Factors Influencing the Awareness and Adoption of Borehole-Garden Permaculture in Malawi: Lessons for the Promotion of Sustainable Practices

Using wastewater accumulating around rural waterpoints to irrigate community gardens, borehole-garden permaculture (BGP) presents a method of sustainable water management. BGP also presents public health benefits through the removal of stagnant water around boreholes, key Malaria breeding grounds, and through providing year-round food to supplement diets. By analysing a dataset of over 100,000 cases, this research examines the awareness and adoption of BGP across Malawi. Generalised linear models identified significant variables influencing BGP awareness and uptake revealing that socioeconomic, biophysical and waterpoint-specific variables influenced both the awareness and adoption of BGP. BGP had low uptake in Malawi with only 2.4% of communities surveyed practising BGP while 43.0% of communities were aware of BGP. Communities in areas with unreliable rainfall and high malaria susceptibility had low BGP awareness despite BGP being particularly beneficial to these communities. This work suggests that future work in the promotion of BGP should focus their efforts within these areas. Furthermore, this work highlights the value of community networks in knowledge sharing and suggests that such social capital could be further used by NGOs and the Government of Malawi in the promotion of BGP and other sustainable practices.

Developing a Predictive Model for Plasmodium knowlesi–Susceptible Areas in Malaysia Using Geospatial Data and Artificial Neural Networks

Plasmodium knowlesi is an emerging species for malaria in Malaysia, particularly in East Malaysia. This infection contributes to almost half of all malaria cases and deaths in Malaysia and poses a challenge in eradicating malaria. The aim of this study was to develop a predictive model for P. knowlesi susceptibility areas in Sabah, Malaysia, using geospatial data and artificial neural networks (ANNs). Weekly malaria cases from 2013 to 2014 were used to identify the malaria hotspot areas. The association of malaria cases with environmental factors (elevation, water bodies, and population density, and satellite images providing rainfall, land surface temperature, and normalized difference vegetation indices) were statistically determined. The significant environmental factors were used as input for the ANN analysis to predict malaria cases. Finally, the malaria susceptibility index and zones were mapped out. The results suggested integrating geospatial data and ANNs to predict malaria cases, with overall correlation coefficient of 0.70 and overall accuracy of 91.04%. From the malaria susceptibility index and zoning analyses, it was found that areas located along the Crocker Range of Sabah and the East part of Sabah were highly susceptible to P. knowlesi infections. Following this analysis, targetted entomological mapping and malaria control programs can be initiated.

Human genetic variant E756del in the ion channel PIEZO1 not associated with protection from severe malaria in a large Ghanaian study

Recently, a common genetic variant E756del in the human gene PIEZO1 was associated with protection from severe malaria. Here, we performed a genetic association study of this gain-of-function variant in a large case-control study including 4149 children from the Ashanti Region in Ghana, West Africa. The statistical analysis did not indicate an association with protection from severe malaria and, thus, providing evidence against a strong protective effect of the PIEZO1 E756del variant on severe malaria susceptibility.

Genetic variation in the immune system and malaria susceptibility in infants: a nested case–control study in Nanoro, Burkina Faso

Background Genetic polymorphisms in the human immune system modulate susceptibility to malaria. However, there is a paucity of data on the contribution of immunogenetic variants to malaria susceptibility in infants, who present differential biological features related to the immaturity of their adaptive immune system, the protective effect of maternal antibodies and fetal haemoglobin. This study investigated the association between genetic variation in innate immune response genes and malaria susceptibility during the first year of life in 656 infants from a birth cohort survey performed in Nanoro, Burkina Faso. Methods Seventeen single nucleotide polymorphisms (SNPs) in 11 genes of the immune system previously associated with different malaria phenotypes were genotyped using TaqMan allelic hybridization assays in a Fluidigm platform. Plasmodium falciparum infection and clinical disease were documented by active and passive case detection. Case–control association analyses for both alleles and genotypes were carried out using univariate and multivariate logistic regression. For cytokines showing significant SNP associations in multivariate analyses, cord blood supernatant concentrations were measured by quantitative suspension array technology (Luminex). Results Genetic variants in IL-1β (rs1143634) and FcγRIIA/CD32 (rs1801274)—both in allelic, dominant and co-dominant models—were significantly associated with protection from both P. falciparum infection and clinical malaria. Furthermore, heterozygote individuals with rs1801274 SNP in FcγRIIA/CD32 showed higher IL-1RA levels compared to wild-type homozygotes (P = 0.024), a cytokine whose production is promoted by the binding of IgG immune complexes to Fcγ receptors on effector immune cells. Conclusions These findings indicate that genetic polymorphisms in genes driving innate immune responses are associated to malaria susceptibility during the first year of life, possibly by modulating production of inflammatory mediators.

Inherited Disorders of Hemoglobin and Plasmodium falciparum Malaria

An estimated 300,000 babies are born each year with severe Inherited Disorders of Hemoglobin (IDH). Despite major advances in the understanding of the molecular pathology, control, and management of the IDH thousands of infants and children with these diseases are dying due to the accessibility to appropriate medical care. In addition, as malaria has been the principal cause of early mortality in several parts of the world for much of the last 5000 years, as a result, it is the strongest force for selective pressure on the human genome. That is why, in the world, there is an overlap of malaria endemicity and IDH. Over the past twenty years several studies have shown that IDH such us hemoglobin and/or red cell membrane abnormalities confer resistance to malaria reducing hence the mortality during the first years of life. This has led to the selection of populations with IDH in malaria-endemic areas. This may explain the overlap between these two pathologies. This chapter aims to present the relationship between IDH and malaria susceptibility, make an overview of the current state of knowledge and the burden of IDH, and highlight steps that require to be taken urgently to improve the situation.