Search Results (2,183)

This study investigated the prevalence of childhood asthma and respiratory symptoms with their associated air pollution sources among adolescents aged 13–14 years residing in a Malaria-endemic region. Methods: A cross-sectional survey was conducted with 2855 adolescents from fourteen (14) selected schools in communities exposed to high levels of air pollution from indoor residual spraying (IRS) that is used for malaria vector control in the Vhembe region. Data were collected using a self-administered standardized International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Statistical software STATA version 17 was used to analyze the data. Binary logistic regression was used to determine the relationship between air pollution sources and childhood asthma/symptoms. Results: The prevalences of asthma, ‘wheeze ever’ and ‘wheeze in the past’ were 18.91%, 37.69% and 24.69%, respectively. The results from the adjusted binary logistic regression model indicated that exposure to tobacco smoke (OR = 1.84; 95% CI: 1.08–3.16), smoking a water pipe (OR = 1.65; 95% CI: 1.16–2.36) and the use of paraffin as fuel for heating (OR = 1.70; 95% CI: 0.97–2.88) and cooking (OR = 0.48; 95% CI: 0.29–1.00) were significant risk factors for asthma. Trucks passing through the streets, having a cat at home and using open fires were significantly associated with ‘wheeze in the past’. Finally, using gas for cooking (OR = 0.72; 95% CI: 0.53–0.99), open fires for heating (OR = 0.53; 95% CI: 0.35–0.80) and smoking a water pipe (OR = 2.47; 95% CI: 1.78–3.44) were associated with ‘wheeze ever’. Conclusions: School children living in these communities had an increased risk of developing asthma and presenting with wheezing due to exposure to environmental air pollution sources. Full article

In this research work, we developed a fractional-order model for the transmission dynamics of malaria, incorporating two control strategies: health education campaigns and the use of insecticides. The theoretical analysis of the model is presented, including the computation of disease-free equilibrium and basic reproduction number. We analyzed the stability of the proposed model using a well-formulated Lyapunov function. Furthermore, model parameter estimation was carried out using real data from malaria cases reported in Zimbabwe. We found that the fractional-order model provided a better fit to the real data compared to the classical integer-order model. Sensitivity analysis of the basic reproduction number was performed using computed partial rank correlation coefficients to assess the effect of each parameter on malaria transmission. Additionally, we conducted numerical simulations to evaluate the impact of memory effects on the spread of malaria. The simulation results indicated that the order of derivatives significantly influences the dynamics of malaria transmission. Moreover, we simulated the model to assess the effectiveness of the proposed control strategies. Overall, the interventions were found to have the potential to significantly reduce the spread of malaria within the population. Full article

Background/Objectives: Severe malaria poses a significant public health concern in Angola, particularly among adults. This study assessed the clinical manifestations and outcomes of severe Plasmodium falciparum malaria in adult patients admitted to Hospital Central Dr. António Agostinho Neto of Lubango (HCL), Angola. Methods: The study retrospectively reviewed medical records of patients over 14 years old admitted with severe malaria during the first quarter of 2021 and 2022, coinciding with the peak transmission season. The World Health Organization (WHO) criteria were used to clarify the disease severity. The cohort included 640 patients—167 in 2021 and 473 in 2022—distributed across the following departments: the Intensive Care Unit (ICU; n = 81), Medicine (MED; n = 458) and Infectiology (INF; n = 101). Results: The median age was 26 years and 59.4% were males. Renal impairment was the most frequent severe manifestation, affecting 37.4% of cases. The mortality rate across the study period was 7%, showing a notable decrease from 10.2% in 2021 to 5.9% in 2022. The higher mortality rate in 2021 may reflect the impact of the COVID-19 pandemic, which limited hospital access and delayed care, resulting in more critical cases being admitted at a later stage. In 2022, with reduced COVID-19 pressures, earlier access to treatment may have improved outcomes, contributing to the lower mortality rate. Conclusions: This study emphasizes the need to assess the clinical burden of severe malaria in low-endemic regions, where shifting patterns may signal emerging threats such as antimalarial drug resistance. Further research is essential to optimize control strategies and strengthen surveillance systems, reducing morbidity and mortality. Full article

