By Dr. Derick Pasternak, Ambassador, Malaria Science & Research Coordinator, MPI
News
Dated July 2025, but appearing only now, WHO published its Guidance on Establishing a National Malaria Data Depository, Version 1.0, available on https://media.malariaworld.org/guidance_on_establishing_a_national_malaria_data_repository_version_1_0_july_2025_d58fd7467e.pdf
Ethiopia “officially launched the R21/Matrix-M malaria vaccine [on 21 October], becoming the 23rd African country to introduce a malaria vaccine into its routine immunization program. This historic step marks a significant advancement in the country’s efforts to reduce the burden of malaria and protect vulnerable populations, particularly children under five. The vaccine rollout has begun in 58 districts across 9 regions, selected based on WHO’s prioritization criteria.” https://www.afro.who.int/countries/ethiopia/news/ethiopia-introduces-malaria-vaccine-protect-children-and-strengthen-health-systems
On 26 October, the Seattle Times carried an article that told the story of how Ugandan researchers showed beneficial results from giving mothers baby wraps that were treated with permethrin. The original article in the New England Journal of Medicine is quoted below (Boyce RM & al. under Prevention/Vectors).
An article by Tawanda Zininga in The Conversations on 27 October claims that P. falciparum possesses three proteins that protect it during the febrile episodes of the person with malaria and disrupting these proteins may be a way to deal with the parasite. There is no reference to a peer reviewed paper in this article (https://medicalxpress.com/news/2025-10-malaria-bodyguards-scientists-parasite-secret.html)
Two researchers at University of South Florida reported the finding of Anopheles stephensi in Madagascar on 28 October; https://www.eurekalert.org/news-releases/1103336
AfricaCDC, headquartered in Addis Ababa, published a 74-page pamphlet with the title of Roadmap for the Implementation of Malaria Genomic Surveillance in Africa (date uncertain). The website africacdc.org is very difficult to access, but a pdf version of the pamphlet is available from this reviewer.
On 12 November, the Seattle Times published an article, Two new malaria treatments show promise as drug resistance grows, sourced from the Associated Press. First, it mentions tetratherapy (4 drugs including an artemisinin) that is apparently effective as a single dose, demonstrated in a study in Gabon; however rising resistance to at least two drugs in the combination may render this therapy to be short-lived. The article is also about GanLum, which contains ganaplacide, a new drug, shown to be effective in clinical studies, in combination with lumefantrine, which is part of some formulations of current artemisinin combination therapy. This combination is likely to be available next year. The ultimate source of this information was papers presented at the annual meeting of the American Society of Tropical Medicine and Hygiene.
On 14 November, WHO published the report of a conference on pediatric dosing to treat malaria. It can be accessed at https://iris.who.int/server/api/core/bitstreams/c5b0a596-42dd-47c0-812c-3788274ccee2/content. In this context, please see also the article by Wounounou G & al. below, under Treatment/Treatment results
PEER REVIEWED ARTICLES (see notes after citations from non-peer-reviewed publications)
Prevention
Vaccines
Using nationally collected data from three years ago, Sarfo M & al., Determinants of Malaria Vaccine Awareness Among Women in Ghana: Findings From the 2022 Ghana Malaria Indicator Survey, Public Health Chall. 2025 Sep 26; 4(4):e70126, https://doi.org/10.1002/puh2.70126 concludes that “[m]alaria vaccine awareness among Ghanaian women is shaped by access to education, digital connectivity, and regional and religious contexts. Public health campaigns should prioritise equitable access to vaccine information, especially for underserved populations, to support Ghana’s 2028 malaria elimination goals.”
Oboh MA & al. “carried out a national evaluation of physicians’ knowledge of and willingness to encourage caregivers to partake in the RTS S/AS01 and R21 Matrix M malaria vaccinations in Nigeria. The study was a cross-sectional online survey among physicians across the six geopolitical zones of Nigeria” Results showed that 30% of those surveyed were unaware of either vaccine and among the ones aware, 34% did not know the guidelines for administering them. The paper is Physicians’ Knowledge of, and Willingness to Encourage Caregivers to Partake in the RTS S/AS01 and R21 Matrix M Malaria Vaccines Roll Out – a National Survey in Nigeria, BMC Infect Dis. 2025 Oct 17; 25:1345, https://doi.org/10.1186/s12879-025-11760-2.
Ndeketa L & al. conducted a “phase 4, disease surveillance study with prospective cohort event monitoring. The study was performed in routine medical practice settings at 12 sites (four per country) in Ghana, Kenya, and Malawi.” They conclude in Effectiveness of the RTS,S/AS01E Malaria Vaccine in a Real-World Setting over 1 Year of Follow-Up After the Three-Dose Primary Schedule: An Interim Analysis of a Phase 4 Study in Ghana, Kenya, and Malawi, Lancet Glob Health, 2025 Nov 6, https://doi.org/10.1016/S2214-109X(25)00415-2 that “[o]ver 1 year of follow-up after the third vaccine dose, vaccination with RTS,S/AS01E in real-world settings showed significant reductions in malaria burden. These findings reinforce the continued use of RTS,S/AS01E vaccination in children as an effective public health measure to reduce malaria-related illness and mortality in endemic regions, and highlight its relevance for future malaria control strategies.”
