By Dr. Derick Pasternak, Ambassador, Malaria Science & Research Coordinator, MPI
News
“A high-level meeting convened on 20 May on the margins of the Seventy-ninth World Health Assembly brought together global and regional leaders, Member States, donors, partners and technical experts to accelerate progress towards the elimination of malaria and neglected tropical diseases (NTDs).
The meeting underscored the importance of strong cross-border collaboration, exchange of best practices, and integrated multi-disease approaches to sustain gains, expand access to essential health services, and protect vulnerable populations across Africa and beyond.
The event was convened by the African Union Commission and the World Health Organization/ Global Onchocerciasis Network for Elimination, in collaboration with partners including the African Leaders Malaria Alliance (ALMA), Drugs for Neglected Diseases initiative (DNDi), The END Fund, the Task Force for Global Health/Health Campaign Effectiveness Coalition, and the RBM Partnership to End Malaria.”
https://www.who.int/news/item/25-05-2026-high-level-meeting-reaffirms-shared-commitment-to-strengthen-cross-border-collaboration-and-accelerate-elimination-of-malaria-and-neglected-tropical-diseases
On the same day, Gavi, the Vaccine Alliance, published an article relating the encouraging introduction of the R21/Matrix M vaccine in Mali. https://www.gavi.org/vaccineswork/mali-one-year-in-hybrid-malaria-vaccine-programme-shows-early-results
In the Correspondence section of the New England Journal of Medicine (not peer reviewed) on 3 Jun, Maitland K & al., Intravenous Artesunate in Artemisinin-Resistant Severe Malaria in Uganda, reports guideline-concordant treatment of children with severe malaria with three doses of parenteral artesunate and three days of artemether-lumefantrine. Genetics of the infecting parasites were checked for mutations associated with partial resistance to artemisinins. The outcomes of the children in terms of mortality and of parasite clearance were not affected by whether they had the partial resistance mutation or not. https://doi.org/10.1056/NEJMc2517274
PEER REVIEWED ARTICLES
Prevention
Vaccines
In a follow-up to the original three-country phase III study of the RTS,S vaccine, Mwapasa V & al. report that at 46 months after “introduction of the RTS,S malaria vaccine in routine immunisation programmes, [vaccination] was associated with a significant reduction in mortality in young children, averting about one in eight deaths, in areas with moderate coverage of three doses of the vaccine and low uptake of the fourth dose.” The paper is Impact of Introducing RTS,S/AS01(E) Malaria Vaccine on Mortality in Young Children in Ghana, Kenya, and Malawi: An Observational Evaluation of a Cluster-Randomised Implementation Programme, Lancet. 2026 May 9; 407(10541):1796-1808, https://doi.org/10.1016/s0140-6736(26)00248-5.
One of a number of recent articles on the subject, Nurani KM & al., Efficacy and Safety of RTS, S and R21 Malaria Vaccines in Children Under Five in Africa: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Malaria J, 2026 May 27, https://doi.org/1186/s12936-026-05954-5 is an analysis of eleven articles from nine African countries. The report essentially repeats previously published results, namely that efficacy of RTS,S against first clinical malaria episode was 32% (…, against multiple episodes was 29% …, and against severe malaria was 17–22% ... The R21 vaccine demonstrated 68% efficacy against first episodes … and 67% against multiple episodes…”
Another paper on the same subject is Painter JA & al., The Malaria Vaccine Implementation Programme Reduced Clinical Malaria in Kenya, 2020 to 2022, Malaria J, 2026 Jun 15, https://doi.org/10.1186/s12936-026-05973-2. The authors collected data from “23 implementing and 23 comparison subcounties in western Kenya” and looked for “monthly numbers of confirmed uncomplicated malaria cases among individuals under 5 years of age (< 5y) and 5 years of age and older (≥ 5y). … During the 3-year evaluation period following dose-3 age-eligibility, < 5y malaria cases were 2.3% lower than predicted in non-implementing facilities and 13.8% lower in implementing facilities, a reduction of 11.6%.”
Though approved by the WHO for use in children in Africa, the RTS,S vaccine has been shown to protect only a minority of those who had undergone the entire four-injection series. Hysa A & al., Antibody Fine Specificity Correlates with Protection from Malaria for the RTS,S Vaccine in Young African Children: A post hoc Analysis of a Phase IIb Randomised Controlled Trial, PLoS Med. 2026 May 14;23(5):e1004877, https://doi.org/10.1371/journal.pmed.1004877 may shed some light on why that is the case. The authors report that the children who had a strong immunoglobulin G (IgG) antibody response to two specific sporozoite segments in the vaccine had a significantly reduced risk of developing clinical malaria than those whose IgG response was limited. The authors don’t comment on what factors may mitigate toward strong versus weak response.
“…recent studies have revealed that P. falciparum parasites from different endemic areas exhibit immense diversity in the Pfcsp gene,” which may account for the limited effectiveness of the currently used RTS,S and R21 vaccines. [Transmission-blockking vaccines (TBVs)] offer a complementary tool in the fight against malaria. Unlike the current vaccines, RTS,S/AS01, R21/Matrix-M and other blood-stage candidates, which primarily protect the vaccinated individual from clinical illness, TBVs target the sexual stages of the parasite inside the mosquito vector, aiming to halt sporozoite development and prevent onward transmission. The leading TBV antigens include the … gametocyte surface proteins Pfs48/45 and Pfs230. [They] critical roles in the fertilization process of the parasite life cycle. Recent studies have demonstrated that these antigens can enhance immune responses, either through vaccination or via naturally acquired immunity during the infection process…” Kisambale AJ & al., Genetic Diversity of the Plasmodium falciparum Pfs230 Gene in Four East African Countries Supports Its Potential as a Malaria Transmission‑Blocking Vaccine Candidate, Malaria J, 2026 Jun 1, https://doi.org/10.1186/s12936-026-05953-6 asserts that there being relative little genetic diversity in the Pfs230 gene, it may be a good candidate for being a transmission blocking vaccine.
Wang X & al. combined mRNAs targeting whole Plasmodium sporozoites with those controlling a blood-stage protein. The resultant vaccine preparation was tested in the mouse malaria model. The authors state that vaccination with this preparation “can establish a potent, multistage immunological barrier by integrating neutralizing antibody activity with strong cellular immunity.” The article is A Dual-Antigen mRNA-Lipid Polyplex Vaccine Elicits Durable Multistage Immunity and Sterile Protection Against Malaria in Mice, Acta Pharmacol Sin. 2026 Jun 16, https://doi.org/10.1038/s41401-026-01850-5.
Vectors
“Indoor residual spraying [IRS] is a key strategy in the control against malaria, … It was recommended by the World Health Organization, yet its effectiveness is still being compromised by low community uptake. Pitua I & al., Community-Level Barriers and Facilitators of Indoor Residual Spraying for Malaria Control: A Systematic Review of Qualitative Evidence from Sub-Saharan Africa, Malaria J. 2026 May 20, https://doi.org/10.1186/s12936-026-05937-6 is the report of an analysis of ten published articles on community acceptance of IRS in seven sub-Saharan countries. “Eight major analytical themes emerged: (1) operational and household burdens, particularly the labor required to prepare homes; (2) perceived efficacy and cognitive factors, including concerns about bedbugs and visible insect control; (3) socio-political dynamics and trust in authorities; (4) programmatic communication and sprayer conduct; (5) gender dynamics in household decision-making; (6) structural and seasonal incompatibility; (7) implementation strategy and spatial equity; and (8) endorsement systems and local health infrastructure.”