Malaria prevention and control programs are mainly oriented to vector control, timely diagnosis and adequate treatment. Malaria transmission is influenced by several factors, including biological and social aspects. Thus, it is relevant to consider community beliefs and practices to ensure sustainable prevention and control strategies. This study aimed to determine knowledge, attitudes and practices (KAP) towards malaria in an endemic locality in northwestern Colombia. Preliminary data were collected through a focus group discussion. Subsequently, a KAP survey was administered to the community. KAP scores were associated with both sociodemographic characteristics and with previous malaria infection. Focus group data revealed knowledge gaps and the absence of or having worn-out nets. Survey results showed that participants recognized a mosquito bite as the transmission mode (72.09%), followed by dirty water (44.19%), high fever (86.05%) and headache (79.07%) as the main symptoms. Regarding attitudes, 44.19% of the people would go to the hospital in the case of having symptoms. The most recognized practices for disease prevention were the use of mosquito nets (65.12%) and fans (23.26%). The results showed that some people had misconceptions about the disease transmission mode. The analysis showed significant associations of either female gender and homemaker occupation with a good knowledge [OR = 3.74, (p = 0.04), OR = 3.55, (p = 0.04), respectively] or female with a positive attitude towards malaria control and prevention [OR = 4.80, (p = 0.04)]. These results showed that the identified gaps in KAP require increasing education among the community in addition to applying public health prevention efforts. The data may be useful in designing malaria control strategies that involve community participation. Full article

Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular whitening, retinal hemorrhages, and vessel color changes) with the total, circulating, or sequestered parasite load in children with CM. Total parasite burden was estimated by measuring plasma levels of Plasmodium falciparum histidine-rich protein 2 (PfHRP2), while the sequestered load was calculated as the difference between the total burden and circulating parasitemia. Children with retinopathy-positive CM (n = 172) had higher total and sequestered parasite burdens compared to retinopathy-negative children (n = 42) (both p = 0.049). In a subgroup with detailed retinopathy grading (n = 52), more extensive vessel color changes correlated with higher total, sequestered, and circulating parasite loads (p = 0.0057, p = 0.0068, and p = 0.0433, respectively). Peripheral retinal whitening was also associated with increased total and sequestered loads (p = 0.0017 and p = 0.0012). No association was found between retinal hemorrhages and parasite burden, indicating that other factors may influence their pathogenesis. Full article

Plasmodium knowlesi is a zoonotic form of human malaria, the pathology of which is poorly understood. While the J domain protein (JDP) family has been extensively studied in Plasmodium falciparum, and shown to contribute to malaria pathology, there is currently very limited information on the P. knowlesi JDPs (PkJDPs). This review provides a critical analysis of the literature and publicly available data on PkJDPs. Interestingly, the P. knowlesi genome encodes at least 31 PkJDPs, with well over half belonging to the most diverse types which contain only the signature J domain (type IIIs, 19) or a corrupted version of the J domain (type IVs, 2) as evidence of their membership. The more typical PkJDPs containing other domains typical of JDPs in addition to the J domain are much fewer in number (type IIs, 8; type Is, 2). This study indentifies PkJDPs that are potentially involved in: folding of newly synthesized or misfolded proteins within the P. knowlesi cytosol (a canonical type I and certain typical type IIs); protein translocation (a type III) and folding (a type II) in the ER; and protein import into mitochondria (a type III). Interestingly, a type II PkJDP is potentially exported to the host cell cytosol where it may recruit human HSP70 for the trafficking and folding of other exported P. knowlesi proteins. Experimental studies are required on this fascinating family of proteins, not only to validate their role in the pathology of knowlesi malaria, but also because they represent potential anti-malarial drug targets. Full article

