By Dr. Derick Pasternak, Ambassador, Malaria Science & Research Coordinator, MPI
News
On 23 Jun, EurekAlert, a news outlet of the American Academy for the Advancement of Science published an update on the article we cited in October 2025, Mombo-Ngoma G & al., Making the Most of Existing Antimalarial Medicines: A Single Dose Cure with Sulfadoxine–Pyrimethamine Plus Artesunate–Pyronaridine, Malaria J, 2025 Sep 30, 24:300, https://doi.org/10.1186/s12936-025-05559-4. It states: “Production of fixed-dose SPAP tablets for the pan-African clinical study is expected to begin this year.” The research is conducted under the leadership of the German Center for Infection Research (DZIF), while Professor Mombo-Ngoma is located in Gabon. https://www.eurekalert.org/news-releases/1133192
Okomu F, Opinion: Malaria should worry us more than genetically modified mosquitoes, 2026 Jun 30, https://www.devex.com/news/malaria-should-worry-us-more-than-genetically-modified-mosquitoes-112732?oauth_response=success is an advocacy piece in favor of increasing gene drive research. He concludes: “Most of these deaths occur in children aged under 5 in Africa. Going by these estimates, the disease killed 1,670 people yesterday, and it will kill the same number today and tomorrow until we act with greater resolve. If a disease were killing this many children in wealthy countries, any delay would be called what it is: a despicable moral failure.”
Those of us living in Seattle or its suburbs may have seen the recent (14 July) article by Chimtom MK in the Seattle Times: The new malaria vaccine helps in Africa but faces a test: Completing all 4 doses. Focusing on Cameroon, the first country to adopt the RTS,S vaccine in a non-research mode, it extols the results of vaccination, but is consistent with scientific articles from elsewhere in Africa, that the fourth dose of the vaccine, to be given 12 months after the third, is frequently neglected.
On 15 July, Medicines for Malaria Venture published a news release regarding an as yet unnamed non-artemisinin drug developed by GSK (MMV367/GSK3772701) that targets the blood stage P. falciparum parasite. Researchers in Australia and Switzerland report on early testing in humans.
In the July issue of Lancet Infectious Diseases, a news article by Bagcchi S, New WHO prequalifications signal hope for malaria (https://doi.org/10.1016/S1473-3099(26)00314-2) comments on the action we reported last
Peer Reviewed Articles
Prevention
Vaccines
Sorgho H & al., Advances in the Development of Malaria Vaccines, BMJ. 2026 Jun 15; 393:e084166, https://doi.org/10.1136/bmj-2025-084166 is a review of work being done to develop new vaccines as well as a commentary on the current status of the two vaccines now in use in Africa. The article includes a graphic that summarizes the various vaccine candidates and where in the parasite’s life cycle they are anticipated to be effective.
Lamien J-V & al. administered questionnaires to 257 health care workers (HCWs) 14 to 15 months after the introduction of the RTS,S vaccine in Burkina Faso. According to Healthcare Workers’ Knowledge and Acceptance of the Malaria Vaccine in the Nanoro Health District of Burkina Faso: A Cross-Sectional Study, Malaria J, 2026 Jun 26, https://doi.org/10.1186/s12936-026-06006-8, the “vaccine acceptance rate was 98.8%. Insufficient information about the vaccine was the primary reason for hesitancy. Twenty-two percent (22.6%) of the HCWs were unaware of the type of vaccine used in the district and had no knowledge of the vaccination schedule. More than half (58.0%) stated that they did not receive any training before the vaccine rollout.”
Kalu EI & al., Awareness and Acceptance of Malaria Vaccines by Caregivers of Under-5 Children in Abia State, Nigeria: A Mixed Methods Study, BMJ Public Health. 2026 Jul 7; 4(3):e004538, https://doi.org/10.1136/bmjph-2025-004538 is a report of responses by 618 “caregivers of under-5 children engaged with the routine immunisation programme” in the area studied. Although specific awareness of the malaria vaccine was low (38.2%), many moere caregivers were ready to accept the vaccine for their children (88.7%), “driven by child protection (67.4%) and provider trust (59.8%). Barriers included fears of side effects (51.4%) and misinformation (18.7%). Significantly, education … and urban residence … predicted awareness, and income … and awareness status … influenced acceptance.”
“In October 2024, Sudan introduced the malaria vaccine, beginning in Al-Qadarif and Blue Nile states amidst an ongoing armed conflict.” Babiker RM & al. report on the results of questionnaires administered to 342 healthcare personnel in two teaching hospitals in Predictors of Malaria Vaccine Acceptability Among Healthcare Providers in Conflict-Affected Sudan: A Cross-Sectional Analysis, Malaria J, 2026 Jul 12, https://doi.org/10.1186/s12936-026-06031-7. “Among the 342 respondents, general vaccine acceptability was promising, yet specific operational knowledge remained limited. Significant overall concern about the vaccine was prevalent (64.0%), primarily regarding adverse effects (57.0%), cold-chain handling conditions in Sudan (56.4%), and vaccine effectiveness (42.7%). Social media (48.5%) and peers (45.0%) were the most common information sources. Multivariable linear regression indicated that older age … and hospital of work … significantly predicted higher knowledge.”
“Correctly evaluating how vaccine efficacy (VE) changes over time is important for understanding long-term protection and guiding vaccination strategies. [Zhao Z & al. used] the 18-month pre-booster data from the multi-center RTS,S/AS01 malaria vaccine trial [to examine] how different approaches of modeling time-varying VE affect the interpretation of vaccine protection” and report in Modeling Time-Varying Efficacy of RTS,S/AS01 Malaria Vaccine Across Trial Settings, NPJ Vaccines. 2026 Jul 3, https://doi.org/10.1038/s41541-026-01519-4 that a so-called four parameter model works the best in predicting “protection over 18 months, with rapid early decline followed by stabilization at 20-40%.”
“Plasmodium vivax malaria is an increasing global health threat and the second leading cause of malaria globally. An efficacious vaccine aimed at preventing disease and transmission would greatly facilitate malaria elimination. The P. vivax circumsporozoite protein (PvCSP) is considered a leading pre-erythrocytic stage vaccine target. While P. falciparum malaria vaccines currently in clinical use have CSP as the critical component, their limited efficacy and the need for multiple doses continue to pose challenges for malaria vaccines.” Ntumngia FB & al., Evaluation of Immunogenicity and Efficacy of a Plasmodium vivax Nanoparticle Vaccine in Mice, Vaccine. 2026 Jun 20; 88:128857, https://doi.org/10.1016/j.vaccine.2026.128857 describes research performed in mice, using PvCSP that had been incorporated in P. berghei, the mouse parasite. The results showed that the nanoparticle vaccine preparation “elicited high-titer anti-CSP antibodies that significantly inhibited hepatocyte infection by transgenic P. berghei sporozoites expressing P. vivax CSP in vitro and partially protected mice following in vivo sporozoite challenge.”
Although Barbosa CRR & al., Identification of Cross-Stage, Cross-Species Malaria CD8+ T Cell Antigens, Nature, 2026 Jul 1, https://www.nature.com/articles/s41586-026-10730-1 is a basic science paper, it is cited here because it identifies a possible path toward the development of a cross species (P. falciparum and P. vivax) vaccine.
Naghizadeh M & al. attempted to improve the immunity induced by circumsporozoite vaccines such as RTS,S. They tested several immunogens targeting different regions of the circumsporozoite and found when tested against a suitably “engineered” P. berghei in the mouse model that nonw of the preparations outperformed the RTS,S vaccine currently in use. The paper is Epitope-Selective Vaccine Designs to Elicit Protective Antibodies Against the Plasmodium falciparum Circumsporozoite Protein, NPJ Vaccines. 2026 Jul 3, https://doi.org/10.1038/s41541-026-01518-5.