Mosaic application of IRS chemicals implies the alternation of insecticides; “macro-mosaic” meaning variation community by community, whereas “micro-mosaic” application means varying the chemicals within each community. Chinula D & al., Indoor Residual Spraying of Distinct Insecticide Formulations in a Household-Scale Micro-Mosaic Format: Feasibility and Effectiveness for Malaria Vector Control in Rural Zambia, Med Vet Entomol. 2026 May 17, https://doi.org/10.1111/mve.70080 describes a study of comparison between the two methods, with results that showed no statistically significant differences in outcomes in terms of mosquito survival. “Household-level micro-mosaic applications of distinct IRS formulations may be just as immediately effective over the short term as conventional macro-mosaic.”
“Accurate measurement of insecticide-treated net (ITN) use is essential for evaluating malaria control programs. Most routine indicators rely on self-reported ITN use, which may be affected by recall and social desirability biases.” Myuama N & al. compared “reported and directly observed ITN use…” As reported in Comparing reported and Observed Use f Insecticide-Treated Nets in Tanganyika, Democratic Republic of the Congo: A Post-Campaign Longitudinal Household Study, Malaria J, 2026 May 28, https://doi.org/10.1186/s12936-026-05962-5, a study of 72 households (465 individuals), there was a significant discrepancy between reported and observed use: “Self-reported ITN use remained high across rounds (average approximately 91%), whereas observed use ranged from 72.9% to 76.5%...” leading the authors to conclude that “[s]elf-reported ITN use is a highly sensitive but poorly specific indicator, leading to systematic overestimation of effective coverage.”
Fagbohoun J & al. “evaluated the insecticidal durability of next-generation ITNs distributed in Mozambique …, focusing on bioefficacy and chemical content over 24 months of household use.” The authors collected nets impregnated with various insecticides. As they report in Durability of the Insecticidal Activity of Next-Generation Insecticide Treated Nets Distributed for Malaria Control in Mozambique: Findings from the New Nets Project (2020-2022), PLOS Glob Public Health. 2026 Jun 5; 6(6):e0005306, https://doi.org/10.1371/journal.pgph.0005306, their findings “demonstrate substantial variation in the durability of next-generation ITNs and support prioritising pyrethroid-chlorfenapyr nets for malaria control programmes in areas with pyrethroid resistance.”
Otolorin GR & al., Impact of Insecticide-Treated Nets on Malaria Morbidity and Mortality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Infect Dis, 2026 Jun 14, https://doi.org/10.1080/23744235.2026.2666823 is an analysis of 25 studies …, including 19 assessing malaria-incidence and 6 evaluating malaria-related mortality. Overall, 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. Meta-regression on 17 studies confirmed an overall significant protective effect of ITNs against malaria.”
According to Stabler TC & al., ITNs “are commonly distributed through mass distribution campaigns (MDCs). MDCs are often followed by substantial loss” of ITNs. Their paper, Where Did the Nets Go? Tracing Long-Lasting Insecticidal Net Migration on Bioko Island, Malaria J, 2026 Jun 25, https://doi.org/10.1186/s12936-026-06019-3, reflects an attempt to trace the migration of ITNs from their original recipients to their destination. In their study of 11,599 individually identified nets distributed, only 7274 were found 10 to 12 months after distribution. Even among those, only half could be traced to their original distribution site. Some were moved to other communities; among these, the authors engaged in complex calculations as to whether the nets were moved to higher or lower risk settings. All the same, 37.3% of nets were simply lost and untraceable.
Shirima G & al., Modelling the Impact of Larviciding as a Supplementary Malaria Vector Control Intervention in Rural South-Eastern Tanzania: A District-Level Simulation Study, PLoS One. 2026 May 19; 21(5):e0337662, https://doi.org/10.1371/journal.pone.0337662 relies on mathematical modeling to conclude that “larviciding is an effective complement to ITNs for interrupting malaria transmission. Implementation should leverage innovative approaches, such as drones for precise mapping and targeted application of biological larvicides, to maximize coverage, and scalability for district-level malaria control and elimination.”
“Despite few studies reporting significant influence of insecticide exposure on vector competence-a mosquito's ability to infect, harbour, and transmit Plasmodium - the relationship between insecticide exposure in mosquitoes and vector competence remains poorly understood and underexplored. While some studies have reported on the impairment of parasite development in mosquitoes, some others concluded that vector competence in mosquitoes is enhanced by insecticide exposure.” Adeboye SO & al., Insecticide Resistance and Malaria Transmission: Divergent Effects on Anopheles Vector Competence, Microb Pathog. 2026 May 15; 217:108557, https://doi.org/10.1016/j.micpath.2026.108557 “reports on recent knowledge about the effects of insecticide resistance on vector competence for malaria transmission in Anopheles populations.”
A different study of post-insecticide vector competence is the subject of Kouame KR & al., Sublethal Effects of Insecticides on the Reproduction Traits of Insecticide-Resistant Anopheles gambiae sensu lato Mosquitoes from Tiassalé, Côte d'Ivoire, Parasit Vectors. 2026 Jun 5, https://doi.org/10.1186/s13071-026-07431-z. Although there was no consistent pattern of injury when sublethal doses of various insecticides were administered to different strains of the mosquito, the authors conclude that “sublethal doses of insecticides can adversely affect reproductive success and blood-feeding behaviour in both susceptible and resistant Anopheles mosquitoes, potentially reducing their vectorial capacity.”
“Zanzibar has achieved and sustained very low malaria prevalence through high coverage of [IRS and ITNs]. However, residual transmission persists, particularly on Pemba Island.” Ali AO & al., “aimed to quantify malaria transmission risk arising from the interaction between human behavior and mosquito biting activity indoors and outdoors on Pemba Island.” Based on human landing catches indoors and outdoors, their paper, Behavioral Patterns of Humans and Anopheles arabiensis Reveal Outdoor Malaria Transmission Risk at Pemba Island, Zanzibar, Malaria J, 2026 Jun 20, https://doi.org/10.1186/s12936-026-06017-5, reports that “approximately 85% of unprotected exposure occurred outdoors while individuals were awake. Children under five experienced relatively more indoor exposure, while school-aged children and adults were predominantly exposed outdoors. Men experienced higher outdoor exposure than women, whereas women had greater indoor exposure while awake.”
Obboh EK & al. “examined malaria vector biting behaviour and transmission risk in Simiw, a community located in the coastal forest of Ghana’s Central Region … Adult malaria vectors were collected using human landing catch (HLC) method during the dry and rainy season of 2021. Vector densities, biting patterns and entomological transmission indices of An. gambiae s.l. were evaluated.” As reported in Anopheles gambiae Biting Behavior and Malaria Transmission Risk in Simiw, a Community Located in the Coastal Forest Zone of the Central Region of Ghana, Malaria J, 2026 Jun 23, https://doi.org/10.1186/s12936-026-05961-6, The study found higher abundance and biting rates of An. gambiae s.l. during the dry season, with both the [human biting rate and entomological inoculation rate] being greater indoors than outdoors.”
