Pregnant Women and Malaria Preventive Measures: A Case of Tamale Teaching Hospital, Ghana

Background. In Saharan Africa, an estimated 25 million pregnancies are all at risk of malaria every year, with substantial morbidity and death effects for both the mother and the fetus. Aim. To investigate the use of malaria preventive measures among pregnant women patronizing antenatal services of Tamale Teaching Hospital. Methodology. This study was conducted using a descriptive cross-sectional survey of 250 participants. Data analysis was done with SPSS version 20. Graphs and tables were used to present the study data. Bivariate analysis was done using Chi-square use to determine the relationships and binary logistics regression used for identification of predictor variables. Results. The mean age of the study participants was 30.0 ± 4.5 years and most of them (73.0%) were within the age group of 25–35 years. Respondents’ favorable knowledge, a favorable attitude, and favorable practice were 78.0%, 62.0%, and 57.6%, respectively. And the following variables were associated with malaria preventive practice: age of the respondent (X2 = 6.276, P = 0.043 ), religion (X2 = 6.904, P = 0.032 ), level of education (X2 = 41.482, P < 0.001 ), employment status (X2 = 20.533, P < 0.001 ), monthly income (X2 = 21.838, P < 0.001 ), and attitude level towards malaria prevention (X2 = 35.885, P < 0.001 ). Further analysis revealed educational level and attitude level as predictors of malaria preventive practice. Conclusion. This study recorded favorable knowledge, attitude, and practice with regards to malaria prevention among more than half of the study participants.

Community Health Workers' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone

Introduction: Community health workers (CHWs) play an integral role in Sierra Leone's health systems strengthening efforts. Our goal was to understand CHWs' experiences of providing immunization and malaria prevention services in urban settings and explore opportunities to optimize their contributions to these services.Methods: In 2018, we conducted an exploratory qualitative assessment in the Western Area Urban district, which covers most of the capital city of Freetown. We purposively selected diverse health facilities (i.e., type, ownership, setting) and recruited CHWs through their supervisors. We conducted eight focus group discussions (FGD) with CHWs, which were audio-recorded. The topics explored included participants' background, responsibilities and priorities of urban CHWs, sources of motivation at work, barriers to CHWs' immunization and malaria prevention activities, and strategies used to address these barriers. The local research team transcribed and translated FGDs into English; then we used qualitative content analysis to identify themes.Results: Four themes emerged from the qualitative content analysis: (1) pride, compassion, recognition, and personal benefits are important motivating factors to keep working as CHWs; (2) diverse health responsibilities and competing priorities result in overburdening of CHWs; (3) health system- and community-level barriers negatively affect CHWs' activities and motivation; (4) CHWs use context-specific strategies to address challenges in their work but require further support.Conclusion: Focused support for CHWs is needed to optimize their contributions to immunization and malaria prevention activities. Such interventions should be coupled with systems-level efforts to address the structural barriers that negatively affect CHWs' overall work and motivation, such as the shortage of work supplies and the lack of promised financial support.

The Dynamics of Malaria Clinical Symptoms with very Strong Emphasis on Asymptomatic Malaria

In the developed world, malaria is a dangerous parasite that contributes to high morbidity and mortality. The disease is variable and its clinical presence varies from extreme to complex, normal, and difficult malaria, asymptomatic malaria. Malaria pathogenesis is complex. Our current research was conducted at Mayo Hospital, Lahore from May 2019 to February 2020. Despite several clinical severities trials the disorder is still poorly known for asymptomatic malaria infection. Malaria remains a problem for asymptomatic malaria, as it has a significant impact on the dynamic of transmission. In order to develop various therapeutic results, a thorough understanding of the relationship between hosts and parasites is important. Problems and obstacles to asymptomatic malaria study and management are addressed in this study. Man and parasite are identified and methods for management and recovery are presented for differential clinical outcomes. They are exposed to disease prevention. In the context of prospective studies to create more efficient malaria prevention methods, important lacunae in the understanding of asymptomatic malaria are further illustrated. Keywords: Malaria Clinical Symptoms, Strong Emphasis, Asymptomatic Malaria.

Assessing health-seeking behaviour and malaria prevention practices among communities in four districts of the Volta Region of Ghana

Background Malaria is a preventable disease that causes huge morbidity and mortality in malaria-endemic areas, especially among children and pregnant women. The malaria control programme focuses on the prevention of mosquito bites using insecticide-treated nets (ITNs) and mosquito aerosol sprays and coils, as well as prevention of severe disease among those infected through prompt and adequate treatment. The success of the malaria control programme in Ghana is dependent on the malaria prevention practices of people in the community. Therefore, this study evaluated the malaria prevention practices of participants in four districts of the Volta Region of Ghana. Methods This was a cross-sectional study conducted in Ketu South, Nkwanta South, Hohoe Municipality and Ho West districts of the Volta Region of Ghana. Questionnaire were administered to adults who consented to each household visited. Questions were asked on the socio-demographics and malaria prevention practices of the households. Data analysis was done using SPSS version 23 with frequency distribution done for all the variables. Pearson chi-square was used to determine the significant association between socio-demographics and malaria prevention practices, and Multivariate nominal logistic regression analysis was used to model the relationship between dichotomous dependent variables (ITN ownership and usage) and independent variables. Results Out of the 2493 participants; 2234 (89.6%) owned ITN and 1528 (68.4%) used ITN a night before this study, 768 (30.8%) used mosquito aerosol spray and 368 (15%) used mosquito coil. More females significantly owned ITN than males (1293, 92.4%, p ≤ 0.001). Participants from Ketu South had 1.5 times higher odds of owning an ITN compared to Ho West whose odds are not different from Nkwanta South or Hohoe (AOR, 1.56 [95% 1.09–2.22]; p = 0.01). In terms of ITN usage, participants in Nkwanta South were less likely to use ITN compared to the other districts; AOR, 0.434 [95% CI 0.31–0.62, p < 0.001]. Also, of the 668 participants that had a fever within the past 3 days, 268 (40.1%) visited a patent medicine store and 156 (23.4%) visited health facilities. Conclusion There is high ownership of ITNs, but relatively low utilization among the community members. Education on malaria prevention practices should be intensified and continuous among the population of the Volta Region to ensure the success of malaria control in the region.