Issiaka D & al., Clinical Presentation of Severe Malaria in Children Who Received the RTS,S/AS01E Malaria Vaccine, Seasonal Malaria Chemoprevention or the Combination of Both Interventions in Burkina Faso and Mali, Malaria J, 2026 Jul 22, https://doi.org/10.1186/s12936-026-06062-0 describes the clinical features of 337 children who developed severe malaria despite having received the malaria vaccine and/or seasonal malaria chemoprevention (SMC) in two Sahel countries.
Please see Kirtley P & al., Addition of Blood-Stage Antibody Enhances Anti-Sporozoite Antibody Protection in a Humanized Mouse Model of Plasmodium falciparum Infection, Cell Rep. 2026 Jun 22; 45(7):117573, https://doi.org/10.1016/j.celrep.2026.117573 below, under Treatment/New drug research.
Vectors
Otolorin GR & al. analyzed 25 published studies on the effectiveness of insecticide treated nets (ITNs) on clinical malaria in Impact of Insecticide-Treated Nets on Malaria Morbidity and Mortality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Infect Dis (Lond). 2026 Jun 14: 1-18, https://doi.org/10.1080/23744235.2026.2666823. “ITNs demonstrated strong protective effects across diverse populations. The pooled-estimate using a random-effects model showed a 29% reduction in malaria incidence among ITNs users in Africa … and 68% in Asia ... The pooled-odds-ratio for malaria incidence in African studies indicated a 40% reduction in odds …, whereas the pooled-rate-ratio for malaria-related-mortality in Asia was 0.82 … from 5 studies, indicating an 18% reduction in mortality.”
Gudeta EA & al. used questionnaires to assess ITN use among individuals suspected of having malaria. As reported in Assessment of Long-Lasting Insecticide-Treated Bed Net Possession, Utilization, and Prevalence of Malaria Among Patients Visiting Bahir Dar Health Center, J Parasitol Res. 2026 Jun 17; 2026:9689904, https://doi.org/10.1155/japr/9689904, among a “total of 403 participants, 283 (70.2%) possessed at least one [ITN] and 268 (66.5%) reported regular use during sleeping hours. The overall malaria prevalence was 3.7% (15/403). Plasmodium falciparum was the predominant species (60.0%), followed by Plasmodium vivax (26.7%) and mixed infections (13.3%). Malaria prevalence was significantly higher among rural than urban residents … and among participants without [ITNs] compared with [ITN] owners ... No significant associations were observed between malaria prevalence and sex, age, educational status, or [net] washing practices.”
“Indoor residual spraying (IRS) and insecticide treated bed nets (ITNs) used either singly or in combination are the main mass mosquito vector control measures for malaria control.” Okek EJ & al. “measured the impact of compounds used in different types and campaigns of IRS and ITNs, different permutations of IRS + ITNs on malaria test positivity rates in high disease transmission settings” in two districts in Uganda. “Data on the following were extracted; socio-demographic characteristics, number of monthly malaria tests, monthly numbers of positive malaria tests, the type of [ITNs] distributed, the type of [IRS] applied and the time points that the interventions were deployed.” As they conclude in Combination of Different Intervention Strategies for Malaria Mosquito Vector Control in Uganda: A Review of Secondary Data of Two Districts with Moderate to High Disease Transmission, PLoS One. 2026 Jul 6; 21(7):e0352455, https://doi.org/10.1371/journal.pone.0352455, in “areas of high malaria transmission, deployment of either ITNs alone, IRS alone, or in combination can be an effective tool for malaria case reduction. However, a more sustained and significant reduction is achieved through the simultaneous deployment of IRS and ITNs.”
Habtamu A & Fenta L investigated the knowledge and practices of malaria prevention and treatment in a group of 366 educated Ethiopians and report in Assessment of Knowledge, Attitudes, Prevention Practices, and Self-Reported Malaria Prevalence Among Summer Degree Students at Debre Markos University, Ethiopia, 2025, J Parasitol Res. 2026 Jun 16; 2026:5834041, https://doi.org/10.1155/japr/5834041 that “75.4% demonstrated satisfactory awareness of malaria, and 82.8% correctly identified its causative agent. However, knowledge about insecticide-treated net (ITN) utilization and appropriate treatment-seeking behavior was limited. … preventive practices were inadequate: only 71.58% reported consistent ITN use, 39.07% sought treatment at health facilities, and 15.57% completed the full course of antimalarial medication. Rural residence, inconsistent ITN use, and failure to eliminate mosquito breeding sites were significantly associated with malaria prevalence…”
Tongwa DZ & al. “assessed knowledge, attitudes, prevention practices and care-seeking behaviours related to” malaria by means of questionnaires described in their paper, Knowledge, Attitudes and Practices Towards Uncomplicated Malaria Management and LLIN Use in Kumba and Muyuka, Cameroon: A Cross-Sectional Study, BMJ Public Health. 2026 Jun 19; 4(2):e004055, https://doi.org/10.1136/bmjph-2025-004055. Among the 1244 responses, only 13.0% in Kumba and 14.9% in Muyuka demonstrated good knowledge although fever was widely recognised (86.1%). [ITN] ownership was significantly higher in Kumba (81.7%) than in Muyuka (57.1%). … In multivariate analysis, younger age, male gender, good knowledge, positive attitudes and good access to malaria information emerged as significant independent predictors of good preventive practices, with specific drivers varying between municipalities.”
McCoy KD & al. “explored the process and interpretations of integrating human behavior estimates from the Malaria Behavior Survey (MBS), a large-scale cross-sectional survey measuring behaviors and their determinants” in Malawi. When accounting for mosquito and human location, most exposure to vector bites was estimated to occur indoors (96%), at times when people were asleep (87%). Although most mosquito bites occurred indoors during sleeping hours—when ITNs could offer protection—only 35% of all exposure to bites was estimated to be prevented, considering that the population-level usage rate of ITNs was only 40%. ITN access, which was only 39%, was identified as an important factor contributing to the protection gap. The paper is Integrating Routinely Collected Mosquito Vector and Human Behavioral Data for Malaria Prevention: A Case Example in Central Region Malawi, Malaria J, 2026 Jul 15, https://doi.org/10.1186/s12936-026-06043-3
Eukubay A & al. “investigated insecticide resistance genes using whole-genome sequencing in a major malaria vector, Anopheles arabiensis sampled across [various] regions of Ethiopia.” They found multiple genetic markers associated with insecticide resistance, but none consistent throughout the country. They conclude in Spatial and Temporal Signatures of Genomic Insecticide Resistance in the Anopheles arabiensis Mosquito Malaria Vector from Ethiopia, Sci Rep. 2026 Jun 25, https://doi.org/10.1038/s41598-026-59658-6 that their findings “highlight the importance of integrating genomic surveillance of resistance markers into entomological monitoring to strengthen insecticide resistance management. They also underscore the need to investigate lesser-known sources of adaptive change that may have significant consequences for vector control.”
Agbevo A & al. assessed the entomological efficacy of DuraNet® Plus, “an alpha-cypermethrin and PBO incorporated net relative to a standard pyrethroid-only net (DuraNet®) and an established pyrethroid-PBO net (Olyset® Plus), in support of WHO prequalification.” The ITNs were tested “unwashed and after 20 standardized washes. Primary outcomes included 24-h mosquito mortality and blood-feeding inhibition.” The authors conclude in A Multi-Country Non-Inferiority Experimental Hut Evaluation of Duranet® Plus, an Alpha-Cypermethrin and Piperonyl Butoxide Treated Net, for Control of Pyrethroid-Resistant Malaria Vectors in West and Central Africa, Malaria J, 2026 Jul 13, https://doi.org/10.1186/s12936-026-06039-z that “DuraNet® Plus showed strong entomological efficacy and wash durability against pyrethroid-resistant malaria vectors across varied settings in West and Central Africa. It met WHO non-inferiority criteria compared to Olyset® Plus and was superior to a pyrethroid-only ITN, supporting its inclusion among WHO-prequalified products.”
