Search Results (222)

Background: Malaria remains hyperendemic in the Democratic Republic of the Congo, while arboviral infections are increasingly reported but remain under-surveilled, particularly in remote regions. Overlapping ecological niches and non-specific clinical presentations complicate case management and surveillance. Methods: A cross-sectional door-to-door survey was conducted in December 2023 in Inkanamongo village (Lokolia Health Area, Boende Health Zone, Tshuapa Province). Blood samples were collected from 379 adults; malaria infection was assessed by using HRP2-based rapid diagnostic tests, and arboviral IgG antibodies were measured on dried blood spots using Luminex^® multiplex immunoassay. Sociodemographic data were collected via standardized questionnaires. Results: Malaria prevalence was 51.7% (95%CI: 46.7–56.7). Overall arboviral seroprevalence reached 78.4% (95%CI: 73.1–81.5), dominated by O’nyong-nyong virus, 42.8% (95%CI: 37.6–47.5), Rift Valley fever virus, 32.0% (95%CI: 26.9–36.2), and chikungunya virus, 23.4% (95%CI: 19.0–27.4). Concurrent malaria infection and arboviral exposure were observed in 40.4% (95%CI: 35.6–45.4) of participants. No sociodemographic factors were significantly associated with co-exposure in the multivariable analysis. Conclusions: Substantial co-exposure of malaria and multiple arboviruses occurs in this remote Congo Basin setting. Integrated surveillance and improved diagnostics are urgently needed to guide febrile illness management and preparedness in under-resourced regions. Full article

Background: Saudi Arabia has made significant progress toward malaria elimination; however, imported cases continue to occur, particularly in the southwestern regions. This study aimed to describe the clinical characteristics and outcomes of patients with malaria in the Aseer Region, Saudi Arabia. Methods: A retrospective observational study was conducted at Khamis Mushait General Hospital, Aseer Region, Saudi Arabia, including all patients with malaria from January 2022 to December 2025. Demographic, clinical, laboratory, and outcome data were extracted from the electronic medical records. Severe malaria was defined according to the World Health Organization criteria. Multivariate logistic regression using Firth’s penalized maximum likelihood estimation was performed to identify independent predictors of severe malaria (≥1 WHO criterion). Statistical analysis was performed using R software (version 4.2.1). Results: A total of 311 patients were included, predominantly male (90.0%), with a mean age of 28.8 ± 11.3 years. Ethiopian nationals comprised nearly half the cases (48.2%), followed by Saudi (16.4%) and Yemeni (15.1%) nationals. Plasmodium vivax was the most common species (51.1%), followed by Plasmodium. falciparum (40.2%). Fever was the most frequent symptom (89.4%), followed by fatigue (50.8%), chills (46.9%), and vomiting (39.5%). Low parasitemia (<1%) was the most frequent finding (33.8%), followed by moderate (27.3%) and mild (18.3%) levels, while high (4.2%) and very high parasitemia (1.9%) were uncommon. Severe malaria (≥1 criterion) was diagnosed at 43.7%, with severe anemia (26.0%) and jaundice (23.2%) being the most frequent WHO severity criteria. Notably, 84% of the cases occurred during 2024–2025, indicating a recent outbreak, with a sharp peak of 43 cases in October 2024. Multivariate logistic regression identified two independent predictors of having at least one WHO severity criterion: higher parasitemia level (adjusted OR = 1.70 per 1% increase, 95% CI: 1.40–2.11, p < 0.001) and non-Saudi nationality (adjusted OR = 2.40, 95% CI: 1.10–5.62, p = 0.027). Conclusions: Malaria in the Aseer Region predominantly affects young adult male expatriates, suggesting its imported nature. The predominance of P. vivax represents a shift from historical patterns. Parasitemia level and being of non-Saudi nationality independently predict severe malaria and may therefore support risk stratification and clinical decision-making. The dramatic case surge in 2024–2025 highlights regional vulnerability to outbreaks despite control progress. These findings support enhanced screening for at-risk populations, maintenance of clinical capacity for severe malaria management, and robust surveillance systems for early outbreak detection. Full article