Ansah RK & al. studied vaccination intent among 3004 women in Ghana, among whom 93.5% indicated intention to vaccinate their children against malaria. Although there were some variation in the education received by those who plan to vaccinate as against those who did not, the “no vaccine” group had slightly higher proportion of educated women among them. The authors suggest that “rural uneducated women appeared to exert greater social influence on their educated rural counterparts” in Untangling Choices: How Awareness and Socio-Economic Status Shape Malaria Vaccination Decisions Among Ghanaian Women, Malaria J, 2025 Nov 6, 24:380, https://doi.org/10.1186/s12936-025-05613-1.
One of the major barriers to effective vaccination against malaria is the requirement for four doses, and the timing of them. Highlighting the barriers to uptake, Price J & al. discuss “guidance, tools, and materials that may help programme staff develop strategies, plans, and materials, including strategies to address the complexity of the schedule and to track four doses for individual children” in Recommendations to Mitigate Barriers to Uptake and Delivery of a Four-Dose Malaria Vaccine Schedule: Insights from the MVIP’s Qualitative Evidence, Malaria J, 2025 Nov 16, 24:408, https://doi.org/10.1186/s12936-025-05611-3.
Vectors
As a result of a study of 400 mother-baby pairs, in which 200 used permethrin impregnated baby wraps versus 200 with traditional wraps, Boyce RM & al. conclude in their paper, Permethrin-Treated Baby Wraps for the Prevention of Malaria, New Eng J Med, 2025 Oct 6, 393(14):1399-1408, https://doi.org/10.1056/NEJMoa2501628 that the “incidence rate of clinical malaria was 0.73 cases per 100 person-weeks … in the intervention group and 2.14 cases per 100 person-weeks … in the control group.” The study lasted 24 weeks and the wraps were retreated every four weeks.
“Insecticide-Treated Nets (ITNs) must retain bioefficacy after 20 washes to receive World Health Organization (WHO) prequalification,” Skomand O & al., Timing Is Everything: A Simple Chemical Method to Determine the Bioavailable Surface
Concentration of Insecticide for Insecticide-Treated Net Evaluation, Malaria J, 2025 Oct 29, 24:362, https://doi.org/10.1186/s12936-025-05602-4 appears to focus on which one of three methods of washing is optimal for predicting bioefficacy, but does not seem to relate the findings to the duration of bioavailability.
A number of articles have correlated the use of ITNs with the educational level of the households surveyed. In contrast, Badolo H & al. report that the most positive correlation for use was the material composition of the nets, polyester favored over polyethylene. Their paper, Factors Associated with Insecticide-Treated Mosquito Nets Utilization for Malaria Prevention in Burkina Faso: Finding from Cross-Sectional Household Survey, Malaria J, 2025 Nov 5, 24:374, https://doi.org/10.1186/s12936-025-05621-1 also report that households with average income were more likely to use INTs than richer households.
Based on a review of 18 carefully selected articles on ITN utilization in the literature between 2008 and 2024, Yirsaw AN & al. report in Prevalence and Determinants of Insecticide-Treated Bed-Net Utilization Among Under-Five Children in Ethiopia: A Systematic Review and Meta-Analysis, Malaria J, 2025 Nov 20, 24:410, https://doi.org/10.1186/s12936-025-05513-4 that the “pooled prevalence of ITN utilization among under-five children in Ethiopia was 53% … indicating substantial heterogeneity. Factors significantly associated with higher ITN utilization included having more than two sleeping spaces …, good knowledge about ITNs …, positive perception of ITNs …, rural residence …, low perceived barriers …, monthly income above 1,000 birr …, household head age over 25 years …, and ownership of a radio…”
Nepomichene T &al., Early Bio-Efficacy Loss of Nets Mass Distributed for Malaria Vector Control in Madagascar in 2018: Implications for Malaria Prevention, Am J Trop Med Hyg. 2025 Oct 23: tpmd240858, https://doi.org/10.4269/ajtmh.24-0858 chronicles an unfortunate situation in which two different brands of ITNs distributed in Madagascar in 2018 were found to have lost their bio-efficacy in less than one year, even though their manufacturers had advertised them as being effective for 36 months. “This bio-efficacy loss could be due to a manufacturing problem, poor storage and transportation conditions, or poor use and net care practices in Madagascar.”
Some of the same authors also studied the effectiveness of a clothianidine-containing compound used in indoor residual spraying. Nepomichene T & al., Efficacy of the Insecticide Formulation SumiShield 50WG for Malaria Vector Control in Experimental Huts in Madagascar, Am J Trop Med Hyg. 2025 Oct 23: tpmd240811, https://doi.org/10.4269/ajtmh.24-0811 reports that the walls of the huts sprayed remained lethal for a laboratory-raised species of Anopheles for eight months, but lost their effectiveness a month later. “The residual efficacy of the formulation, which lasts up to 8 months, is sufficient to cover the malaria transmission season in most endemic areas of Madagascar.”