“Uganda Virus Research Institute (UVRI) and Liverpool School of Tropical Medicine (LSTM) built capacity and improved on existing computational capabilities in line with molecular surveillance of Anopheles gambiae, the primary malaria vector in sub-Saharan Africa.” Lukindu M & al., Local Implementation of Scalable Malaria Molecular Surveillance in a Low-Resource Setting: A North–South Collaborative Model, Malaria J, 2026 Jul 13, https://doi.org/10.1186/s12936-026-06040-6 presents a “panel capable of simultaneously detecting 55 Insecticide Resistance markers and 35 Ancestral Informative Markers, as well as polymorphisms in the doublesex gene—a key target for homing-based gene drives aimed at suppressing malaria vector populations. This represents a substantial advancement over conventional surveillance tools. The panel was tested and locally validated at UVRI with the lab colony and wild populations…”
“Anopheles stephensi is a malaria mosquito vector that has been raising international concern due to its invasive nature in Africa, including the nation of Djibouti. Since its initial detection in Djibouti in 2012, malaria morbidity and mortality have increased exponentially in the country.” Rao S & al., Evidence of Anopheles stephensi Involvement in the Transmission of Plasmodium vivax in Djibouti City Using Highly Sensitive Sporozoite Detection Assay, Parasit Vectors. 2026 Jul 8, https://doi.org/10.1186/s13071-026-07532-9 reports that among 196 captured An. stephensi mosquitoes, two were found to have P. vivax sporozoites. Based on genetic analysis the authors confirmed the relatedness of this A. stephensi population to that of the rest of the Horn of Africa.
“Larval source management (LSM) was once central to malaria control before insecticide-treated nets and indoor residual spraying dominated.” Msugupakulya BJ & al., Less is More: Modelling the Impact of Species-Targeted Versus Broadcast Larviciding in Anopheles funestus-Dominated Malaria Transmission Settings, Malaria J, 2026 Jul 1, https://doi.org/10.1186/s12936-026-06018-4 is a “modelling study [that] quantified the potential impact of larviciding in African settings where multiple vector species contribute unequally to malaria transmission.” Although larviciding for two species of Anopheles yielded more potential reduction of potential inoculation rates than concentrating on An. funestus alone, the authors deemed that the marginal cost of the broader approach was not justified and therefore advocate concentrating on An. funestus larvae.
“Madagascar piloted drone-delivered microbial larviciding using Bacillus thuringiensis israelensis (Bti) in rice fields in two districts with populations unfamiliar with drones during Feb–Jul 2022.” Bowen A & al. “assessed knowledge and perceptions among purposefully selected rice farmers, rice field workers, and community members during focus group discussions (FGDs) in the two districts three to four months after the intervention. … Despite initial concerns, both Bti-based larviciding and using drones to apply larvicides were ultimately well accepted by rice field owners and workers and community members in rice-growing areas of Madagascar.” The article is Perceptions and Acceptability of Drone-Based Larviciding Using Bacillus thuringiensis israelensis in Rice Fields in Madagascar, 2022: a Qualitative Study, Malaria J, 2026 Jul 7, https://doi.org/10.1186/s12936-026-05978-x.
Agonhossou R & al. “assessed malaria transmission, vector diversity, and insecticide resistance in two health districts to support the National Malaria Control Programme in designing targeted and effective vector control strategies… An. gambiae s.s. dominating in the rainy season …, while An. coluzzii predominated in the dry season … High frequencies of kdr L1014F mutations [associated with pyrethroid resistance] were detected … The article is Malaria Transmission Dynamics, Vector Diversity, and Insecticide Resistance Profiles in Two Health Districts of Southern Benin, BMC Infect Dis. 2026 Jul 2, https://doi.org/10.1186/s12879-026-13892-5
“Entomological surveillance provides critical information for National Malaria Programs (NMPs), yet there is limited evidence on the cost-effectiveness of alternative sampling approaches. Conventional surveillance often relies on purposive, fixed-site sampling, which may produce biased or non-representative data. To address these limitations, the Entomological Adaptive Sampling Framework (EASF) was developed to optimize sampling strategies based on spatiotemporal vector dynamics.” Avanceña ALV & al., Entomological Adaptive Sampling Framework (EASF) for Malaria Vector Surveillance: An Economic Evaluation of Pilot Implementation in Ghana and Mozambique, Malaria J, 2026 Jul 13, https://doi.org/10.1186/s12936-026-06020-w “evaluates the costs and cost-effectiveness of EASF compared to routine entomological surveillance in Ghana and Mozambique.” Based on the authors’ calculations, they conclude that “EASF has the potential to improve the efficiency of entomological surveillance by collecting more mosquitoes at lower costs. Future research should build on these findings by demonstrating the downstream value of improved entomological data on NMP decision-making and malaria transmission.”
“Experimental huts are the gold standard for the semi-field evaluation of insecticide-treated nets (ITNs) but the design of the huts used varies markedly between sites” according to Assenga AA & al., Design Matters: Structural Variation in Experimental Huts Significantly Alters Entomological Endpoints in Insecticide Treated Net (ITN) Evaluation---a Comparative Experimental Hut Trial Using a Latin Square Design in Tanzania and Côte d’Ivoire, Malaria J, 2026 Jul 25, https://doi.org/10.1186/s12936-026-06066-w. In comparing four different hut designs, the authors found six-fold variations in mosquito capture, with the ones that captured the fewest mosquitoes recording the highest mortality for any given ITN source. The authors conclude that “[e]xperimental hut design substantially affected key entomological outcomes, influencing both the magnitude of measured efficacy of ITNs and the statistical power of trials. … Harmonising experimental hut designs and reporting standards would strengthen cross-site comparability, improving the reliability of vector control product assessments…”
Chemoprophylaxis
Ikoona E & al. “compared malaria recurrence among study infants and explored associated risk factors.” As they report in Clinical Malaria Recurrence and Associated Factors in Infancy Following IPTp-DP Versus IPTp-SP in Busia, Uganda; a Secondary Analysis Using the Conditional Frailty Model, Malaria J, 2026 Jun 30, https://doi.org/10.1186/s12936-026-06025-5, a “total of 640 infants born to women who received IPTp-DP or IPTp-SP were followed-up for 12 months. These infants experienced a total of 997 malaria episodes … Compared with IPTp-SP, IPTp-DP did not significantly reduce malaria recurrence in infants. Maternal education, maternal age, and distance to health center were associated with the hazard of malaria recurrence in infants. Recurrent malaria episodes were correlated, with evidence of event dependence across successive episodes.”
Snyman K & al. “conducted a cross-sectoral benefit–cost analysis (BCA) of malaria chemo-prevention in school-aged children (SAC) across ten high-burden sub-Saharan African countries. Using recent trial data, [the authors] estimated impacts on malaria morbidity, mortality, school absenteeism and literacy. The intervention was projected to cost [USD] 422 million and generate [USD] 5.7 billion in societal net benefits, yielding a benefit–cost ratio (BCR) of 14.3.” Their findings, reported in A Smart Investment: The Health, Education and Economic Returns of Malaria Chemoprevention in School-Aged Children Across Ten High-Burden Countries, J Benefit-Cost Anal, 2026 Jul 14, 2026:1-23. https://doi.org/10.1017/bca.2026.10050, “offer policymakers and funders strong evidence to prioritize malaria chemoprevention in SAC as a high-value investment in both health and human capital in malaria-endemic regions.”
Other
“With more vector control options but limited resources, malaria programs face complex decisions influenced by local transmission intensity, mosquito species, and dynamic insecticide resistance patterns.” Oxborough RM & al., Portable Experimental Hut Tents (PEHTs): A Conceptual Framework for Improved Malaria Vector Control Decision-Making with a Review of Fixed Experimental Hut Sites in Africa, Parasit Vectors. 2026 Jun 26, https://doi.org/10.1186/s13071-026-07483-1 is a review of 34 publications that describe the use of PEHTs in decision making as to where to deploy pyrethroid-impregnated ITNs versus the newer, more expensive ITNs that contain more effective insecticides.