Background/Objectives: Febrile illness in returning travelers presents a diagnostic and operational challenge for emergency medicine clinicians as early symptoms of high-consequence tropical infections often overlap with common viral syndromes. This review synthesizes current evidence to guide frontline clinicians in the systematic evaluation, diagnosis, and management of internally acquired febrile illnesses with a focus on pathogen of greatest relevance to United States (US) emergency departments (ED). Methods: We conducted a narrative review of the literature addressing epidemiology, clinical presentation, diagnostic testing, and management strategies for key travel-associated infections. Special consideration was given to rapid diagnostic modalities, pediatric risk factors, and infections most frequently implicated in returning travelers, including chikungunya (CHIK), dengue virus (DENV) disease, Ebola virus (EBV) disease, malaria, Mpox, typhoid fever (TF), yellow fever (YF), and Zika virus (ZIKV) disease. Results: Effective evaluation begins with a detailed travel and exposure history, recognition of epidemiologic and clinical red flags, and targeted use of rapid diagnostic tests. Malaria remains the most common life-threatening cause of post-travel fever and the only pathogen with reliable Food and Drug Administration (FDA)-cleared rapid testing available in the ED. Arboviral infections such as DENV, CHIK, ZIKV, and YFrequire region-specific consideration and phase-appropriate molecular or serologic evaluation. Emerging and high-consequence pathogens, including Mpox and EBV, necessitate strict infection control measures and coordination with public health authorities. Pediatric travelers, particularly those visiting friends and relatives, face disproportionate risk for severe systemic infections and often require broader diagnostic testing. Conclusions: A structured approach integrating travel history, focused examination, rapid diagnostics, and early recognition of high-risk features is essential to improving outcomes for febrile returning travelers. Strengthened vector control, enhanced vaccination uptake, and global surveillance are critical to reducing future disease burden. Full article

Malaria remains a major public health issue worldwide and a repeated cause of illness and death in tropical and subtropical areas. It is caused by protozoan parasites of the genus Plasmodium and transmitted through bites of infected female Anopheles mosquitoes, but it can also be transmitted via blood transfusions, organ transplants, and congenitally from mother to child. Despite decades of intervention efforts, millions of new cases and hundreds of thousands of deaths still occur each year, primarily in low- and middle-income countries. This review summarizes current epidemiological data on the global burden of malaria, mainly from the World Health Organization’s (WHO) World Malaria Report 2024 and Global Burden of Disease estimates. It brings together the latest evidence on worldwide malaria epidemiology, regional trends, determinants, and control strategies, with a particular focus on socio-economic factors, intervention methods, and emerging challenges such as drug resistance, climate change, and limited funding. Disease prevention and management require global, multifactorial approaches that are tailored to the local environment. Strengthening health education with locally relevant knowledge is important to improving outcomes in primary health prevention, secondary health prevention, and tertiary health prevention. The review concludes with a discussion of policy priorities needed in the future to meet the WHO Global Technical Strategy goals for malaria elimination by 2030. Full article

Background/Objectives: Malaria remains a major cause of hospitalization in rural Madagascar, yet data on in-hospital clinical presentation, management, and patient outcomes remain limited. Methods: We conducted a three-year retrospective study (2023–2025) at a rural district hospital in Ambatoboeny, Madagascar, including patients of all ages hospitalized with malaria confirmed by rapid diagnostic testing and microscopy. Sociodemographic, clinical, laboratory, and treatment data were extracted from routine records. Length of hospital stay (LOS) was analyzed continuously and categorized as ≤2, 3–4, or ≥5 days. Seasonal admission patterns and factors associated with LOS were assessed using chi-square or Fisher’s exact tests, and associations with rainfall seasonality were explored using Spearman’s correlation. Results: Among 134 hospitalized patients, median age was 15 years (interquartile range (IQR) 7–25) and 52.2% were female. Plasmodium falciparum predominated (94.0%), while mixed-species infections were identified in 6.0% of cases; 20.1% of cases were classified as severe malaria, including 10.4% with cerebral malaria. Co-infections were frequent (52.2%), most commonly Schistosoma haematobium infection (14.2%) and typhoid fever (12.7%). Intravenous artesunate was initiated in 97.8% of patients; all received paracetamol and 94.8% received intravenous fluids. Median LOS was 2 days (IQR 2–3); 12.7% had prolonged hospitalization (≥5 days). Prolonged LOS was significantly associated with cerebral malaria, high parasitemia (≥5%), blood transfusion, and age < 15 years (all p ≤ 0.034), while co-infection and nutritional status were not. Conclusions: Hospitalized malaria in rural Madagascar presents with heterogeneous clinical phenotypes and a high burden of co-infections. Prolonged LOS is primarily driven by markers of severe disease and supportive care requirements, underscoring the need for early severity recognition and resource planning in low-resource hospitals. Full article