Chemoprophylaxis
Using “Malaria Indicator Survey (MIS) or Demographic and Health Survey (DHS) data from 18 sub-Saharan African (SSA) countries, conducted between 2018 and 2024, “Alemu EA & al., Use of Insecticide-Treated Nets (ITN) and Intermittent Preventive Treatment (IPTp) for Malaria Prevention and Its Associated Factors Among Pregnant Women in Sub-Sahara Africa, Malaria J, 2026 Jun 2, https://doi.org/10.1186/s12936-026-05970-5 report’s the following: Among a sample of “63,561 pregnant women, … 28.9% (95% CI 28.4, 29.3%) used both an ITN (slept under one the previous night) and IPTp (3 or more doses), and 17.6% (95% CI 17.2, 18.0%) used neither ITN nor IPTp… age, educational status, sex of household head, wealth index, mass media exposure, residence and sub-region of SSA were significant factors associated with ITN and IPTp utilization.”
Lahai WK & al. studied the use of IPTp and report in Compliance with Intermittent Preventive Malaria Treatment in Pregnancy at a Tertiary Hospital in Sierra Leone, Public Health Action. 2026 May 18; 16(2):112-116, https://doi.org/10.5588/pha.25.0049 that among “733 pregnant antenatal care attendees, 682 (93%) registered after the first trimester, and only 30 (4%) had ≥4 antenatal contacts. Of the 733, 406 (55%) received first dose and only 62 (8%) received three doses.” The authors highlight “the need to understand the reasons for the gaps in treatment and to address them systematically. Strategies to increase the number of antenatal care contacts may improve compliance with the recommended minimum three doses.”
Yunivita V & al. evaluated “the addition of Dihydroartemisinin-Piperaquine (DHA-PPQ) to Trimethoprim-Sulfamethoxazole (TMP-SMX) for Intermittent Preventive Treatment (IPT) in HIV-positive pregnancies, focusing on its effects on malaria infection, maternal adverse events, fetal adverse events, and birth outcomes” based on analyzing three studies covering 1353 patients. They report in Maternal, Fetal, and Neonatal Outcomes of Additional Dihydroartemisinin-Piperaquine to Trimethoprim-Sulfamethoxazole in Intermittent Preventive Treatment for Malaria in HIV-Positive Pregnancies: A Systematic Review and Meta-Analysis, Ther Clin Risk Manag. 2026 May 27; 22:571864, https://doi.org/10.2147/tcrm.s571864 that “[a]dditional DHA-PPQ shows promising efficacy in reducing malaria infection, a statistically significant reduction in maternal adverse events, with no significant differences in fetal and birth outcomes.”
Djedanem M & al. state that “retrospective data on the burden of malaria among children aged 5 to 10 years could justify extending” seasonal malaria chemoprophylaxis (SMC) to that age group and compared malaria fata in two regions, one in which SMC was used in children under age 5 only and one in which the same SMC regimen was given to the older group as well. The results, published in Extension of Seasonal Malaria Chemoprevention to Older Children: A Pragmatic Comparative Study in Two Health Districts in the Zinder Region, Niger, BMC Infect Dis. 2026 May 28, https://doi.org/10.1186/s12879-026-13669-w indicated a significant decline in malaria infections in the 5 to 10 year group in the area in which SMC was administered to them, in comparison with the other district where SMC was given only t those under age five. The authors conclude that “SMC is an effective, low-cost strategy for preventing malaria cases in children of all ages.”
“South Sudan, a country with a high malaria burden, faces considerable health system challenges due to decades of civil war, which disrupts access to essential services.” Three years after the implementation of SMC by the Malaria Consortium, Ayuiel ARD & al. conducted surveys and interviews with 60 community members, whether they had children receiving SMC or not. According to the responses, [f]actors that enabled SMC distribution and access included government support, community trust, efficient logistics, integrated activities, access to vital information, involvement of Boma health workers, supervisor transportation, and organized malaria management. The main challenges included shortages of healthcare workers, drug shortages, geographic and transportation difficulties, caregiver relocation, delayed referrals, and poor communication.” The paper is Implementing Seasonal Malaria Chemoprevention in Conflict-Affected Settings: Experiences from Northern Bahr el Ghazal, South Sudan, Malaria J. 2026 Jun 15, https://doi.org/10.1186/s12936-026-05984-z.
Sam J & al., “We Are Not Sick, So Why Take Medicine?” Community Perspectives on Barriers, Facilitators, and Implementation Strategies for IPTsc in Ghana, Malaria J, 2026 Jun 15, https://doi.org/10.1186/s12936-026-05997-8 also explores barriers to successful chemoprevention of malaria; in this case among students in four junior high schools. Caregivers and educators were also interviewed. “Perceived barriers included concerns about drug origin, fear of side effects, administering medicines to asymptomatic children, tablet size and taste, and doubts about programme continuity. Facilitators centred on perceived benefits such as reduced malaria episodes, improved school attendance, lower household treatment costs, and community willingness to support [the program]. Preferred implementation strategies included school-based delivery complemented by community outreach, administration by trained health professionals, clear communication on drug timing and food intake, and early parental involvement.”
Kumar Y & al. aim to “summarize the advancements in long-acting drug delivery systems developed for antimalarial chemoprophylaxis and highlights recent clinical developments in this field” in Long-Acting Antimalarial Drug Delivery Systems for Chemoprophylaxis: Formulation Strategies and Routes of Administration, Pharm Res. 2026 Jun 4, https://doi.org/10.1007/s11095-026-04126-z. “Various formulation approaches reported in the literature for sustained antimalarial drug release were reviewed, including oral, parenteral, and topical long-acting delivery systems. Strategies such as gelatin capsules, solid drug nanoparticles, oil-based solutions, implants, polymeric nanorods, lipid-based depot systems, in situ-forming gels, microspheres, and microneedle-based delivery systems were evaluated … Long-acting drug delivery systems represent a promising strategy for improving malaria chemoprophylaxis by overcoming adherence-related challenges associated with conventional dosing regimens.”
Please see Tibiri YNG & al., Submicroscopic Malaria Infections and Inadequate IPTp-SP Coverage Among Pregnant Women in Rural Burkina Faso: An Observational Study, J Infect Public Health. 2026 Jun 2; 19(8):103275, https://doi.org/10.1016/j.jiph.2026.103275 under Diagnosis/General Diagnostics
Other
Baloyi RE & al. used questionnaires and interviewed 384 households and 15 healthcare workers (HCSs) in an effort to understand why malaria remains endemic in the region they studied. They report in Community and Healthcare Worker Contributions to Malaria Prevention: A Culturally Tailored Behaviour Change Approach in Jozini, South Africa, Malaria J. 2026 May 27, https://doi.org/10.1186/s12936-026-05943-8 that among community mambers, “97% had high knowledge, 79% positive attitudes, and 64% good practices. Knowledge was significantly associated with age … but not with gender, education, employment status, or residence duration, and knowledge level was not significantly associated with attitudes or practices … Healthcare workers showed strong technical knowledge of malaria transmission and prevention, and most reported involvement in diagnosis, treatment, and community outreach activities. However, qualitative findings highlight challenges related to irregular training, staffing gaps, and shortages of diagnostic tools and commodities.”