Donini C & al. state that “new tools are needed to broaden the scope and enhance the effectiveness of preventive strategies, particularly in high transmission areas.” New Malaria Prevention Modalities: Long-Acting Interventions Beyond Vaccines, Cold Spring Harb Perspect Med. 2026 Jun 29: a041859, https://doi.org/10.1101/cshperspect.a041859 “examines emerging modalities for malaria chemoprevention beyond vaccination, illustrating advances toward long-acting interventions that can provide sustained protection with fewer doses. The pharmacological rationale and essential considerations for the clinical development and deployment of monoclonal antibodies, long-acting oral agents, and long-acting injectable small-molecule formulations are explored with examples. These innovations represent a step-change in malaria prevention, improving operational feasibility and long-term impact in endemic settings.”
Monoclonal antibodies are not drugs but by acting on the target of the blood-stage parasite, they mimic drug action. Kirtley P & al., Addition of Blood-Stage Antibody Enhances Anti-Sporozoite Antibody Protection in a Humanized Mouse Model of Plasmodium falciparum Infection, Cell Rep. 2026 Jun 22; 45(7):117573, https://doi.org/10.1016/j.celrep.2026.117573 appears to consider this use as prevention. In their study of the mouse model, addition of [a blood stage monoclonal antibody (mAb)] to a partially protective anti-CSP mAb yields additional benefits by controlling the ensuing blood stage parasitemia to a transient and extremely low-level infection.”
CIS43LS is a long-acting monoclonal antibody that “targets the Plasmodium falciparum circumsporozoite protein.” Tran TM, & al., Pharmacokinetics and Pharmacodynamics of a Long-Acting Monoclonal Antibody Against Malaria in African Adults, J Clin Invest. 2026 Jul 2: e207559, https://doi.org/10.1172/jci207559 demonstrates in 348 trial participants that “protective CIS43LS levels can be maintained over the course of a single malaria season…”
War disrupts healthcare and disease prevention in many ways. Ewinetu MK &al., Malaria Prevention Practice and Associated Factors Among Residents in Fogera District, Ethiopia, During the Armed Conflict Between Amhara Fano Forces and the Federal Government, 2025, Malaria J, 2026 Jul 21, 25:266, https://doi.org/10.1186/s12936-026-06035-3 underlines this fact with data. Among 804 individuals in a war zone queried by nurses, 48% were deemed to have “good practice of malaria prevention and control interventions.” One third of responders did not possess bed nets of any kind. “… male gender ..., urban residence …, having bed net … and adequate knowledge … were significantly associated with malaria prevention practice.”
Diagnosis
General diagnostics
None this month
Field diagnostics
“Because P. falciparum and P. vivax coexist in [parts of Ethiopia], accurate malaria diagnosis is essential for effective case management. Low parasitemia and pfhrp2/3 gene deletions limit the performance of conventional HRP2-based rapid diagnostic tests (RDTs). The new Bioline Malaria multi-Ag Pf/Pf/Pv RDT, detecting HRP2 and dual pLDH for both species, addresses this limitation.” Bogale A & al., Comparative Evaluation of a Multi-Antigen Malaria Rapid Diagnostic Test Against qPCR and Microscopy in a Co-Endemic Area of Southern Ethiopia, Sci Rep. 2026 Jun 25, https://doi.org/10.1038/s41598-026-58042-8 describes the testing of “579 febrile patients from health facilities … during the major transmission period from October to December 2025,” compared with expert microscopy and species-specific quantitative polymerase chain reaction (qPCR). “Using microscopy as a reference, multi antigen RDT showed high sensitivity 86.2% … and specificity 98.6% … with almost perfect agreement …); however, against qPCR, sensitivity decreased for P. falciparum 77.1% … despite consistently high specificity 97.1% …, indicating missed submicroscopic infections. The Bioline Malaria Ag Pf/Pf/Pv RDT demonstrated high specificity and substantial agreement with microscopy but moderate sensitivity compared with qPCR, suggesting that low-density infections were overlooked.”
Some DY & al., Improving the Field Accuracy of a Malaria Diagnostic Algorithm Combining Sequential Interpretation of Rapid Diagnostic Test Detecting PfHRP2 and pLDH in Febrile Children in a Seasonal Hyperendemic Malaria Transmission Area in Burkina Faso, PLoS One. 2026 Jun 23; 21(6):e0351990, https://doi.org/10.1371/journal.pone.0351990 describes an unblinded field study in which the authors compared the diagnostic accuracy of conventional HRP2-based RDTs versus RDTs that also tested for lactic dehydrogenase (LDH), plus consideration of previous antimalarial treatments within the past four weeks. Using microcopy as the definitive diagnostic test, they found that adding the LDH-based RDT improved the diagnostic accuracy when both RDTs were positive but created uncertainty in situations where conventional RDT was positive and LDH based RDT was negative. Among these situations, recent malaria treatment as a factor was investigated with no conclusive outcome.
Kouakou OMA & al. “identified factors associated with providers’ guideline adherence and accurate RDT reporting in in two high-burden regions in Côte d’Ivoire” and report in A Qualitative Study Exploring Factors Associated with the Accuracy of Recording Malaria Rapid Diagnostic Test Results in Two High-Burden Regions of Côte d’Ivoire, Malaria J, 2026 Jul 23, https://doi.org/10.1186/s12936-026-06053-1 that after quality control of RDT readings by field health workers, interviews were conducted, comparing high performers with low performers. The authors concluded that “[d]ifferences in guideline adherence and RDT recording were driven by risk perceptions and confidence in results rather than a lack of procedural knowledge, guideline access, or supply constraints. Interventions should target clinical decision-making for RDT-negative fevers…”
New diagnostic methods
Malaekah E & al. describe a system of automated diagnosis based on “digitized images of blood smears… For the study, the database included images of 191 blood smears of patients infected with malaria and 227 images of blood samples from healthy patients. According to Intelligent Automation Cognitive System for Accurate Malaria Diagnosis Using Digital Blood Smears, PLoS One. 2026 Jun 18; 21(6):e0348280, https://doi.org/10.1371/journal.pone.0348280, close to 70% of patients with malaria were found to be positive with the method, while it yielded no false positives in samples from healthy patients.
Diagnostic testing for P. vivax is complicated by the fact that the parasite may persist in the liver (the hypnozoite stage) after the blood stages have been completely cleared. Sampaio JR & al., A Rapid Immunochromatographic Test for Antibody Detection as a New Tool for Monitoring Malaria Caused by Plasmodium vivax, PLoS Negl Trop Dis. 2026 Jun 26; 20(6):e0014447, https://doi.org/10.1371/journal.pntd.0014447 is of interest in this context, because it describes a rapid immunologic test for the antibody against the parasite; persistence of positive antibodies may signal persistence of the parasite in the body.
Maurya SK & al. claim to “present a capillary-driven image flow cytometer with a cost comparable to microscopy-based diagnostics” of P. falciparum malaria in A Novel Capillary-Driven Dual-Mode Imaging Flow Cytometry System for Malaria Parasite Detection and Quantification, Biosens Bioelectron. 2026 Jun 29; 311:118956, https://doi.org/10.1016/j.bios.2026.118956. According to the authors, the process involves “staining of [capillary] blood with SYBR Green I before loading it into a microfluidic chip. The chip is then placed under a microscope with both brightfield and fluorescence illumination. Automated image acquisition and processing enable the generation of diagnostic results without user intervention. … The platform successfully diagnoses malaria and quantifies parasitemia with a relative error of less than 10% compared to standard flow cytometry on the cultured Plasmodium falciparum”. The authors acknowledge that much more investigation is necessary before concluding that the method is reliable and feasible in the field.