New insecticides for indoor residual spraying (IRS) are being developed to manage resistance. Chlorfenapyr (Sylando^® 240SC), a pro-insecticide, is metabolized by active mosquitoes into the toxic metabolite tralopyril. This mode of action requires adapted “free flying” bioassays (because chlorfenapyr is converted to its toxic metabolite tralopyril when mosquitoes are metabolically active). A miniature-experimental hut (MEH) assay was developed within the Ifakara Ambient Chamber Test (I-ACT) with a rabbit as a host to measure residual efficacy under controlled conditions. Sylando^® 240SC was compared with SumiShield^® 50WG (clothianidin) for 12-month residual efficacy against malaria and arbovirus vectors. Residual activity was assessed on mud, wood and concrete with two huts per substrate treated with Sylando^® 240SC, one with SumiShield^® 50WG, and one with untreated control. Five replicates of 20 mosquitoes per strain (malaria vectors: pyrethroid-susceptible Anopheles gambiae and -resistant An. arabiensis and An. funestus; culicines Aedes aegypti and Culex quinquefasciatus) were exposed overnight at one-week post spraying and monthly thereafter. Multivariable mixed-effect logistic regression with binomial errors and log link function assessed non-inferiority with a 7% margin on mosquito mortality as the primary outcome for malaria vectors. Both products induced delayed mortality, with higher effects on malaria vectors than culicines. Across all substrates and malaria species combined over the full 12 months of observation, Sylando^® 240SC was non-inferior to SumiShield^® 50WG on mortality measured at 72 h (76% vs. 67%, OR = 0.86, 95% CI: 0.77–0.97) and 168 h (89% vs. 82%, OR = 0.74, 95% CI: 0.63–0.87). Sylando^® 240SC performed comparably to SumiShield^® 50WG, supporting its use as an IRS additional option. The new I-ACT mini-experimental-hut assay provides a practical tool for evaluating pro-insecticides. The importance of free-flight evaluation methods for pro-insecticides is discussed. Full article

Yellow fever (YF) and malaria co-infections are real public health concerns in Africa, especially in countries such as Nigeria, where mosquitoes carrying both pathogens (Aedes for YF, Anopheles for malaria) coexist. A mathematical model that considers the critical factors influencing the transmission dynamics and control interventions of YF and malaria co-infections is formulated and used to analyse the problem. The essential dynamical features of the model, such as the basic reproduction number and disease-free equilibrium, are determined and analysed. The qualitative analysis of the model illustrates the conditions under which the disease can be eradicated or persists. Further analysis, supported by numerical simulations, reveals the intrinsic dynamics of the model and the impact of control interventions such as yellow fever vaccination, use of insecticide-treated mosquito nets, treatment of malaria-infected humans, and use of insecticides. The results of the analysis demonstrate the impact of interventions; specifically, effective implementations of interventions such as yellow fever vaccination, use of insecticide-treated mosquito nets, and use of insecticides appear to have a significant impact in eradicating YF and malaria co-infections in endemic areas. Effective treatment of malaria-infected humans may lead to a decrease in infections but might not necessarily lead to eradicating infections in endemic areas. These findings are expected to aid in improving the management of YF and malaria co-infections in endemic regions for expeditious disease eradication. Full article

The progressive degradation of surface waters should become one of the most important problems requiring an urgent solution. One of the methods developed is filtering water through loose, degraded sediments, blooms of cyanobacteria or algae, or a bed of hemp (Cannabis sativa L.) waste or hemp fibers. The conducted tests on the percolation of water samples and/or water with sediment from surface waters at sites with different ecological statuses indicate the possibility of using hemp waste for the reclamation of water reservoirs and rivers. The effect of filtration is a rapid improvement in water quality and, consequently, an improvement in the ecological status. The best result was achieved for a small freshwater reservoir with a large number of algae and loose degraded sediment. The initial turbidity value was at the limit of the device’s measurement capability, reaching 9991 NTU. After filtration through the hemp waste bed, the turbidity dropped to 42.52 NTU, a 99.57% decrease. The remaining parameters, C, TDS, and pH, were not subject to significant variability as a result of filtering. Excessive amounts of organic matter, which create a problem for surface waters, are removed. Due to the carrier (hemp waste), which is organic waste, any possible release of small amounts into the aquatic environment will not pose a threat. After applying filtration, a decision can be made on further actions regarding the water reservoir or river: Self-renewal of the reservoir or further percolation using, for example, mill gauze or cleaning the reservoir with other, non-invasive methods. After the filtering procedure, the hemp waste, enriched with organic matter and water remaining in the waste, can be used for composting or directly for soil mulching (preliminary tests have yielded positive results). A hemp waste filter effectively removes Chronomus aprilinus larvae (Chrinomidae) from water. This result indicates the possibility of removing mosquito larvae in malaria-affected areas. The use of hemp filters would reduce the amount of toxic chemicals used to reduce mosquito larvae. Improving the ecological status of surface waters by filtering contaminants with hemp waste filters can reduce the need for chemical treatment. The use of natural, biological filters enables sustainable surface water management. This is crucial in today’s rapidly increasing chemical pollution of surface waters. Full article