Gerbi T & al. studied the social determinants of treatment seeking for malaria “through in-depth interviews (n = 32), key informant interviews (n = 8), two focus group discussions, participant observation, and document review.” They report in The Social Experience of Malaria Treatment-Seeking: Pathways, Gender, and Inequality in Jimma Zone, Ethiopia, Malaria J. 2026 Jun 9, https://doi.org/10.1186/s12936-026-05969-y that “[g]ender dynamics strongly influenced care-seeking: females were typically the first to recognize illness and provide care but often lacked decision-making authority and financial control, contributing to delays in accessing treatment. Males' occupational and social activities increased their exposure to malaria risk. Structural barriers including poverty, drug stockouts, transport constraints, inadequate housing, and weak health infrastructure further constrained timely and effective care.”
Diagnosis
General diagnostics
Zhang S & al. “conducted a landscape review and analysis by gathering current information on the advancements in malaria RDTs that are either commercially available or in late-stage development, as reported in Advances in Rapid Diagnostic Tests for Malaria: A Landscape Review and Analysis, Am J Trop Med Hyg. 2026 May 19: tpmd250450, https://doi.org/10.4269/ajtmh.25-0450. However, the abstract is nonspecific beyond stating that that authors “identified 67 malaria RDTs from 27 different international manufacturers. Among these RDTs, most are simple to use on a whole blood specimen, provide test results within 30 minutes, and have reported high (≥98%) diagnostic sensitivity and specificity.” The full article was not available for review.
WHO “recommends parasitological confirmation before treating suspected malaria cases. However, diagnosing malaria in pregnancy (MiP) remains challenging due to parasite sequestration in the placenta, which results in low peripheral parasite density often undetectable by point-of-care diagnostic tools. Studies have reported conflicting findings on the relationship between ABO blood groups, anaemia, and MiP.” Kipchirchir D & al. “investigated the performance of microscopy and the First Response™ Malaria Ag PAN/Pf rapid diagnostic test (mRDT) compared to quantitative polymerase chain reaction (qPCR) in diagnosing MiP. It also explored the associations between MiP, ABO blood groups, and anaemia.” After a study of 236 women delivering at two hospitals, the authors report in Evaluation of Microscopy and First Response Malaria Ag PAN/Pf RDT Compared to qPCR and Hemoglobin Levels in Pregnant Women at Delivery in Busia County, Western Kenya, BMC Infect Dis. 2026 May 23, https://doi.org/10.1186/s12879-026-13577-z that malaria was found in peripheral blood diagnosis less than 10% of the time (RDT more sensitive than microscopy and qPCR higher than both. However, in placental blood, qPCR results were positive in 15.7% of cases whereas microscopy was positive only at 7.2% of the time. “No significant associations were observed between MiP and ABO blood groups or anaemia.”
The basic thrust of Tibiri YNG & al.’s paper, Submicroscopic Malaria Infections and Inadequate IPTp-SP Coverage Among Pregnant Women in Rural Burkina Faso: An Observational Study, J Infect Public Health. 2026 Jun 2; 19(8):103275, https://doi.org/10.1016/j.jiph.2026.103275 is the major discrepancy between the routinely available testing RDT and microscopy) of pregnant women during their first antenatal visit and “real time” PCR done at the same time. “PCR prevalence was 23.5% versus 8.2% by microscopy and 8.7% by RDT, with approximately two-thirds of infections missed by routine diagnostics.” While apparently 78.6% of the 515 women received three or more doses of IPTp, those who received more were less likely to test positive for malaria at delivery.
Bogale A & al. conducted a study in three health centers, comparing microscopy to qPCR in diagnosing two Plasmodium species. They report in, Diagnostic Gaps in Light Microscopy for Malaria Case Management and Control in Dilla Zuria Health Facility, Southern Ethiopia, Sci Rep. 2026 Jun 7, https://doi.org/10.1038/s41598-026-56354-3 that for both P. falciparum and P. vivax, as well for mixed infections, microscopy, as performed by trained laboratory personnel was significantly less sensitive in detecting infections than qPCR. While the authors advocate more training for technical personnel, they don’t comment on the possible inherent limitation of microscopy.
Field diagnostics
While it is difficult to prove a negative, Akala HM & al. demonstrate in Absence of False Negative RDT Results Due to pfhrp2 Deletion Among Symptomatic Malaria Infections in Kenya: Findings from the 2022 Kenya National Longitudinal Surveillance of pfhrp2/3 deletions, Malaria J, 2026 Jun 2, https://doi.org/10.1186/s12936-026-05942-9#Abs1 that among 5394 samples from individuals presenting with symptoms of malaria at selected health facilities in ten Kenyan counties, histidine rich protein (HRP) based and lactic dehydrogenase (LDH) based rapid diagnostic tests (RDTs) showed extremely close positivity rates (44% vs. 45%), with minimal discordance (i.e. one test positive, the other negative). All discordant samples, plus a random subset of the Plasmodium positive samples, were sequenced to characterize HRP2/3 gene deletion… . None of the discordant samples carried pfhrp2 deletions, although 5.4% (3/56) had single pfhrp3 deletions, comparable to concordant infections. Among 598 samples that were sequenced, single pfhrp2 and pfhrp3 deletion prevalences were 4.5% and 12.4%, respectively, with no double-deletions detected.” The authors conclude that although “single pfhrp2 and pfhrp3 deletions were observed across Kenya, they do not appear to be the primary cause of false-negative HRP2-based RDT results.”
Igbokwe U & al. “assessed facility readiness, testing-before-treatment (TBT) coverage, and facility-level determinants of malaria diagnostic readiness among [418] public health facilities in Kaduna and Kano States, Nigeria. … Facility readiness was assessed using five indicators: availability of RDTs, availability of microscopy services, trained staff on malaria case management, availability of standard operating procedures, and absence of stock-outs of RDTs or artemisinin-based combination therapy within the previous three months.” They report in Facility Readiness and Determinants of Malaria Test-Before-Treat Implementation in Public Health Facilities in Kaduna and Kano States, Nigeria, Malaria J, 2025 Jun 19, https://doi.org/10.1186/s12936-026-05949-2 that “381 facilities (91.1%) demonstrated full readiness, … Microscopy services were available in 23.0% of facilities. Most facilities reported high TBT coverage, with 90.4% reporting ≥ 85% testing coverage.”
New diagnostic methods
None this month
Treatment
Treatment results
Nhama A & al. analyzed six published studies, “comprising 20 single-arm trials and including 1862 participants” in the preparation of their article, Efficacy of Artemether-Lumefantrine for Uncomplicated Plasmodium falciparum Malaria Treatment in Mozambique: A Systematic Review and Meta-Analysis, Malaria J, 2026 May 22, https://doi.org/10.1186/s12936-026-05931-y. “The pooled uncorrected efficacy of AL was 91.0% …, while the PCR-corrected efficacy was 98.3% … During the 28-day follow-up period, early treatment failure was observed in 0.05% … of participants. Late clinical failure and late parasitological failure occurred in 2.73% … and 5.3% …. of participants, respectively. Recrudescence was observed in 1.8% … of cases, whereas new infections accounted for 8.6% … The day 3 parasite positivity rate remained low, at about 0.78%...” leading to the conclusion that “AL remains efficacious for the treatment of uncomplicated malaria with an efficacy above 90%...”
“Accurate estimation of antimalarial drug efficacy against P. falciparum requires PCR correction to distinguish recrudescence from new infection in recurrent infections.” Cantoreggi SL & al. describe two alternate molecular genetics methods to make that distinction in Comparison of Techniques and Markers to Distinguish Plasmodium falciparum Recrudescence from New Infection in Rwanda, Sci Rep. 2026 Jun 10, https://doi.org/10.1038/s41598-026-57063-7.