Hennies MT & al. report on the testing of a PCR product that is said by the manufacturer to distinguish between the various species of Plasmodium. Whereas the abstract of Head-to-Head Evaluation of a Commercial Real-Time PCR Assay Targeting Plasmodial Species Causing Human Malaria Against a Composite Reference Standard, Eur J Microbiol Immunol (Bp). 2026 Jul 1: 1886.2026.00033, https://doi.org/10.1556/1886.2026.00033 is difficult to interpret in this regard, the conclusion of the article is definitive: “the assessed real-time PCR assay proved to be suitable for plasmodial discrimination on species level and – depending on the expected local epidemiology concerning non-addressed zoonotic Plasmodium spp. – also as a primary diagnostic tool in case of suspected human malaria.”
Other
“Private drug retail outlets, including community pharmacies and over the counter medicine sellers (OTCMS), play a major role in malaria case management in Ghana.” Saaka S & al., Malaria Diagnosis Practices in Formal Private Drug Retail Shops in the Ho Municipality, Ghana: A Cross-Sectional Survey, Malaria J, 2026 Jul 25, https://doi.org/10.1186/s12936-026-06068-8 is a report of a survey of 86 outlets, of which 16 were official pharmacies. The paper documents the fact that in the community studied, pharmacies generally had the supplies of RDT kits, they did not necessarily use them before dispensing antimalarials. On the other hand, fewer than 25% of OTCMS had RDTs available, and the ones that had them tended not to use them, even though the authors state that “[m]ost respondents (76.7%) had received training in malaria diagnosis, mainly organized by the Pharmacy Council.”
Treatment
Treatment results
Debash H & al. conducted a prospective study over 15 months “among 159 patients with uncomplicated malaria, including 81 P. falciparum and 78 P. vivax infections. Patients received treatment according to national guidelines, with artemether-lumefantrine for P. falciparum and chloroquine for P. vivax, while a subset also received a single low dose of primaquine.” They report “adequate clinical and parasitological response rates of 88.9% among P. falciparum patients and 97.4% among P. vivax patients” in Therapeutic Efficacy, Safety and Gametocyte Clearance After Antimalarial Treatment of Uncomplicated Plasmodium falciparum and Plasmodium vivax Malaria in Northeast Ethiopia, Sci Rep. 2026 Jun 22, https://doi.org/10.1038/s41598-026-58540-9. “A transient increase in gametocyte carriage on day 3 was observed more frequently among participants who did not receive primaquine. Primaquine significantly accelerated gametocyte clearance, reducing the median clearance time from 11 to 7 days in P. falciparum and from 7 to 4 days in P. vivax.”
Sixteen years after the introduction of artemether-lumefantrine for treatment of malaria, Abuaku B & al. studied the outcome of this treatment in 738 children between the ages of six months to nine years. They report in Efficacy of Artemether-Lumefantrine Combination for the Treatment of Uncomplicated Plasmodium falciparum Malaria After 16 Years of Its Introduction into Ghana’s Antimalarial Medicines Policy, Malaria J, 2026 Jul 3, https://doi.org/10.1186/s12936-026-06003-x that the cure rate after 28 days was over 90%, as measured by qPCR.
Side effects and complications
“Adherence to radical cure for Plasmodium vivax remains a major challenge for malaria control programmes. Novel regimens, such as 7-day high-dose primaquine regimen and single-dose tafenoquine, may improve treatment adherence and antirelapse effectiveness but can increase the risk of haemolysis in individuals with glucose-6-phosphate dehydrogenase deficiency.” Mwaura M & al, Risk Perceptions of High-Dose Primaquine and Tafenoquine Among Plasmodium vivax Malaria Stakeholders in Ethiopia: A Qualitative Study, BMJ Glob Health. 2026 Jun 29; 11(6):e021763, https://doi.org/10.1136/bmjgh-2025-021763 describes the result of interviews with “clinical trial staff and participants, health centre personnel, health extension workers and routine care patients” in a hospital and three ambulatory health clinics. “The 7-day-high-dose primaquine regimen and single-dose tafenoquine were viewed as promising solutions to the adherence challenges of the standard 14-day primaquine regimen; however, participants raised concerns about the effectiveness of the shortened treatment duration and the safety of the increased daily dose of primaquine. A risk perception lens revealed that concerns about effectiveness and safety were influenced by prior public health messaging emphasising completion of the full 14-day regimen alongside fears of overdosing and drug-induced haemolysis.”
Guidelines
“The issue of self-medication with anti-malarial drugs is a critical public health challenge.” Addis WD & al., Self-Medication Practice with Anti-Malarial Drugs and Its Associated Factors Among Patients with Fever Attending Public Health Facilities in Dera District, Northwest Ethiopia, PLoS One. 2026 Jul 6; 21(7):e0352762, https://doi.org/10.1371/journal.pone.0352762 reports that the “prevalence of self-medication with anti-malarial drugs was 42.8% … Factors positively associated with self-medication included: [low] monthly income …, poor knowledge about malaria …, poor risk perception towards self-medication [and] distance ≤5 km from private drug sellers … Community-based health insurance membership was negatively associated with self-medication.”
Yousif YOE & al. surveyed 371 Sudanese medical professionals as to their adherence to national treatment guidelines. “High awareness was reported, with 67.9% of participants knowing about the 2023 protocol. Knowledge of first-line treatments was strong, with 93.5% correctly identifying Artemether-Lumefantrine for uncomplicated malaria and 83.0% correctly identifying Intravenous Artesunate for severe malaria. However, a significant gap in formal training was observed: 69.5% of participants reported no formal training on the new protocol. Furthermore, only 41.5% reported ‘always’ adhering to the protocol in their practice.” The paper is Knowledge, Attitudes, and Practices of Sudanese Medical Professionals Regarding The 2023 Sudan Malaria Treatment Protocol: A Cross-Sectional Study, Malaria J, 2026 Jul 22, https://doi.org/10.1186/s12936-026-06064-y.
Drug resistance
“…malaria treatment is threatened by the emergence and spread of artemisinin resistance, which is associated with mutations in the PfK13 propeller domain.” Amito FP & al. “aimed at establishing the prevalence of P. falciparum malaria infection in association with Kelch 13 mutations among patients presenting with fever at” a Ugandan regional hospital in Polymorphism of pfmdr1 Gene Mutation Conferring Resistance to Artemisinin-Based Combination Therapy in Plasmodium falciparum in Patients at Gulu Regional Referral Hospital in Northern Uganda, J Parasitol Res. 2026 Jun 9; 2026:8966853, https://doi.org/10.1155/japr/8966853. The results are deemed troublesome by the authors in that among 214 infectious agents studied, the genetic marker most strongly associated with artemisinin resistance was present in 53 (16.7%).
Also in Uganda, Katairo T & al. studied 8518 samples obtained from malaria patients of various ages and geographic locations. Their paper, Sustained High Prevalence of Multiple Antimalarial Drug Resistance Markers in Uganda in 2023-2024, Antimicrob Agents Chemother. 2026 Jun 15: e0036126, https://doi.org/10.1128/aac.00361-26, reports mutations consistent with partial artemisinin resistance of over 20%, but with great geographic variations. Also present were mutations consistent with chloroquine resistance (38%) and antifolate resistance (up to 76%).
Two studies from DRC on the subject of drug resistance markers were published the same day: “Recent reports have documented P. falciparum with mutations associated with artemisinin partial resistance in eastern DRC, raising concerns about reduced drug susceptibility.” Stauning MA & al. examined “the prevalence of mutations linked to reduced ACT efficacy” in a different region of the country, by testing for mutations in dried blood spots from 532 children. They report in Prevalence of Molecular Markers Related to Artemisinin Partial Resistance and ACT Partner Drug Resistance in the Plasmodium falciparum Population in Kongo Central, DRC, Malaria J, 2026 Jun 29, https://doi.org/10.1186/s12936-026-06022-8 that a “potential marker of artemisinin partial resistance was found in a single sample, while [two] mutations …, also suspected of being linked to artemisinin partial resistance were found in 20% and 22% of the sequencing positive samples, respectively…” While there was no clinical evidence of artemisinin partial resistance in these cases, the authors’ “findings are of concern and continued molecular surveillance is needed to monitor emerging resistance patterns and allow for a timely response.” Luzulu Khote F & al., Prevalence of Antimalarial Drug Resistance Markers and Factors Associated with Plasmodium falciparum Infection in Asymptomatic Children Prior to Rectal Artesunate Implementation in Kapolowe Health District, Democratic Republic of the Congo, Malaria J, 2026 Jun 29, https://doi.org/10.1186/s12936-026-06016-6 reveals that among 1242 children screened in 906 households, 656 (53%...) were P. falciparum malaria rapid diagnostic test-positive” and treated with rectal artesunate. “Two … mutations associated with reduced dihydroartemisinin susceptibility … were observed. … the … haplotype … associated with reduced lumefantrine susceptibility was identified” in 15% of the samples. This latter article could be cited under Epidemiology/General epidemiology.