Accurate malaria diagnosis is essential for effective case management and transmission control; however, the sensitivity, operational requirements, and field applicability of current conventional methods are limited. Hemozoin, an optically and magnetically active crystalline biomarker produced by Plasmodium species, offers a reagent-free target for next-generation diagnostics. This scoping review, following PRISMA-ScR and Joanna Briggs Institute guidance, synthesizes recent advances in hemozoin-based detection technologies and maps the current landscape. Twenty-four studies were reviewed, spanning eight major technology classes: magneto-optical platforms, magnetophoretic microdevices, photoacoustic detection, Raman/SERS spectroscopy, optical and hyperspectral imaging, NMR relaxometry, smartphone-based microscopy, and flow cytometry. Magneto-optical systems—including Hz-MOD, Gazelle™, and RMOD—demonstrated the highest operational readiness, with robust specificity but reduced sensitivity at low parasitemia. Photoacoustic Cytophone studies demonstrated promising sensitivity and noninvasive in vivo detection. Raman/SERS platforms achieved sub-100 infected cell/mL analytical sensitivity but remain laboratory-bound. Microfluidic and smartphone-based tools offer emerging, potentially low-cost alternatives. Across modalities, performance varied by parasite stage, with reduced detection of early ring forms. In conclusion, hemozoin-targeted diagnostics represent a rapidly evolving field with multiple viable translational pathways. While magneto-optical devices are closest to field deployment, further clinical validation, improved low-density detection, and standardized comparison across platforms are needed to support future adoption in malaria-endemic settings. Full article

Vector-borne infections are a growing public health concern in Romania, influenced by ecological diversity, climate change, and socioeconomic factors. West Nile virus, tick-borne encephalitis, and Lyme borreliosis represent the most significant threats, with additional risks posed by emerging pathogens, such as leishmaniasis, and the potential reintroduction of malaria. While surveillance systems exist for human cases and, to a lesser extent, vectors, these remain fragmented, underfunded, and limited in their integration across human, veterinary, and environmental health domains. By highlighting both gaps and opportunities, this review provides a forward-looking perspective on strengthening Romania’s capacity to anticipate and manage vector-borne disease threats. Transitioning from reactive surveillance to proactive, prediction-driven strategies will be critical to safeguarding public health in the context of accelerating environmental change. Full article

Background: Geohelminthiasis and malaria are major public health problems in Kinshasa. Pregnant women are particularly vulnerable to these conditions due to their weakened immunity, with severe complications such as maternal anemia and low birth weight. This study assessed the prevalence and associated factors of geohelminth–malaria co-infection. Methods: A cross-sectional study was conducted in two hospitals in Kinshasa, Democratic Republic of the Congo, which included 336 pregnant women. The lab analyses included thick smears for malaria, stool examinations for geohelminths, and hemoglobin measurements. Multivariate logistic regression was used to identify associated variables, with a significance level set at p < 0.05. Results: Geohelminth–malaria co-infection was observed in 5.7% of pregnant women, while the prevalence of geohelminthiasis alone was 7.7%. Ascaris lumbricoides was the most frequent parasite (6.3%), followed by Trichuris trichiura (1.5%) and Ancylostoma duodenale (0.3%). The third trimester was associated with a significantly increased risk of co-infection and geohelminthiasis (ORa = 5.8; 95% CI: 1.36–9.23; p = 0.0077). No significant association was found between co-infection and maternal anemia. Conclusions: Although co-infection prevalence was low in Kinshasa, the third trimester is a risk period. Systematic screening and integrated management during pregnancy are recommended. Full article

Malaria control in sub-Saharan Africa lies at the intersection of changing climate suitability and the scale-up of vector control and case management. Drawing on recent evidence from Kenya, we argue that climate variability already exerts effects on malaria outcomes comparable to, and sometimes stronger than, those of commonly measured interventions at local scales. Transmission dynamics display non-linear, lagged relationships with temperature and rainfall. As a result, climate change is expected to alter prevailing conditions and extremes, reshaping the geography and seasonality of malaria risk. At the same time, socio-economic development and vector control intervention such as insecticide-treated bed nets (ITNs) and timely case management continue to reduce malaria incidence and deaths, especially among young children. However, their population-level impact depends on when and where interventions are deployed relative to climate-favoured windows of transmission. We propose a practical agenda for “climate-smart” malaria control in Kenya advocating for dynamic targeting of interventions according to observed climate lags and thresholds, sustaining protection for the youngest, and innovating approaches for school-age reservoirs of infection. Access to effective care should be re-conceptualized as a climate-adaptation strategy, and short-term, locally tailored forecasts should be embedded into routine planning to support anticipatory and equitable malaria control. Full article