Side effects and complications
Plasmodium vivax malaria is common in Ethiopia. Its treatment includes the prevention of recurrences by administering primaquine or similar drugs. However, these drugs may cause serious side effects, such as hemolysis, in patients deficient in glucose-6-phosphate dehydrogenase (G6PD). Because of that, and the lack of ready access to G6PD testing, patients with vivax malaria sometimes receive no primaquine, or half the WHO-recommended dose. Degaga TS & al., Analysis of the Effect of Primaquine Dose on Efficacy, Safety, and Tolerability in Patients with Plasmodium vivax Malaria In Ethiopia: A Systematic Review and Individual Patient Data Meta-Analysis, Malaria J. 2026 Jun 6, https://doi.org/10.1186/s12936-026-05968-z is an analysis of five published studies on the subject, covering 1378 patients over 24 years. “The cumulative incidence of P. vivax recurrence by day 180 was 61.0% … in patients who were not treated with primaquine, 16.6% … following low total dose and 8.9% … following high total dose primaquine. High total dose primaquine (7 mg/kg) was associated with a reduced rate of recurrence compared with low total dose (3.5 mg/kg).” Hemolysis was present in three patients; gastrointestinal complaints were up to 24% of patients receiving the high (WHO recommended) dose primaquine. {However, the article clarifies that only patients who tested normal for G6PD were included in this article.}
Guidelines
Kamara ARY & al. studied treatment of 735 children treated for severe malaria diagnosed by RDT and/or clinical assessment. Of them, 650 received three doses or parenteral artesunate, as recommended by the guideline; 48 children received on or two doses, the rest none. Among the children, 73 “had unfavourable hospital exit outcomes, including 59 deaths, 13 discharged against medical advice, and 1 absconded. Underweight status, multiple convulsions, and failure to receive correct artesunate dosing were associated with unfavourable hospital exit outcomes.” The paper is Parenteral Artesunate Compliance and Hospital Outcomes in Children Under Five with Suspected Severe Malaria in Sierra Leone, Public Health Action. 2026 May 18; 16(2):106-111, https://doi.org/10.5588/pha.25.0047.
Among the species causing malaria in humans, “Plasmodium vivax and Plasmodium ovale can form dormant liver stages known as hypnozoites, which require additional treatment to prevent relapse of the disease. … anti-relapse therapies [include] single-dose tafenoquine (TQ) and a 14-day course of primaquine. Both medications carry the risk of hemolysis in patients with glucose-6-phosphate-dehydrogenase (G6PD) deficiency, necessitating G6PD testing before administering.” DeVita TN & al. analyzed published reports on using TQ after treating vivax malaria with chloroquine. They report in Efficacy of Delayed Tafenoquine Administration for Radical Cure of Plasmodium vivax Malaria: A Systematic Review, Acta Trop. 2026 Jun 6: 108175, https://doi.org/10.1016/j.actatropica.2026.108175 that while no conclusive data about long-term efficacy are available, the data “suggest that delayed TQ is likely better than treatment with chloroquine alone and could be a preferable option to the 14-day primaquine regimen in situations where adherence is unlikely.”
Kojom Foko LP & al., Knowledge, Attitudes, and Practices of Antimalarial Drug Prescriptions by Healthcare Providers in Cameroon: A Systematic Review, Expert Rev Anti Infect Ther. 2026 Jun 1, https://doi.org/10.1080/14787210.2026.2683607 is a review of twelve articles on the subject of practitioner adherence to malaria treatment guidelines in Cameroon. “The analysis indicates that healthcare providers are knowledgeable about ACTs and national treatment guidelines. However, their attitudes and practices toward adherence to guidelines remain inconsistent and often suboptimal. Drug prescription without laboratory confirmation of malaria, non-prescription drug administration, and incorrect prescriptions (incorrect drugs and/or posology) are the main malpractices. Key gaps include a lack of studies in underrepresented regions, non-P. falciparum malaria treatment, and therapeutic management of special populations.”
“Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are important primary sources of care for many Nigerians. They are {often?} the first line of contact for those seeking advice or treatment for fever.” Baruwa S & al., Effect of Malaria Training on Community Healthcare Providers' Compliance with Malaria Treatment Guidelines in Nigeria Using Propensity Score Matching, Malaria J. 2026 Jun 9, https://doi.org/10.1186/s12936-026-05991-0 “examines the effect of the malaria training module on knowledge, acceptability, and compliance with WHO treatment guidelines and identification of quality drugs among CPs and PPMVs … Findings showed a significant positive impact of training on knowledge of malaria diagnosis and treatment … and acceptability of the WHO test, treat, and refer guidelines among trained CPs and PPMVs … However, the training has no effect on compliance with treatment guidelines and identification of quality drugs.”
One of the drawbacks of primaquine treatment is the required 14-day duration. Tsega EA & al. highlight the poor adherence to this regimen in Adherence to 14-Day Primaquine Treatment for Radical Cure of Plasmodium vivax and Mixed Malaria Patients Treated at Health Centers in Yilmana Densa District, Ethiopia: A Community-Based Cross-Sectional Study, Malaria J, 2026 Jun 24, https://doi.org/10.1186/s12936-026-05982-1. Only 282 of 594 patients studied claimed full adherence at interviews. “Female sex …, having knowledge that malaria can relapse …, and a prior history of malaria infection … were positively associated with probably adherent, [w]hereas experiencing side effects was negatively associated…” {The authors do not comment on the existence of an alternative regimen of single dose tafenoquine for radical cure.}
Drug resistance
Dinzouna-Boutamba SD & al. studied the persistence of genetic markers associated with chloroquine resistance 20 years after the drug was withdrawn from use against P. falciparum. They report that despite the “persistence of mutant genotypes in both pfcrt and pfmdr1, [they demonstrated a] decline in their frequencies over time, suggesting a progressive restoration of [chloroquine] susceptibility.” The paper is Status of pfcrt and pfmdr1 Mutations in Plasmodium falciparum Isolates in Gabon in 2019 After Chloroquine Withdrawal, Acta Trop. 2026 May 22: 108153, https://doi.org/10.1016/j.actatropica.2026.108153
Egwu CO & al. point out in Variance in IC50 in in vitro/ex vivo Antimalarial Drug Susceptibility Assays in Laboratories Across Africa, J Antimicrob Chemother. 2026 Jun 3; 81(7):dkag187, https://doi.org/10.1093/jac/dkag187 that laboratories monitoring susceptibilities to antimalarials, such as the 50% inhibitory concentration (IC50) assay, across Africa do not appear to be consistent with each other. The authors “recommend regional harmonization of the IC50 protocol for antimalarial drug efficacy surveillance and formation of a regional quality assessment network of malaria IC50 labs, as a step towards reliable data sharing and integration into strategic plans for malaria elimination.”
New drug research
Rajaram K & al., Genetic Analysis of Pyrimidine Biosynthetic Enzymes in Plasmodium falciparum, PLOS Pathogens, 2026 May 27, https://doi.org/10.1371/journal.ppat.1014269 is a genetic analysis of a biosynthetic pathway (pyrimidine synthesis) that offers a new approach to drugs against the malaria parasite.