Also from DRC, Bitshi M & al. report of their studies of changes in the k13 gene in Drug Resistance Gene Polymorphisms of Plasmodium falciparum Clinical Isolates from Kinshasa, Democratic Republic of the Congo, Trop Med Health. 2026 Jul 7, https://doi.org/10.1186/s41182-026-01022-5. While they found no evidence of the particular mutation associated with resistance to artemisinins, the authors point out finding a number of other mutations at the same locus.
In their study of artemisinin partial resistance (ART-R) in East Africa, Young NW & al. collected data from 120 studies published over 11 years ending in 2025, to which they added “privately held datasets” and numerous “public repositories,” encompassing over 200,000 data points. “The highest predicted prevalence of k13 mutations in 2024 was observed in Northern Province, Rwanda, at 62·2% …, increasing from 0·2% … in 2012 at an average annual increase of 5·2 percentage points.” The conclusion of Mapping the Prevalence of Molecular Markers of Plasmodium falciparum Artemisinin Partial Resistance in Africa: A Systematic Review and Spatiotemporal Modelling Study, Lancet Infect Dis, 2026 Jul 7, https://doi.org/10.1016/s1473-3099(26)00237-9 is unequivocal: The rapid, multicentric expansion of k13 ART-R mutations in east Africa threatens ACT efficacy, especially where k13 and markers of reduced susceptibility to partner drugs … co-occur.”
New drug research
Nascimento IJDS & al., Design, Synthesis, and Antimalarial Evaluation of Novel Quinazolin-4(3H)‑one Derivatives with Molecular Modeling Insights into Target Selectivity, ACS Omega. 2026 Jun 10; 11(24):36346-36362, https://doi.org/10.1021/acsomega.6c04943 describes the synthesis of four compounds that inhibit P. falciparum in the laboratory but are ineffective against two non-Plasmodium parasites tested.
“The pyrrolidinamide drug MMV367 has been tested preclinically as an antimalarial.” Barber BE & al. “report a clinical assessment of the antimalarial activity of MMV367 in healthy volunteers experimentally infected with blood-stage Plasmodium falciparum, as reported in The Pyrrolidinamide Antimalarial Drug MMV367 Rapidly Clears Blood-Stage Plasmodium falciparum in Healthy Adults with Experimental Malaria, Science Translational Medicine, 2026 Jun 10, 18:853, https://doi.org/10.1126/scitranslmed.aec1863. “Twelve experimentally infected volunteers were randomized to receive single-dose oral administration of MMV367. MMV367 was well tolerated by volunteers and rapidly killed blood-stage malaria parasites.”
According to Muchonjo JK & al., “[c]urrent artemether-lumefantrine (AL) therapy is limited by low bioavailability and drug resistance.” In their paper, Preparation, Characterization and Pre-Clinical Evaluation of Artemether-Lumefantrine-Paracetamol (AL-P) Loaded Nanocarriers in the Treatment of Malaria, Malaria J, 2026 Jul 8, htrtps://doi.org/10.1186/s12936-026-06001-z, they describe the preparation of lipid nanoparticles that contain AL. They added paracetamol (acetaminophen in the US) for its supposed kidney-protective effects and because many patients are dosed with it for pain relief during their malaria episodes. In the mouse model, their preparation achieved over 95% “chemosuppression (95.67%) and 100% day-60 survival … surpassing free drugs and placebo nanoparticles. Toxicity studies in pre-clinical experiments showed normal parameters, except for one mouse that developed a pulmonary lesion.” The authors describe their preparation as a “highly effective delivery system for malaria triple therapy compared to free drugs.”
“Novel antimalarial combinations are needed to address the threat of emerging resistance to artemisinins.” Mombo-Ngoma G & al., Safety, Pharmacokinetics, and Antimalarial Efficacy of Single-Dose Cabamiquine–Pyronaridine Combination Therapy for the Treatment of Adults and Adolescents with Acute Uncomplicated Plasmodium falciparum Malaria (Capture 1): A Prospective, Multicentre, Open-Label, Phase 2a Study, Lancet Infect Dis, 2026 Jul 16, htpps://doi.org/10.1016/S1473-3099(26)00233-1 evaluated the safety, tolerability, pharmacokinetics, and efficacy of a single oral dose of cabamiquine–pyronaridine for the treatment of uncomplicated Plasmodium falciparum malaria. (The same team published on a different single dose combination in Malaria J, 2025 Sep 30, 24:300, https://doi.org/10.1186/s12936-025-05559-4.) Thirty-eight patients with proven P. falciparum monoinfection were segregated into two cohorts. The smaller one (12 patients) received a smaller dose and the larger one (26 patients) double the dose of both drugs. Both cohorts manifested 90+ percent 28 day cures and while the authors state that side effects “were predominantly mild or moderate in severity (grade 1 or 2), and no serious adverse events or deaths were reported”, they expressed concern about the drug levels achieved in the second cohort. In any event they conclude that a “single dose of cabamiquine–pyronaridine showed promising safety and efficacy in this proof-of-concept trial in adults and adolescents, which supports further development for combination therapy in larger trials and in children.”
Plant extracts and traditional treatments
None this month
Campaigns and Policies
Campaigns and Policies
Ouedraogo WD & al. “assessed the effectiveness of malaria control efforts in Burkina Faso … In 2024, the use of [ITNs] was recorded at 81.02% among pregnant women and 68.2% among children aged < 5 years. Seasonal malaria chemoprevention (SMC) coverage was 97.8%. The adoption rates of rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACTs) were 98.5% and 97.96%, respectively. These measures collectively led to a reduction in malaria cases from 537.5 to 446.4 per 1,000 people annually. However, supply chain disruptions and inefficient resource use continue to hinder their overall success”. The article is Evolution of the Performance of the Malaria Control Program in Burkina Faso: Analysis from 2020 to 2024, J Epidemiol Glob Health. 2026 Jun 3, https://doi.org/10.1007/s44197-026-00593-0.
Atwijukiire H & Otwiine A, Integrated and Sustainable Community Approach to Malaria Prevention in Gulu District, Northern Uganda, Trans R Soc Trop Med Hyg. 2026 Jul 2: trag073, https://doi.org/10.1093/trstmh/trag073 is a “cross-sectional qualitative study [reporting on] eight focus group discussions and 10 in-depth interviews with community members, leaders, and health workers” in a region in Northern Uganda. “The facilitators for community-integrated malaria control were government mosquito net distribution, village health teams, and combined preventive methods. The barriers were inconsistent preventive practices, financial and resource constraints, misuse of mosquito nets, cultural misconceptions, and limited support for volunteers.” The authors conclude that “[p]ersistent socioeconomic barriers undermine both uptake and long-term sustainability at the community level.”
