Background: Anaemia and malaria are common and life-threatening diseases among preschool-aged children in many tropical and subtropical areas, and Malawi is no exception. Accordingly, this study aimed to examine the association of referral clinical malaria with anemia (hemoglobin [Hb] < 110 g/L) in preschool-aged children in Malawi.
Methods: Using cross-sectional data obtained from the 2015-2016 Malawi Micronutrient Survey (MNS), multivariate logistic regression models were constructed using surveylogistic to account for the complex survey design. Blood samples of 1051 children aged 6-59 months were evaluated for malaria (using rapid diagnostic test [RDT] - SD BIOLINE Malaria Ag P.f/Pan test histidine-rich protein (HRP-II)™), Hb (using HemoCue 301), α-1-acid glycoprotein (AGP), and serum ferritin biomarkers (using simple sandwich enzyme-linked immunosorbent assay technique, ELISA) and inherited blood disorders from dry blood samples (DBS) using polymerize chain reaction (PCR). Diagnosis of clinical malaria was made on the basis of fever and a positive rapid diagnostic test (RDT).
Results: Of the 1051 PSC analysed, 29% had anaemia while 24.4% had a referral to the hospital due to malaria. After adjustments for known confounders, PSC with a history of referral clinical malaria had increased odds of being anaemic (adjusted odds ratio [aOR] = 4.63, 95% confidence interval [CI]: 2.90-7.40), P < 0.0001.
Conclusions: This study found that clinical malaria increased the risk of anaemia in PSC. Thus, elimination of malaria-causing parasites from the PSC's blood should be rapid and complete in order to prevent the progression of uncomplicated malaria to a chronic infection that can lead to the development of malaria-related anaemia.
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http://dx.doi.org/10.1186/s40249-019-0607-8 | DOI Listing |
Malar J
January 2025
Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Background: In moderate-to-high malaria transmission regions, the World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) alongside insecticide-treated bed nets to reduce the adverse consequences of pregnancy-associated malaria. Due to high-grade Plasmodium falciparum resistance to SP, novel treatment regimens need to be evaluated for IPTp, but these increase pill burden and treatment days. The present qualitative study assessed the acceptability of IPTp-SP plus dihydroartemisinin-piperaquine (DP) in Papua New Guinea, where IPTp-SP was implemented in 2009.
View Article and Find Full Text PDFThe clinical development of novel vaccines, injectable therapeutics, and oral chemoprevention drugs has the potential to deliver significant advancements in the prevention of Plasmodium falciparum malaria. These innovations could support regions in accelerating malaria control, transforming existing intervention packages by supplementing interventions with imperfect effectiveness or offering an entirely new tool. However, to layer new medical tools as part of an existing programme, malaria researchers must come to an agreement on the gaps that currently limit the effectiveness of medical interventions for moderate to low transmission settings.
View Article and Find Full Text PDFLancet Microbe
December 2024
Jenner Institute, University of Oxford-NIHR Oxford Biomedical Research Centre, Oxford, UK. Electronic address:
Background: Malaria remains a substantial public health burden among young children in sub-Saharan Africa and a highly efficacious vaccine eliciting a durable immune response would be a useful tool for controlling malaria. R21 is a malaria vaccine comprising nanoparticles, formed from a circumsporozoite protein and hepatitis B surface antigen (HBsAg) fusion protein, without any unfused HBsAg, and is administered with the saponin-based Matrix-M adjuvant. This study aimed to assess the safety and immunogenicity of the malaria vaccine candidate, R21, administered with or without adjuvant Matrix-M in adults naïve to malaria infection and in healthy adults from malaria endemic areas.
View Article and Find Full Text PDFLancet Microbe
January 2025
Jenner Institute, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
Background: R21 is a novel malaria vaccine, composed of a fusion protein of the malaria circumsporozoite protein and hepatitis B surface antigen. Following favourable safety and immunogenicity in a phase 1 study, we aimed to assess the efficacy of R21 administered with Matrix-M (R21/MM) against clinical malaria in adults from the UK who were malaria naive in a controlled human malaria infection study.
Methods: In this open-label, partially blinded, phase 1-2A controlled human malaria infection study undertaken in Oxford, Southampton, and London, UK, we tested five novel vaccination regimens of R21/MM.
PLoS Med
January 2025
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Background: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative bacteriological test result. There is limited information on the factors that determine clinicians' decisions to initiate TB treatment when initial bacteriological test results are negative.
Methods And Findings: We performed a systematic review and individual patient data meta-analysis using studies conducted between January 2010 and December 2022 (PROSPERO: CRD42022287613).
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