however, still presents significant difficulties. This is due to its unique biological traits, which, in comparison to P. falciparum, pose serious challenges for malaria elimination approaches. P. vivax's numerous distinctive characteristics and its ability to live for weeks to years in liver cells in its hypnozoite form, which may elude the human immune system and blood-stage therapy and offer protection during mosquito-free seasons. Many malaria patients are not fully treated because of contraindications to primaquine use in pregnant and nursing women and are still vulnerable to P. vivax relapses, although there are medications that could radical cure P. vivax. Additionally, due to CYP2D6's highly variable genetic polymorphism, the pharmacokinetics of primaquine may be impacted. Due to their inability to metabolize PQ, some CYP2D6 polymorphism alleles can cause patients to not respond to treatment. Tafenoquine offers a radical treatment in a single dose that overcomes the potentially serious problem of poor adherence to daily primaquine. Despite this benefit, hemolysis of the early erythrocytes continues in individuals with G6PD deficiency until all susceptible cells have been eliminated. Field techniques such as microscopy or rapid diagnostic tests (RDTs) miss the large number of submicroscopic and/or asymptomatic infections brought on by reticulocyte tropism and the low parasitemia levels that accompany it. Moreover, P. vivax gametocytes grow more quickly and are much more prevalent in the bloodstream. P. vivax populations also have a great deal of genetic variation throughout their genome, which ensures evolutionary fitness and boosts adaptation potential. Furthermore, P. vivax fully develops in the mosquito faster than P. falciparum. These characteristics contribute to parasite reservoirs in the human population and facilitate faster transmission. Overall, no genuine chance of eradication is predicted in the next few years unless new tools for lowering malaria transmission are developed (i.e., malaria elimination and eradication). The challenging characteristics of P. vivax that impede the elimination and eradication of malaria are thus discussed in this article.
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Affiliation(s)
- Kassahun Habtamu
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
- Menelik II Medical & Health Science College, Addis Ababa, Ethiopia
| | - Beyene Petros
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA 92697 USA
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