Background and Clinical Significance: Fever in the returning traveler is a medical emergency warranting prompt exclusion of potentially life-threatening infections such as malaria. Case Presentation: We describe a case of a febrile returned traveler to South Africa whose prompt initial diagnostic work-up was notable for a false-positive malaria rapid diagnostic test (RDT), and who nevertheless responded quickly to oral atovaquone-proguanil, despite an ultimate diagnosis of African tick bite fever. Subsequent RDT and malaria thick- and thin-film blood examination failed to corroborate a diagnosis of malaria and all other microbiological testing other than rickettsial serology remained non-contributory. Conclusions: The case presented highlights important points regarding diagnostic test performance characteristics and premature diagnostic closure. Full article

Spectroscopic techniques have emerged as crucial tools in the field of malaria research, offering immense potential for improved diagnosis and enhanced understanding of the disease. This review article pays tribute to the pioneering contributions of Professor Henry Mantsch in the realm of clinical biospectroscopy, by comprehensively exploring the diverse applications of spectroscopic methods in malaria research. From the identification of reliable biomarkers to the development of innovative diagnostic approaches, spectroscopic techniques spanning the ultraviolet to far-infrared regions have played a pivotal role in advancing our knowledge of malaria. This review will highlight the multifaceted ways in which spectroscopy has contributed to the field, with a particular emphasis on its impact on diagnostic advancements and drug research. By leveraging the minimally invasive and highly accurate nature of spectroscopic techniques, researchers have made significant strides in improving the detection and monitoring of malaria parasites. These advancements hold the promise of enhancing patient outcomes and aiding in the global efforts towards the eradication of this devastating disease. Full article

Dihydroartemisinin (or artenimol)–piperaquine is one of the six artemisinin-based combination therapies recommended in uncomplicated malaria treatment. However, artemisinin partial resistance has been reported in Cambodia, Laos, Vietnam, India, and, recently, in Africa. Polymorphisms in the Pfk13 gene have been described as molecular markers of artemisinin resistance and the amplification of the plasmepsine II/III (Pfpmp2/Pfpmp3) gene has been associated with piperaquine resistance. However, some therapeutic failures with this combination remain unexplained by strains’ characterization. We provide an overview on the use of dihydroartemisinin–piperaquine in malaria treatment and discuss tools available to monitor its efficacy. Full article

Endometriosis is a chronic, inflammatory, oestrogen-dependent disorder that is defined by the presence of endometrium-like tissue in the extra-uterine environment. It is estimated to affect approximately 10% of women of reproductive age, and the cause is still largely unknown. The heterogenous nature and complex pathophysiology of the disease results in diagnostic and therapeutic challenges. This review examines the emerging role of host extracellular vesicles (EVs) in endometriosis development and progression, with a particular focus on bacterial extracellular vesicles (BEVs). EVs are nano-sized membrane-bound particles that can transport bioactive molecules such as nucleic acids, proteins, and lipids, and therefore play an essential role in intercellular communication. Due to their unique cargo composition, EVs can play a dual role, both in the disease pathogenesis and as biomarkers. Both host and bacterial EVs (HEVs and BEVs) have been implicated in endometriosis, by modulating inflammatory responses, angiogenesis, tissue remodelling, and cellular proliferation within the peritoneal microenvironment. Understanding the intricate mechanisms underlying EVs in endometriosis pathophysiology and modulation of the lesion microenvironment may lead to novel diagnostic tools and therapeutic targets. Future research should focus on uncovering the specific cargo, the inter-kingdom cell-to-cell interactions, and the anti-inflammatory and anti-microbial mechanisms of both HEVs and BEVs in endometriosis in the hope of discovering translational findings that could improve the diagnosis and treatment of the disease. Full article