Castro W & al. tested metallo-organic compounds in their search of drugs that may be effective against resistant P. falciparum. They describe in Searching for New Candidates for Antimalarial Therapy: Physicochemical and in vitro Evaluation of Gold(I) and Silver(I) N-Heterocyclic Carbene Complexes. Malaria J. 2026 Jun 10, https://doi.org/10.1186/s12936-026-05944-7 how a gold- and a silver- containing compound was effective in the laboratory against several strains of P. falciparum. The authors conclude that both “complexes exhibit moderate activity, indicating potential for further evaluation.”
“MMV367 is a novel, fast-acting candidate antimalarial drug currently in clinical development for treating uncomplicated Plasmodium falciparum malaria. Developed collaboratively by GlaxoSmithKline (GSK) and the Medicines for Malaria Venture (MMV), it represents a completely new chemical class of antimalarials called pyrrolidinamides.” (ref Br J Clin Pharmacol, 2025 May 29; 91(6):1821–1833. https://doi.org/10.1111/bcp.70000). Barber BE & al., The Pyrrolidinamide Antimalarial Drug MMV367 Rapidly Clears Blood-Stage Plasmodium falciparum in Healthy Adults with Experimental Malaria, Sci Transl Med. 2026 Jun 10; 18(853):eaec1863, https://doi.org/10.1126/scitranslmed.aec1863 reports on the results of human experimentation with variable single doses of the drug. Individuals who received the three highest doses (of six) all cleared the parasites from their blood, as measured by qPCR. Only two of eight individuals, treated by higher doses, experienced any (unspecified) mild side effects, which cleared spontaneously. The authors urge further studies of the drug.
Plant extracts and traditional treatments
As a result of a survey by Oisay EE & al. of urban and rural (200 each) residents, the authors found that rural residents relied more on herbal remedies due to accessibility, affordability, and family traditions, while urban respondents, despite higher education levels, also used herbal extracts and often alternated them with prescription drugs. Residence, occupation, and age were significant predictors of knowledge and use (P < 0.05), whereas education was not. Nonetheless, perceived efficacy and high prescription costs further sustained herbal use.” The article is Family Traditions, Accessibility and Cost Shape the Continued Reliance on Cajanus cajan and Azadirachta indica for Malaria and Typhoid Despite Prescription Medicines in Urban and Rural Nsukka, Nigeria, BMC Complement Med Ther. 2026 Jun 4, https://doi.org/10.1186/s12906-026-05426-y.
Other
Delays in treatment of malaria in young children may make the difference in life or death. Olapeju B & al. used a framework of the “Three Delays Model (delay 1: deciding to seek care; delay 2: reaching a facility; delay 3: receiving quality care)” to seek what they regard of causes of delays. They report in Three Delays of Malaria Care-Seeking in Malawi: A Cross-Sectional Study, BMJ Open. 2026 May 28; 16(5):e115859, https://doi.org/10.1136/bmjopen-2025-115859 that based on interviews with “913 female caregivers who reported a child with fever in the past 2 weeks … care-seeking was primarily associated with delay 1 … and psychosocial … factors. Significant factors included incorrect knowledge of malaria symptoms, cause and diagnosis …, negative attitudes towards care-seeking …, incorrect knowledge of when and where to seek care … and far distance from a health facility…”
Campaigns and Policies
Baloyi RE & al. interviewed 384 community members and 15 healthcare workers to “investigate community and healthcare worker perceptions regarding malaria prevention, control and elimination interventions to enable development of a Social Behavioural Change Communication (SBCC) strategy” in a municipality. They found that “although awareness of malaria is generally high in Jozini local municipality, misconceptions and inconsistent prevention practices remain. Community health workers are key information sources, but barriers such as poverty, cultural beliefs, and limited resources affect prevention efforts. Healthcare providers are knowledgeable but face operational challenges.” They recommend “targeted SBCC interventions to support malaria control” in Community and Healthcare Worker Contributions to Malaria Prevention: A Culturally Tailored Behaviour Change Approach in Jozini, South Africa, Malaria J, 2026 May 27, https://doi.org/10.1186/s12936-026-05943-8.
Toner E & al. conducted a survey in 34 villages in which Peace Corps volunteers and health care workers distributed ITNs during the summer of 2025. The results, reported in Impact of Distribution Campaigns on the Use and Availability of Long-Lasting Insecticide-Treated Nets in Rural Guinea, Malaria World J, 2026 May 28, 17:12, https://doi.org/10.5281/zenodo.20429788 were as follows: “Campaign presence was associated with increased household ownership of at least one LLIN, from 45.8% to 94.5% … Mean population access to LLINs saw a three-fold increase from 20.8% to 72.9% … LLIN use among children under five doubled from 24.8% to 50.0% …, while adult use rose from 28.3% to 42.0% … in campaign-exposed areas. At the household level, net density reached the target of 1.00 net per sleeping space …. While median ownership reached 1.00 net per bed, the median number of nets actually hung was only 0.55, indicating that logistical success has not yet translated into universal deployment.”
“Proactive community case management (ProCCM) of malaria is a strategy to improve access to prompt and effective case management of malaria at the community level by supporting community health workers (CHWs) to visit every household in their community every 1 to 2 weeks to identify people with malaria symptoms, offer rapid diagnostic tests, and first line malaria treatment for those with positive tests.” Thwing J & al. “sought to determine if this strategy could decrease malaria parasite prevalence in high malaria transmission settings” and report “of a 3-year cluster-randomized controlled trial of ProCCM, covering a population of over 100,000” in their article, Impact of Proactive Community Case Management of Malaria on Malaria Prevalence in Bankass, Mali: A Cluster-Randomised Controlled Trial, Malaria J. 2026 May 20, https://doi.org/10.1186/s12936-026-05849-5 that there was “no difference between intervention and control arms in parasite prevalence among all ages, fever in the last 2 weeks, care seeking, or access to diagnostic testing for malaria among children under 5 years. However, CHWs in the intervention arm reached the goal of two visits per month in less than half the households.”
Ndong IC & al. report on the follow-up of a mass drug administration (MDA) campaign in their article, Community Perspective on Feasibility of Malaria Mass Drug Administration: A Qualitative Evidence from the Eastern Region of Ghana, Malaria J. 2026 Jun 10; 25:235, https://doi.org/10.1186/s12936-026-05979-w. Based on interviews with selected community members and leaders, the authors conclude that MDA interventions were widely perceived as beneficial in reducing malaria burden and associated household healthcare costs in rural Ghana. Consistent with the Theoretical Framework of Acceptability, perceived effectiveness and economic benefits outweighed the burden of transient adverse events, contributing to perceived high community acceptability. Strengthening communication, pharmacovigilance, and community engagement could be critical for sustaining uptake and supporting the potential scale-up of MDA in high-burden malaria settings.”
In order to refine planning for prevention campaigns, Chiziba C & al., Archetype-Based Stratification to Inform Sub-National Tailoring of Malaria Interventions in Zambia, Malaria J, 2026 Jun 18, https://doi.org/10.1186/s12936-026-05998-7 reports on what they call “archetypes” of population, behavior, and environment based stratification. They specify four archetypes, designated A through D, using specific clustering of characteristics, such as quality of housing, bedbnet use, etc. The authors claim that “Identified Archetypes Are Relatively Spatially Homogeneous Across [health facility catchment areas] Compared to Incidence.”