“Between 2022 and 2023, the Mozambican National Malaria Control Programme developed a locally-tailored implementation strategy for programmatic mass drug administration (pMDA), [in] southern Mozambique. Two rounds of door-to-door pMDA with dihydroartemisinin-piperaquine were conducted, targeting 59,271 individuals in 14,818 households.” Tusell M & al., Implementation, Coverage and Impact of a Programmatic Mass Drug Administration Campaign for Malaria in Southern Mozambique, BMC Public Health. 2026 Jul 3, https://doi.org/10.1186/s12889-026-28353-6 describes the results and lessons learned. “…household availability coverage (households reached/target households) increased from 59.4% (8,796/14,818) in the first round to 94.3% (13,972/14,818) in the second, following optimization of the implementation strategy. … Although more than 90% of target households and individuals were reached in the second round, achieving the recommended 80% programmatic coverage remained challenging. This target was reached only when considering participation in either of the two rounds, highlighting the importance of conducting multiple rounds. High coverage requires strong community engagement, household revisits and/or fixed points, and substantial human and logistical resources.”
Amegah P & al. “assessed the willingness of adults in [a municipality] of Ghana to accept Malaria MDA programs using the Theoretical Framework of Acceptability (TFA) constructs and explore factors influencing its acceptability in urban Accra” based on questionnaires administered to 421 adults. As they conclude in Willingness of Adults to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability: A Cross-Sectional Study in an Urban Municipality, Ghana, BMC Public Health. 2026 Jul 9, https://doi.org/10.1186/s12889-026-28308-x, only 58% of the respondents expressed willingness to participate, since it meant taking medications when they were not ill. “Individuals aged 50-59 years had 66% lower odds of MDA acceptability compared to those aged 18-29 years … Those with tertiary education had 72% lower odds of MDA acceptability compared to those with primary education.”
The abstract of Htike W & al., Health System Readiness—the Neglected Catalyst in Malaria Elimination, Malaria J, 2025 Jul 23, https://doi.org/10.1186/s12936-026-06059-9 is quoted in its entirety: “While strong political commitment and robust technical strategies are essential to drive malaria elimination, the readiness of national health systems ultimately determines whether these commitments can be successfully translated into action. Without adequate preparation, gaps in the health system can undermine the transition from malaria burden reduction to elimination policies, reduce the effectiveness of interventions, and jeopardise progress toward achieving zero local transmission of malaria. Despite its critical importance, there is currently no systematic and comprehensive approach for assessing health system readiness for malaria elimination. This paper highlights the consequences of unprepared health systems and the urgent need for standardised, structured, comprehensive readiness assessments that would enable policymakers and programme managers to systematically evaluate health system readiness for malaria elimination at national and subnational levels, identify and address critical gaps, and strengthen the health systems. These efforts will support sustained elimination and achieve WHO-certified malaria elimination.”
Epidemiology
Climate change, biodiversity and environment
Huxley PJ & al. studied the role of atmospheric humidity in the development of juvenile An. stephensi as a factor beyond temperature and rainfall. In Beyond Temperature: Relative Humidity Systematically Shifts Juvenile Thermal Performance and Projected Population Growth in a Malaria Vector, Ecol Lett. 2026 Jun; 29(6):e70416, https://doi.org/10.1111/ele.70416 the authors assert that humidity modulates the effects of the other environmental factors.
Gbaguidi GJ & al. “applied high-resolution environmental covariates and a … model to investigate the distribution of malaria prevalence across Benin. Remote sensing-derived variables, including temperature and vegetation indices, as well as information about soil, built-up areas, and bare surfaces, were integrated into the model.” They report in Guiding Malaria Elimination Interventions: A Data-Driven Approach to Resource Optimization in Benin, West Africa, Malaria J, 2026 Jul 5, https://doi.org/10.1186/s12936-026-06033-5 that their “findings reveal pronounced spatial dependence in malaria prevalence, with transmission patterns strongly associated with temperature and vegetation cover. Distinct hotspots were identified in the northern and central regions of the country, indicating areas of elevated risk. The model demonstrated satisfactory predictive accuracy …, underscoring the utility of environmental covariates in capturing the spatial variability of malaria transmission.”
Okeke OA & Adebanjo S investigated “the nonlinear and lagged effects of climatic factors on malaria incidence using a balanced monthly panel of 20 [sub-Saharan Africa (SSA)] countries covering the period 2015-2024 (N = 2400 observations). Monthly malaria incidence per 1000 population [was] modelled as a function of rainfall, 2-m air temperature, and vegetation greenness, while population density and elevation [were] included as demographic and topographic controls.” Nonlinear and Lagged Climatic Drivers of Malaria Incidence in Sub-Saharan Africa Using Multi-Country Panel Analysis 2015-2024, Sci Rep. 2026 Jul 4, https://doi.org/10.1038/s41598-026-61260-9 reveals “significant nonlinear and temporally lagged effects of rainfall and temperature on malaria incidence, with evidence of threshold behaviour across climatic ranges. Vegetation greenness exhibits an increasing-then-saturating association with transmission. Population density is positively associated with malaria incidence, whereas elevation exerts a significant protective effect. The models explain approximately 70-73% of the observed variation in malaria incidence and satisfy key diagnostic requirements.”
In a study of environmental effects on Anopheles, Mebrahtu FG & al. conclude in Environmental Suitability of Anopheles Mosquito Species in the Maekel Region, Eritrea: Species Distribution Modeling Using Maximum Entropy, Malaria J, 2026 Jul 8, https://doi.org/10.1186/s12936-026-06042-4 that “large areas of the Maekel region are highly suitable for Anopheles species, with projected increases in suitability by 2030 and 2050 under both climate change scenarios.”
Risk factors
“Malaria and schistosomiasis are co-endemic across sub-Saharan Africa. Lang MM & al. reviewed 30 publications of co-infections from 12 African countries and report in Shared Risk Factors for Malaria and Schistosomiasis Co-Infection: A Systematic Review and Meta-Analysis, PLoS Negl Trop Dis. 2026 Jun 15; 20(6):e0014369, https://doi.org/10.1371/journal.pntd.0014369 that in 23 of them, “schistosomiasis infection was associated with 1.27 times higher odds of malaria … Narrative synthesis identified age as an important predictor, with risk consistently peaking in older children and adolescents … Direct water contact was strongly associated with co-infection.”
Bardoe D & al. studied 462 pregnant women by testing their blood using microscopy and using questionnaires about their home environments and knowledge about malaria. In Drivers of Trimester Disparities in Asymptomatic Malaria During Pregnancy in Kintampo South District: Evidence from an Oaxaca-Blinder Decomposition Analysis, BMC Public Health. 2026 Jun 17, https://doi.org/10.1186/s12889-026-27837-9, they report that overall prevalence of asymptomatic malaria “was 13.4%, with a significantly higher burden in the second trimester. ... Plasmodium falciparum accounted for most infections. … major contributors to the explained disparity were suboptimal uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) (71.3%), frequent evening outdoor activity (58.6%), infrequent use of mosquito repellents (50.6%), proximity to overgrown vegetation (42.5%), ≤2 malaria diagnostic tests during antenatal care (ANC) (24.1%), and infrequent iron-folate supplementation (18.4%). Conversely, ownership of [ITNs] reduced the unexplained disparity by 41.9%, highlighting its protective effect.”
Ranjan S & al. searched for “evidence on ABO blood group's role in severe P. falciparum malaria (SM) through meta-analysis and trial sequential analysis” by reviewing 23 studies comprising 3553 SM and 6112 uncomplicated malaria cases. The results, reported in Association of ABO Blood Group and Severe Plasmodium falciparum Malaria: An Updated Meta-Analysis and Trial Sequential Analysis, Trop Med Int Health. 2026 Jun 19, https://doi.org/10.1111/tmi.70186 revealed “higher SM risk in blood groups A …, AB … and non-O … versus group O. These associations were confirmed in African and South Asian populations, while Melanesians showed different patterns. Non-O groups showed increased risk in adults and children. Group A was linked to severe malarial anaemia …, while group B showed protective effects …. SM patients had lower haemoglobin .., with parasite density showing no correlation with severity.”