Municipal solid waste (MSW) management poses substantial challenges in rapidly urbanizing areas, with implications for both the environment and public health. This study focuses on the city of Kinshasa in the Democratic Republic of Congo, investigating whether the presence or absence of solid waste collection services results in varying health and economic impacts, and additionally, seeking to establish a correlation between residing in proximity to dumpsites and the prevalence of diseases like malaria and typhoid, thereby providing a comprehensive understanding of the health implications tied to waste exposure. Health data were collected through survey questionnaires, and the geospatial distribution of 19 dumpsites was analyzed using Google Earth Pro 7.3.1 for satellite imagery and GIS software 10.3.1 to map dumpsites and define 1 km buffer zones around the largest dumpsites for household sampling. Statistical analyses were conducted using R Version 4.2.3, employing Chi-square tests for disease prevalence and logistic regression to assess associations between waste management practices and health outcomes. A multivariate regression was used to evaluate correlations between discomfort symptoms (e.g., nasal and eye irritation) and waste activities. The geospatial analysis revealed significant variation in dumpsite size and location, with larger dumpsites near water bodies and flood-prone areas. The study contributes valuable insights into waste-related health risks, emphasizing the need for improved waste management policies in rapidly urbanizing areas like Kinshasa. The socio-demographic analysis reveals distinct traits within the surveyed populations of two communes, Bandalungwa (Bandal) and Bumbu. Bumbu, characterized by larger open dumpsites and limited waste collection services, exhibits a higher prevalence of certain diseases, particularly typhoid fever, and malaria. This discrepancy is statistically significant (p < 2.2 × 10⁻¹⁶), suggesting a potential link between waste exposure and disease prevalence. In Bandal, self-waste collection is a high risk of exposure to typhoid (OR = 4.834 and p = 0.00001), but the implementation of a waste collection service shows protective effect (OR = 0.206 and p = 0.00001). The lack of waste collection services in Bumbu increases the risk of exposure, although not significantly (OR = 2.268 and p = 0.08). Key findings indicate that waste disposal methods significantly differ between Bandal and Bumbu. Bumbu’s reliance on burning and dumping creates environments conducive to disease vectors, contributing to elevated disease transmission risks. However, an in-depth correlation analysis reveals that specific waste management practices, such as burning, burying, and open dumping, do not exhibit statistically significant associations with disease prevalence, underlining the complexity of disease dynamics. This study contributes valuable insights into the importance for urban public health, particularly in rapidly urbanizing cities like Kinshasa, where inadequate waste management exacerbates health risks. By investigating the correlation between proximity to unregulated dumpsites and the prevalence of diseases such as malaria and typhoid fever, the research underscores the urgent need for targeted waste management policies. The stark health disparities between Bandal, with better waste services, and Bumbu, where services are lacking, highlight the protective effect of organized waste collection. These findings suggest that expanding public waste services and enforcing stricter regulations on waste disposal could reduce disease prevalence in vulnerable areas. Additionally, the study supports integrating waste management into urban planning as a critical public health measure. Its evidence-based approach offers valuable insights for policymakers in Kinshasa and other cities facing similar challenges, emphasizing the broader health implications of environmental governance in urban settings. Full article

Over the last few decades, malaria-derived extracellular vesicles (EVs) have gained increasing interest due to their role in disease pathophysiology and parasite biology. Unlike other EV research fields, the isolation of malaria EVs is not standardized, hampering inter-study comparisons. Most malaria EV studies isolate vesicles by the “gold-standard” technique of differential (ultra)centrifugation (DC). Here, we describe in detail an optimized and reproducible protocol for the isolation of malaria-derived EVs by DC. The protocol begins with a description of cultivating high-parasitemia, synchronous P. falciparum cultures that are the source of EV-containing conditioned culture media. The isolation protocol generates two EV subtypes, and we provide details of characterizing these distinct subtypes by analyzing human and parasite proteins by Western blot analysis. We identify some of these proteins as suitable markers for malaria EV subpopulations and subtypes. Full article

Malaria is currently the most prevalent life-threatening infectious disease in the world. In this case report, we present a 44-year-old Caucasian woman with a low level of education and no significant past medical history who presented to the emergency room of the Emergency County Hospital of Arad, Romania, with a general affected state, a fever of 38.5 °C, chills, weakness, headache, muscle pain, nausea, icterus, and watery diarrheal stool. A viral infection was initially suspected, and the patient was transferred to the Infectious Diseases Department. The anamnesis revealed that the patient traveled to Nigeria (Ado Ekiti) and returned to Romania 14 days before presenting to the hospital without following antimalarial prophylaxis. A peripheral blood smear was conducted and revealed parasitemia with ring forms of Plasmodium falciparum (P. falciparum) of 10–15% within the red blood cells. Parasitemia increased within a day to 15–18%, and her health rapidly deteriorated. She was transferred to the Victor Babeș Infectious Disease Hospital in Bucharest for the urgent initiation of antimalarial treatment. The patient’s condition continued to worsen rapidly, and she succumbed to her illness due to multi-organ failure. This report details the first documented case of malaria imported from Nigeria to Romania. People traveling to malaria-endemic areas should be educated about preventing this parasitic infection, both by adopting measures to reduce the risk of mosquito bites and by using appropriate chemoprophylaxis. In the context of resuming travel after the COVID-19 pandemic, understanding and adhering to prophylactic measures is crucial to avoid tragic situations, as highlighted in this case report. Full article