Climate change and the El Niño Southern Oscillation (ENSO) events have been increasingly linked to infectious disease outbreaks. While growing evidence has connected climate variability with systemic illnesses, the ocular implications remain underexplored. This study aimed to assess the relationships between ENSO-driven climate events and infectious diseases with ophthalmic consequences. A narrative review of 255 articles was conducted, focusing on infectious diseases influenced by ENSO and their associated ocular findings. 39 articles met criteria for full review, covering diseases such as dengue, zika, chikungunya, malaria, leishmaniasis, leptospirosis, and Rift Valley fever. Warmer temperatures, increased rainfall, and humidity associated with ENSO events were found to enhance vector activity and disease transmission. Ocular complications included uveitis, retinopathy, and optic neuropathy, but the specific disease findings varied by infectious disease syndrome. The climactic variable changes in response to ENSO events differed across diseases and regions and were influenced by geography, local infrastructure, and socioeconomic factors. ENSO event-related climate shifts significantly impact the spread of infectious diseases with ocular symptoms. These findings highlight the need for region-specific surveillance and predictive models that may provide insight related to the risk of ophthalmic disease during ENSO events. Further research is needed to clarify long-term ENSO effects and develop integrated strategies for systemic and eye disease detection, prevention, and management. Full article

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants with significant ecological and public health implications, particularly in urban wetlands exposed to chronic anthropogenic stress. This study evaluates the occurrence, spatial distribution, seasonal variability, and ecological risk of three low molecular weight PAHs—naphthalene (NAP), phenanthrene (PHEN), and anthracene (ANT)—in surface waters of Caño La Malaria, the main freshwater source of Cucharillas Marsh, Puerto Rico’s largest urban wetland. Surface water samples were collected at four locations during both wet- and dry-season campaigns. Samples were extracted and quantified by GC-MS. NAP was the dominant compound, Σ3PAHs concentrations ranging from 7.4 to 2198.8 ng/L, with higher wet-season levels (mean = 745.79 ng/L) than dry-season levels (mean = 186.71 ng/L); most wet-season samples fell within the mild-to-moderate contamination category. Compositional shifts indicated increased levels of PHEN and ANT during the wet season. No significant spatial differences were found (p = 0.753), and high correlations between sites (r = 0.96) suggest uniform input sources. Diagnostic ratios, inter-species correlations, and principal component analysis (PCA) consistently indicated a predominant pyrogenic origin, with robust PHEN–ANT correlation (r = 0.824) confirming shared combustion-related sources. PCA revealed a clear separation between dry- and wet-season samples, with the latter showing greater variability and stronger associations with NAP and ANT. Ecological risk assessment using hazard quotients (HQ_water) indicated negligible acute toxicity risk across all sites and seasons (<0.01); the highest HQ_water (0.0095), observed upstream during the wet season, remained within this range. However, benchmark exceedances by PHEN and ANT suggest potential chronic risks not captured by the acute ERA framework. These findings support integrated watershed management practices to mitigate PAH pollution and strengthen long-term ecological health in tropical urban wetlands. Full article

This study introduces a novel Fuzzy Piecewise Fractional Derivative (FPFD) framework to enhance epidemiological modeling, specifically for the multi-phasic co-infection dynamics of Omicron and malaria. We address the limitations of traditional models by incorporating two key realities. First, we use fuzzy set theory to manage the inherent uncertainty in biological parameters. Second, we employ piecewise fractional operators to capture the dynamic, phase-dependent nature of epidemics. The framework utilizes a fuzzy classical derivative for initial memoryless spread and transitions to a fuzzy Atangana–Baleanu–Caputo (ABC) fractional derivative to capture post-intervention memory effects. We establish the mathematical rigor of the FPFD model through proofs of positivity, boundedness, and stability of equilibrium points, including the basic reproductive number (R0). A hybrid numerical scheme, combining Fuzzy Runge–Kutta and Fuzzy Fractional Adams–Bashforth–Moulton algorithms, is developed for solving the system. Simulations show that the framework successfully models dynamic shifts while propagating uncertainty. This provides forecasts that are more robust and practical, directly informing public health interventions. Full article