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Half of all pregnancies at risk of malaria worldwide occur in the Asia-Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic.
There are scant and variable data concerning the incidence of malaria in infants in endemic areas. This study evaluated the impact of maternal antimalarial treatment given postpartum on malaria incidence and growth/development in infants from coastal Papua New Guinea (PNG).
Global efforts led by The Kids Research Institute Australia’s Child Health Analytics program will see nations impacted by high rates of malaria empowered to develop their own controls and solutions.
Malaria remains a leading cause of morbidity and mortality and is responsible for over 0.5 million annual deaths globally. During the first two decades of this century, scale-up of a range of tools was associated with significant reductions in malaria mortality in the primary risk group, young African children.
Since their first detection in 2010, Plasmodium falciparum malaria parasites lacking the P. falciparum histidine-rich protein 2 gene (pfhrp2) have been observed in 40 of 47 surveyed countries, as documented by the World Health Organization. These genetic deletions reduce detection by the most widely used rapid diagnostic tests, prompting three countries to switch to alternative diagnostics.
The World Health Organization recommends perennial malaria chemoprevention (PMC), generally using sulfadoxine-pyrimethamine (SP) to children at high risk of severe Plasmodium falciparum malaria. Currently, PMC is given up to age two in perennial transmission settings. However, no recommendation exists for perennial settings with seasonal variation in transmission intensity, recently categorized as 'sub-perennial'.
Climatic conditions are a key determinant of malaria transmission intensity, through their impacts on both the parasite and its mosquito vectors. Mathematical models relating climatic conditions to malaria transmission can be used to develop spatial maps of climatic suitability for malaria. These maps underpin efforts to quantify the distribution and burden of malaria in humans, enabling improved monitoring and control.
In high-transmission areas, school-aged children have higher malaria prevalence and contribute significantly to the transmission reservoir. Malaria infections can be asymptomatic or present with symptoms which may contribute to anaemia, severe illness and fatal malaria. This analysis provides trends of malaria prevalence and associated risk factors among school-aged children in mainland Tanzania.
The 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.
Melissa Penny PhD, PD, BSc (Hons) Professor Fiona Stanley Chair in Child Health Research melissa.penny@thekids.org.au Professor Fiona Stanley Chair