Vitex negundo L. Essential Oil: Odorant Binding Protein Efficiency Using Molecular Docking Approach and Studies of the Mosquito Repellent

(1) Background: Malaria fever affects millions of people yearly in Africa and Asia’s tropical and subtropical areas. Because there is no effective vaccine, malaria prevention is solely dependent on avoiding human-vector interaction. (2) Aim: This study examines the interaction between the constituents of Vitex negundo essential oil and Anopheles gambiae Odorant Binding Proteins (OBP) as well as the compositional variation, repellent efficacy, and toxicity profile. (3) Methods: The oils were subjected to GC-MS and mosquito behavioral analysis. OBP–ligand interactions, Anopheles species authentication, and the toxicity profile were determined by molecular docking, PCR assay and in silico ADME/tox tool. Docking protocol validation was achieved by redocking the co-crystallized ligands into the protein binding pocket and root mean square deviation (RMSD) calculation. (4) Results: The oil yields and compositions are climate–soil dependent with ≈71.39% monoterpenes and ≈16.32% sesquiterpene. Optimal repellency is achieved at 15 min at ED50 0.08–0.48% v/v while the RMSD was estimated to be within 0.24–1.35 Å. Strong affinities were demonstrated by α-pinene (−6.4 kcal/mol), citronellal (−5.5 kcal/mol), linalool (−5.4 kcal/mol), and myrcene (−5.8 kcal/mol) for OBP1, OBP7, OBP4, and OBP; respectively. The hydrophobic interactions involve Leu17 (α-helix 1), Cys35 (α-helix 2), ALA52 (α-helix 3), Leu73, Leu76 (α-helix 4), Ala88, Met91, Lys93, Trp114 (α-helix 5), Phe123 (α-helix 6), and Leu124 (α-helix 7) receptors within the binding cavities, and may cause blocking of the olfactory receptors resulting in disorientation. (5) Conclusion: The ligand efficiency metrics, ADME/tox and repellency screening are within the threshold values; hence, α-pinene, linalool, and myrcene are safe and fit-to-use in the development of a green and novel repellent.

Extracellular vesicles in malaria: an agglomeration of two decades of research

Malaria is a complex parasitic disease, caused by Plasmodium spp. More than a century after the discovery of malaria parasites, this disease continues to pose a global public health problem and the pathogenesis of the severe forms of malaria remains incompletely understood. Extracellular vesicles (EVs), including exosomes and microvesicles, have been increasingly researched in the field of malaria in a bid to fill these knowledge gaps. EVs released from Plasmodium-infected red blood cells and other host cells during malaria infection are now believed to play key roles in disease pathogenesis and are suggested as vital components of the biology of Plasmodium spp. Malaria-derived EVs have been identified as potential disease biomarkers and therapeutic tools. In this review, key findings of malaria EV studies over the last 20 years are summarized and critically analysed. Outstanding areas of research into EV biology are identified. Unexplored EV research foci for the future that will contribute to consolidating the potential for EVs as agents in malaria prevention and control are proposed.

The Immune Home: Domestic Enclaves, Diffuse Protections

This essay tracks a paradigm shift in the use of chemicals to control malaria: away from insecticidal approaches, focused on killing mosquitoes within private domestic dwellings, and toward the creation of protective communal atmospheres. An ongoing study of the efficacy of spatial repellents to reduce malaria transmission in rural Tanzania provides an opportunity to rethink the oikographic assumptions of malaria control—and of many global health interventions—and to foreground the specific relationalities of peri-domestic spaces. Yet a sense of moral ambivalence permeates this inquiry, as malaria prevention becomes untethered from any long-lasting material improvement in the house. We reflect on the power of chemicals to reveal chronic forms of neglect and, just possibly, conjugate new, if diffuse, forms of communitas.

Identifying an optimal dihydroartemisinin-piperaquine dosing regimen for malaria prevention in young Ugandan children

Intermittent preventive treatment (IPT) with dihydroartemisinin-piperaquine (DP) is highly protective against malaria in children, but is not standard in malaria-endemic countries. Optimal DP dosing regimens will maximize efficacy and reduce toxicity and resistance selection. We analyze piperaquine (PPQ) concentrations (n = 4573), malaria incidence data (n = 326), and P. falciparum drug resistance markers from a trial of children randomized to IPT with DP every 12 weeks (n = 184) or every 4 weeks (n = 96) from 2 to 24 months of age (NCT02163447). We use nonlinear mixed effects modeling to establish malaria protective PPQ levels and risk factors for suboptimal protection. Compared to DP every 12 weeks, DP every 4 weeks is associated with 95% protective efficacy (95% CI: 84–99%). A PPQ level of 15.4 ng/mL reduces the malaria hazard by 95%. Malnutrition reduces PPQ exposure. In simulations, we show that DP every 4 weeks is optimal across a range of transmission intensities, and age-based dosing improves malaria protection in young or malnourished children.