Topazian HM & al “used data from 392,843 individuals from 66 Demographic and Health surveys from countries within Africa to investigate the association between household animal ownership and Plasmodium infection.” While they report in Spatial and Temporal Associations Between Animal Ownership and Malaria Prevalence in Africa Using Cross-Sectional National Demographic and Health Surveys, One Health. 2026 Jun 24; 23:101499, https://doi.org/10.1016/j.onehlt.2026.101499 that “ownership of cattle, chickens/poultry, goats, horses/donkeys/mules, pigs, and sheep was broadly associated with malaria infection, with odds ratios ranging from 1.55 to 1.67”, they acknowledge that there is broad heterogeneity in the data, ranging from odds of 0.30 to 3.33 by geography. {The difference is not surprising at all, since urban residents, who are less likely to own household animals, also tend to be less prone to suffer from malaria.}
In early 2025, a District in Ethiopia was subject to a localized outbreak of malaria, with an attack rate of 274.7 infections per 1000 inhabitants. Desta NA & al., Malaria Outbreak in Meinit Goldia District, Southwest Ethiopia Peoples Regional State, 2025: Risk Factors and Epidemiological Insights from a Case-Control Study, BMC Infect Dis. 2026 Jun 26, https://doi.org/10.1186/s12879-026-13844-z studied risk factors by comparing answers from interviews and questionnaires from 145 individuals with malaria versus the same number who tested negative for malaria. The following risk factors were identified as a result of analysis of responses: Never utilized ITNs …. [l]iving near broken glass bottle es …, [o]pen deep well near household …, [poor knowledge of malaria transmission, signs, symptoms, and prevention/control measures [and] [s]ometimes utilized ITNs… Wearing long protective clothing at night” was protective against infection.
Atusingwize E & al. “conducted a qualitative study exploring stakeholder perspectives on social determinants of malaria … [conducting a] cross-sectional study using fourteen key informant interviews at community, health facility, district and national levels, 10 focus group discussions among community members and community health workers, and 11 in-depth interviews with household heads. As they report in their paper, ‘Poverty is the Biggest Barrier’: Stakeholder Perspectives on Social Determinants of Malaria in Wakiso District, Uganda, Malaria J, 2026 Jun 30, https://doi.org/10.1186/s12936-026-06007-7, the “participants linked poverty to malaria through five themes: poor housing conditions; limited access to malaria control services; limited water and sanitation-related exposures; occupational and psychological exposures; and heavy economic burden (consequences) of malaria.”
Mulakwa LM & al., Transfusion-Transmitted Malaria in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Plasmodium spp. Carriage in Blood Units and Confirmed Transmission n Recipient, Malaria J, 2026 Jul 7, https://doi.org/10.1186/s12936-026-05975-0 reflects “a major concern in malaria-endemic regions of Sub-Saharan Africa (SSA), where routine screening of blood donors for Plasmodium species is rarely implemented.” The authors reviewed 12 articles covering over 11,800 asymptomatic blood donors. According to the articles, six to twenty percent of donors were revealed to harbor Plasmodium parasites, with a study-wide average of 12%. “Three studies reported post-transfusion follow-up data. Comparative risk analysis revealed pronounced discrepancies between parasite prevalence in transfused blood and the number of documented [transmission transmitted malaria] cases, with transmission rates among infected blood units ranging from 63% to 100%.”
In order to understand geographic variations in childhood malaria in Malawi, Magoya M & al. applied a “spatial non-stationarity modeling approach to data from the recent 2024 Malawi Demographic and Health Survey to estimate district-specific associations between childhood malaria and selected risk factors.” They report in Modelling Geographical Variation in the Determinants of Childhood Malaria in Malawi Using Geographically Weighted Regression, Malaria J, 2026 Jul 15, https://doi.org/10.1186/s12936-026-06036-2 that among the risk factors of mosquito net use, place of residence, household wealth, maternal age, and maternal education, place of residence modifies the other risk factors, thus giving insight on how to vary preventive efforts by geographic location.
General epidemiology
“Imported malaria is a critical obstacle to achieving elimination in low transmission settings.” Pujol A & al., Estimating Probabilities of Malaria Importation in Southern Mozambique Through Modelling P. falciparum Genomics and Mobility Patterns, eLife. 2026 Jun 26; 14:RP107136, https://doi.org/10.7554/elife.107136 demonstrates through genetic study of P. falciparum from infected patients that in two low-transmission districts, 63% of cases were imported from a province further north in the country. The authors consider this fact as compelling reason for concentrating malaria control efforts to the high-transmission areas, which will reduce infections elsewhere too.
Mensah L & al., Malaria Among Febrile Patients During a Yellow Fever Outbreak in Ghana: A Cross-Sectional Study, Malaria J, 2026 Jun 29, https://doi.org/10.1186/s12936-026-06000-0 is a study in four communities during a yellow fever outbreak, two within the outbreak area, and two without. “Out of a total of 498 febrile participants, 129/498 (25.90%) tested positive by PCR for P. falciparum parasites.” Since none of the febrile patients from any of the communities were positive for yellow fever (on PCR-based testing), the study became a spatiotemporal one. “High malaria prevalence was found in participants in the study sites, affecting preschool and the school-aged children the most.”
“Malaria transmission in the Sahel persists during the dry season despite low microscopic parasite prevalence, maintaining reservoirs that hinder elimination efforts.” Zeguime A & al., Serological Evidence of High Exposure to Plasmodium falciparum Gametocytes in Dry Season in Kenieroba, Mali, Malaria World J, 2026 Jul, 17:15, https://doi.org/10.5281/zenodo.21136984 describes a “cross‑sectional survey in Kéniéroba, Mali, at three time points representing key seasonal periods: December 2024 (end of rainy season), May 2025 (dry season), and August 2025 (rainy season). A total of 356 participants were enrolled across three age groups (5-8, 9-17, and ≥18 yrs).” The results of “serological analyses indicate widespread and seasonally variable exposure to P. falciparum in Kéniéroba, with consistently high IgG and IgM responses to gametocytes reflecting intense back-ground malaria exposure and cross‑reactive immunity from asexual stages. Seasonal and age‑stratified patterns identify school‑aged children as an important reservoir sustaining transmission.”
Please see Khote FL & al., Prevalence of Antimalarial Drug Resistance Markers and Factors Associated with Plasmodium falciparum Infection in Asymptomatic Children Prior to Rectal Artesunate Implementation in Kapolowe Health District, Democratic Republic of the Congo, Malaria J, 2026 Jun 29, https://doi.org/10.1186/s12936-026-06016-6 under Treatment/Drug resistance above.
Spatiotemporal studies
Lang MM & al., Non-Linear Age Dynamics of Malaria Infection and Fine-Scale Environmental Exposure in Rural Uganda, BMC Med. 2026 Jun 19, https://doi.org/10.1186/s12916-026-04928-3
Mahamoud H & al., Prevalence of Malaria and Associated Factors Among Adult Population in Borama Community, Somaliland: A Cross-Sectional Study, Health Sci Rep. 2026 Jul 1; 9(7):e72726, https://doi.org/10.1002/hsr2.72726
Tsehay A & al., Prevalence and Associated Risk Factors of Malaria in Amhara National Regional State: A Systematic Review and Meta-Analyses, Malaria J, 2026 Jul 7, https://doi.org/10.1186/s12936-026-06034-4
Wu Q & al., Malaria Prevalence and Epidemiological Characteristics in Northern Malawi: A Nine-Year Retrospective Hospital-Based Study, Malaria J, 2026 Jul 8, https://doi.org/10.1186/s12936-026-06046-0
Seyoum S & Esmael M, Prevalence of Malaria and Associated Risk Factors in Loka Abaya District, Sidama Regional State, Southern Ethiopia, Malaria J, 2026 Jul 8, https://doi.org/10.1186/s12936-026-06032-6
Adam J & al., The Burden of Malaria and Associated Factors Among Children Aged 6–59 Months in Mozambique: A Nationwide Cross‑Sectional Survey, Malaria J, 2026 Jul 22, https://doi.org/10.1186/s12936-026-06070-0