Epidemiology
Climate change, biodiversity and environment
AlAbbas M studied the effects of access to suitable housing on the risk of malaria. Based on data collected from 17 sub-Saharan countries, the author reports in Housing and Malaria Risk: Evidence Across Ecological and Climatic Gradients in Sub-Saharan Africa, Soc Sci Med. 2026 May 25; 403:119410, https://doi.org/10.1016/j.socscimed.2026.119410 that “[m]odern housing was associated with lower odds of RDT positivity in the baseline model (β=-0.543, p<0.001), net of socioeconomic status, WASH conditions, net usage, and ecological-climatic controls. Predicted probabilities of positive RDTs varied substantially by ecological context, but remained lower in modern dwellings. Climatic gradients shifted baseline predicted risk in expected directions for rainfall and elevation, whereas temperature displayed more complex patterning…”
“Mozambique … has been experiencing significant impacts of climate change [including] changing weather patterns and more frequent and intense storms.” Zhu H & al., Exploratory Analysis of the Correlation Between Precipitation and Storms and Malaria Cases from National Surveillance in Mozambique, Malaria J. 2026 Jun 11, https://doi.org/10.1186/s12936-026-05959-0 describes “evidence of strong spatial variation in malaria cases, malaria hospitalizations, and malaria deaths. There was evidence of a clear temporal relationship between precipitation and malaria cases throughout Mozambique. Nationally, there was an increased relative risk for malaria at an 8-week temporal lag. However, this varied when stratified by region. In the Northern Region there was an increased relative risk for malaria between 6-week and 8-week temporal lags; in the Central region there was an increased relative risk for malaria between 10-week and 12-week temporal lags; and in the Southern region there was an increased relative risk for malaria between 10-week and 13-week temporal lags.”
“Malaria remains a major public health concern in flood-prone districts where environmental vulnerability and weak health infrastructure exacerbate transmission risks.” Khan Y & al., Geospatial and Machine Learning Approaches for Malaria Risk Mapping in Flood-Prone Districts: Implications for Public Health Decision-Making, Public Health. 2026 Jun 16; 257:106367, https://doi.org/10.1016/j.puhe.2026.106367 is a “geospatial modeling study integrating environmental, meteorological, and socio-demographic datasets with decision analysis and machine learning … Eleven predictor variables, including elevation, land surface temperature (LST), rainfall, slope, drainage density, humidity, flood inundation, population, proximity to roads and health facilities, and land use/land cover (LULC), were processed to generate hazard, vulnerability, and elements-at-risk (EAR) layers.” The authors state that compared to actual data collected over ten years, their model achieved 93% accuracy and the “methodology is transferable to other disaster-prone regions for targeted interventions and resource allocation.”
Malawi is a landlocked country, yet Elling MT & al. claim in their paper, Tropical Oceans Drive Variability in Soil Moisture and Malaria in Malawi, Commun Med (Lond). 2026 May 30, https://doi.org/10.1038/s43856-026-01681-9, that ocean currents influence the incidence of malaria. They state: “A warm tropical Atlantic leads to wet conditions in Malawi and increased malaria cases. In contrast, a warm Indian Ocean drives hot, dry conditions and reduces malaria cases. We find that soil moisture is the crucial link between these remote climate drivers and local disease dynamics, and looking ahead, future climate change is expected to reduce soil moisture levels in the country by 2100 (magnitude uncertain), which could reshape transmission patterns.”
Risk factors
Using data from “Malaria Indicator Surveys (2016-2022), including 51,457 children under five from 17 [sub-Saharan] countries, Kassie AT & al. report in their paper, Determinants of Malaria Prevalence Among Children Under 5 Years of Age in 17 Sub-Saharan African Countries: Insights from Malaria Indicator Surveys, Glob Health Action. 2026 May 22; 19(1):2677281, https://doi.org/10.1080/16549716.2026.2677281, that “more than one-third of children under five in several sub-Saharan African (SSA) countries were infected with malaria. At the individual level, significant risk factors included age … and low household wealth index … Protective factors were maternal primary education … and the use of insecticide-treated bed nets … At the community level, increased malaria risk was associated with rural residence … and high community illiteracy rates…”
Fawole JK & al. explored the risk of acquiring malaria in hospitals. They report in Nosocomial Malaria Transmission Risk in Hospital Wards in Abeokuta Nigeria: Entomological and Parasitological Evidence from Secondary Healthcare Facilities, Malaria J, 2026 May 27, https://doi.org/10.1186/s12936-026-05947-4 that among 105 patients admitted to specialty care for reasons other than malaria and 29 caregivers on the same units, 74.6% had asymptomatic parasitemia on microscopy. “Only 3.7% of participants reported using mosquito nets while on admission.” The authors also collected 714 mosquitoes on the same hospital units, of which 80 were Anopheles females. The authors conclude that the “coexistence of asymptomatic parasitaemic patients, infective mosquitoes, and inadequate protective measures indicates a plausible risk of nosocomial malaria transmission within hospital wards.”
Joko S & al. evaluated knowledge about malaria along with other risk factors in a community with high malaria prevalence, especially in the age group of 5 to 18 years. As reported in Knowledge, Attitudes and Practices Towards Malaria in a Peri-Urban Cameroonian Village: Persistent Silent Transmission Despite Satisfactory Awareness, PLoS One. 2026 May 27; 21(5):e0348617, https://doi.org/10.1371/journal.pone.0348617, despite generally good understanding of the principles of malaria prevention, actual practices were poor. No risk factors stood out as causative.
Geography and poverty are the main risk factors for the incidence of pedicatrric malaria, according to the study of Osayomi T & Adedun OA. As they describe in Geographic Patterns and Drivers of Paediatric Malaria in Nigeria: Walking in the Shadow of Poverty, J Parasit Dis. 2026 Jun; 50(2):467-480, https://doi.org/10.1007/s12639-025-01864-6, the main distinguishing feature of the “hotspots” for malaria in children is the poverty of households in comparisons to “cold spots.”
In a modest size (353 participants), Aninagyei E & al. explored the risk of conversion from asymptomatic to symptomatic malaria. In their population, “PCR detected more P. falciparum infections (52.1%) than mRDT (42.8%), indicating a substantial burden of submicroscopic asymptomatic malaria. … During follow-up, 131 participants (37.1%) converted to mRDT and microscopy positivity. They report in From Silent Infection to Symptomatic Malaria: Host Phenomic Determinants of Plasmodium falciparum Outcomes in Fanteakwa South District, Ghana, Malaria J, 2026 Jun 13, https://doi.org/10.1186/s12936-026-05985-y that “[p]rogression from asymptomatic to symptomatic P. falciparum infection is strongly shaped by age and host erythrocyte phenomic traits. Blood groups A and AB and the HbAA phenotype favour early conversion, whereas blood group O and HbAS delay or prevent progression.”
General epidemiology
Woldegiorgis BT & al. set out to “assess the efficiency of DNA recovery from used RDT kits for molecular malaria surveillance and drug resistance monitoring by comparing its performance with the conventional filter paper [dried blood spot (DBS)] method.” They collected 417 “paired samples of RDT kits and DBS on filter paper were collected from malaria-positive cases at six health centres in … Ethiopia. After comparing DNA extracted from both type of samples, they concluded that “[used RDT kits can serve as an alternative DNA source and may be utilized for molecular surveillance of malaria and monitoring drug resistance in conditions when DBS is not available.” The article is Rapid Diagnostic Test Kit as a Source of DNA in Comparison with Filter Paper for Malaria Molecular Surveillance and Drug Resistance Monitoring: A Cross-Sectional Study, Malaria J. 2026 May 12, https://doi.org/10.1186/s12936-026-05930-z.