Background: Malaria remains a climate-driven public health issue in Burkina Faso, yet the interactions between climatic factors and malaria interventions across different zones are not well understood. This study estimates time delays in the effects of climatic factors on malaria incidence, develops forecasting models, and assesses their short-term forecasting performance across three distinct climatic zones: the Sahelian zone (hot/arid), the Sudano-Sahelian zone (moderate temperatures/rainfall); and the Sudanian zone (cooler/wet). Methods: Monthly confirmed malaria cases of children under five during the period 2015–2021 were analyzed using Bayesian generalized autoregressive moving average negative binomial models. The predictors included land surface temperature (LST), rainfall, the coverage of insecticide-treated net (ITN) use, and the coverage of artemisinin-based combination therapies (ACTs). Bayesian variable selection was used to identify the time delays between climatic suitability and malaria incidence. Wavelet analysis was conducted to understand better how fluctuations in climatic factors across different time scales and climatic zones affect malaria transmission dynamics. Results: Malaria incidence averaged 9.92 cases per 1000 persons per month from 2015 to 2021, with peak incidences in July and October in the cooler/wet zone and October in the other zones. Periodicities at 6-month and 12-month intervals were identified in malaria incidence and LST and at 12 months for rainfall from 2015 to 2021 in all climatic zones. Varying lag times in the effects of climatic factors were identified across the zones. The highest predictive power was observed at lead times of 3 months in the cooler/wet zone, followed by 2 months in the hot/arid and moderate zones. Forecasting accuracy, measured by the mean absolute percentage error (MAPE), varied across the zones: 28% in the cooler/wet zone, 53% in the moderate zone, and 45% in the hot/arid zone. ITNs were not statistically important in the hot/arid zone, while ACTs were not in the cooler/wet and moderate zones. Conclusions: The interaction between climatic factors and interventions varied across zones, with the best forecasting performance in the cooler/wet zone. Zone-specific intervention planning and model development adjustments are essential for more efficient early-warning systems. Full article

Djibouti is confronted with malaria resurgence, with malaria having been occurring in epidemic proportions since a decade ago. The current epidemiology of drug-resistant Plasmodium falciparum is not well known. Molecular markers were analyzed by targeted sequencing in 79 P. falciparum clinical isolates collected in Djibouti city in 2023 using the Miseq Illumina platform newly installed in the country. The objective of the study was to analyze the key codons in these molecular markers associated with antimalarial drug resistance. The prevalence of the mutant Pfcrt CVIET haplotype (92%) associated with chloroquine resistance and mutant Pfdhps-Pfdhfr haplotypes (7.4% SGEA and 53.5% IRN, respectively) associated with sulfadoxine-pyrimethamine resistance was high. By contrast, Pfmdr1 haplotypes associated with amodiaquine (YYY) or lumefantrine (NFD) resistance were not observed in any of the isolates. Although the “Asian-type” PfK13 mutations associated with artemisinin resistance were not observed, the “African-type” PfK13 substitution, R622I, was found in a single isolate (1.4%) for the first time in Djibouti. Our genotyping data suggest that most Djiboutian P. falciparum isolates are resistant to chloroquine and sulfadoxine-pyrimethamine but are sensitive to amodiaquine, lumefantrine, and artemisinin. Nonetheless, the presence of an isolate with the R622I PfK13 substitution is a warning signal that calls for a regular surveillance of molecular markers of antimalarial drug resistance. Full article