“Placental malaria [PM] is linked to adverse fetal outcomes such as preterm birth, low birth weight, small-for-gestational-age infants, congenital malaria, and intrauterine death. Primigravidae are particularly vulnerable due to limited malaria-specific immunity and socio-economic barriers.” Buhaga G & al. report in High Burden of Histology-Confirmed Placental Malaria and Associated Adverse Birth Outcomes Among Primigravidae in Northwestern Tanzania: A Cross-Sectional Study, Malaria J, 2026 May 28, https://doi.org/10.1186/s12936-026-05946-5 that among “422 primigravidae, malaria prevalence was higher by microscopy than mRDT in maternal 19.7% … and 6.9% …, respectively. Histopathology showed 39.8% prevalence. Adolescents had higher infection rates… PM was significantly associated with low birth weight …, preterm birth …, and small-for-gestational-age neonates.”
Kigozi SP & al. investigated the function of health management information system (HMIS) in collecting data about malaria in order to understand how the system supports the effort to mitigate the impact of malaria in society. Based on actual observation of the work products of 34 professionals in the 30 districts under study, they conclude in Attitude and Practices of District-Level HMIS Managers Towards Malaria Routine Reporting in Uganda: A 2024 Cross-Sectional Study, Malaria J, 2026 Jun 1, https://doi.org/10.1186/s12936-026-05951-8 that “[h]ighly capable human resource teams at district-level health offices administered HMIS routine reporting. Teamwork with health facility officials provides a framework for HMIS strengthening. Gaps remain in: use of or adherence to standard operating procedures for data reporting, feedback, and follow-up; conducting scheduled and/or evidence-driven support supervision; and confidence in and advanced analytical skills facilitating improved data use.”
Gonçalves HEM & al. report in Age-Related and Seasonal Variation in Malaria and Other Causes of Fever and Their Association with Clinical Outcomes in Southern Angola: A Hospital-Based Study, Trop Med Int Health. 2026 May 16, https://doi.org/10.1111/tmi.70166 that two thirds of 849 patients admitted to a hospital in Southern Angola with fever over two three-month periods did not have malaria as investigated by microscopy. While advocating for better diagnostic accuracy of febrile patients, the authors do not claim inappropriate use of antimalarials.
According to Ranjha R & al., “[s]ubclinical malaria presents a challenge to global malaria elimination efforts. It often evades detection by conventional diagnostic tools due to low parasite densities. Despite being clinically silent, asymptomatic infections within the broader spectrum of subclinical malaria serve as hidden reservoirs that sustain transmission.” Their paper, Mechanistic Insights into Subclinical Plasmodium Infections: Unveiling the Silent Drivers of Malaria Transmission, iScience. 2026 May 17; 29(6):115979, https://doi.org/10.1016/j.isci.2026.115979, “examines the epidemiological burden, biological mechanisms, diagnostic challenges, and health consequences of subclinical malaria. The urgent need for field-deployable, sensitive diagnostic tools and integrative approaches is underscored. Understanding the mechanisms sustaining subclinical and asymptomatic infections is essential for targeted interventions and malaria elimination.”
Analyzing data from 33 relevant studies, Mohamed K & al., Prevalence and Determinants of Asymptomatic Malaria Infection Among Schoolchildren in Africa: Insights from a Systematic Review and Meta-Analysis, BMC Infect Dis. 2026 May 20, https://doi.org/10.1186/s12879-026-13548-4 reports that “the summary estimate of asymptomatic malaria infection among schoolchildren across 33 African countries was 34% … However, there was substantial heterogeneity …, indicating that this summary figure shows a significant difference between transmission settings. The prevalence ranged from 5% in Ethiopia to 53% in Cameroon, varying significantly by geographic region, [p]ublication year, and diagnostic method.”
Kojom Foko LP & al., Public Availability of Malaria Intervention Data Will Be Vital for the Acceleration of Its Control and Elimination, Am J Trop Med Hyg. 2026 May 21: tpmd250412, https://doi.org/10.4269/ajtmh.25-0412 is an advocacy paper for transparency of data relating to malaria. The authors “highlight gaps in data availability at district levels and propose actionable strategies, including standardized data platforms. This policy shift can accelerate malaria elimination, ensuring that data drive health equity worldwide.”
Sowole O & al. studied child parameters one year after being birthed by 1144 mothers. 250 (21.9%) had prenatal malaria exposure, and 525 (45.9%) had early child malaria infection. “Children with prenatal malaria as compared to those without had higher risk for poorer length growth … Malaria beginning in pregnancy was associated with poorer growth outcomes.” The paper is Prenatal and Child Malaria and Child Growth: Evidence from a Ghanaian Pregnancy Cohort, BMJ Paediatr Open. 2026 Jun 4; 10:e004409, https://doi.org/10.1136/bmjpo-2025-004409.
It became evident recently that the perception that P. vivax cannot infect those whose red blood cells do not possess the so-called Duffy antigen (Duffy Neg blood group). Dieng CC & al. tested blood samples from 1373 individuals and report in Epidemiological Insights and Genetic Diversity of the Duffy Binding Protein of Plasmodium vivax in Duffy-Negative Cameroonians, PLoS Negl Trop Dis. 2026 Jun 4; 20(6):e0014404, https://doi.org/10.1371/journal.pntd.0014404 that “P. vivax prevalence was 10.8% among hospital patients (86/793) and 5.5% in community participants (32/580), and all confirmed infections occurred in Duffy-negative individuals.” In addition, P. vivax LDH-based RDTs failed to detect infection in 85% of qPCR positive individuals. Genetic testing disclosed multiple mutations in the genes controlling the Duffy progein.
Spatiotemporal studies
Falama AM & al., Mapping Malaria Hotspots Through Spatial and Spatio-Temporal Analysis in Sierra Leone, 2021-2024, Public Health Action. 2026 May 18; 16(2):99-105, https://doi.org/10.5588/pha.25.0048
Duguma T & al., Prevalence of Malaria and Soil-Transmitted Helminths and Associated Factors Among Pregnant Women Visiting Mizan-Tepi University Teaching Hospital, Southwest Ethiopia, J Parasitol Res. 2026 May 21; 2026:2720965, https://doi.org/10.1155/japr/2720965
Amare R & Hailegebriel T, Prevalence of Malaria and Associated Factors Among Febrile Patients Visiting Gissa Health Center, Awi Zone, Northwest Ethiopia, Malaria J, 2025 Jun 2, https://doi.org/10.1186/s12936-026-05965-2
Hassan YSA & al., Spatial and Temporal Inequalities in Malaria Incidence and Mortality Among Children Aged 0-4 Years in Somalia: A Subnational Analysis, 2010-2019, Trop Med Health. 2026 Jun 4; 54:106, https://doi.org/10.1186/s41182-026-00991-x
Emnetu A & al., Assessment of Malaria Prevalence and Determinants Among Clinically Suspected Individuals Attending Dejen Primary Hospital, East Gojjam Zone, Northwest Ethiopia, Malaria J. 2026 Jun 10, https://doi.org/10.1186/s12936-026-05992-z