Yet a third paper by Nepomichene T & al., Malaria Outbreak in Farafangana District, Southeast Madagascar, 2018: Are Secondary Vectors a Threat to Current Malaria Control Approaches? Am J Trop Med Hyg. 2025 Oct 23: tpmd240834, https://doi.org/10.4269/ajtmh.24-0834 recounts an outbreak of malaria in an area that had just implemented ITN distribution among its population. The authors collected 1488 Anopheles mosquitoes, among whom the majority were outdoor biting species. “Of 226 individuals tested using RDTs, 71 (31.4%) had positive results. A total of 61 (85.9%) of these individuals were asymptomatic, most of whom were children. Highly infected secondary malaria vectors, in addition to primary vectors, combined with a predominance of exophagy, contributed to parasite transmission in the Farafangana District, where indoor-targeted vector control measures had been implemented. A high proportion of asymptomatic infections likely sustained transmission.”
“Indoor residual spraying (IRS) represents a major malaria vector control strategy to reduce malaria burden. [Chabi J & al.] report on the effect of clothianidin-based IRS on key entomological indices of malaria transmission in the IRS districts following three rounds of IRS with clothianidin-based insecticide formulations” in Entomological Impact of Three Years of Clothianidin-Based Indoor Residual Spraying in Two High Malaria Endemic Districts in Côte d’Ivoire, Malaria J, 2025 Nov 21, 24:418, https://doi.org/10.1186/s12936-025-05663-5. Two of the “entomological indicators …included [h]uman biting rates (HBR) … and entomological inoculation rates (EIR) … Clothianidin-based IRS was associated with a clear reduction in An. gambiae and An. coluzzii biting densities in the IRS districts and, more importantly, a significant reduction in EIR after accounting for changes over the same period in the neighbouring control areas.”
“…vector control strategies, particularly ITNs and indoor residual spraying (IRS), have played a critical role in reducing transmission [of malaria]. However, the emergence and spread of insecticide resistance among malaria vectors threatens to undermine these gains. In response, many countries in the region have developed national insecticide resistance management (IRM) plans.” Tabue RN & al., Managing Insecticide Resistance in Malaria Vectors in Africa: Case Studies from Cameroon, Côte d’Ivoire and Tanzania, Malaria J, 2025 Nov 5, 24:375, https://doi.org/10.1186/s12936-025-05606-0 evaluates the adequacy and implementation of these plans in three countries, each of which have embarked on plans to deal with resistance. However, the authors found that “implementation gaps, largely driven by funding shorta
ges (a challenge that has increased since the study was completed), undermine the effectiveness of existing strategies.”
Madraa G & al. queried 301 individuals selected by uncertain criteria, about their knowledge about and attitude toward gene drive as a way to reduce the incidence of malaria. They report in “Have Scientists Done Enough?” Community Perspectives on Gene Drive-Modified Mosquitoes for Malaria Control in Northern Uganda: A Mixed-Methods Study, J Epidemiol Glob Health. 2025 Oct 20; 15:122, https://doi.org/10.1007/s44197-025-00465-z that only 60 of them were aware of the gene drive campaign, but once informed about it, 193 (64.9%) displayed a positive attitude toward it. “Qualitative findings revealed three themes: limited awareness, facilitators (e.g., perceived benefits, trust in authorities, safety assurances), and barriers (e.g., environmental and ethical concerns).”
Kouadio KWU & al. propose changes in the way rice fields are irrigated in Innovative Water Management for Vector Control: The Case of Rice Cultivation in Burkina Faso’s Vallée du Kou, Malaria J, 2025 Nov 12, 24:397, https://doi.org/10.1186/s12936-025-05641-x. In a three-pronged and controlled experimental rice field study, “minimum tillage combined with intermittent flooding significantly reduced larval densities, by up to 80% at the transplanting stage and nearly 85% at maturation…” In addition, a “reduction in insemination status and a shift towards younger males unable to mate was observed.” The authors recommend incorporating this method as part of an integrated vector control strategy.
Adeniyi-Akee MA & al. report in Isolation, Identification and Characterization of Compounds from the N-Hexane Fraction of Citrus limon Seeds: Cytotoxic and Mosquito Repellent Activities, Malaria J, 2025 Nov 10, 24:392, https://doi.org/10.1186/s12936-025-05458-8 that they found two compounds in extracts of lemon seeds that were non-toxic and functioned as mosquito repellents “with repellencies of 77.87% and 75.15%, respectively, as compared to the standard, DEET.”
Chemoprophylaxis
Gebreegziabher EA & al. assessed the ongoing population-level impact of Seasonal Malaria Chemoprevention (SMC) “under routine programme conditions by evaluating rates of uncomplicated and severe malaria following four rounds of administration.” They report in Trends in Uncomplicated and Severe Malaria Following Seasonal Malaria Chemoprevention Administration in Nouna, Burkina Faso: A Quasi-Experimental Pre-Post Study, Malaria J, 2025 Nov 6, 24:376, https://doi.org/10.1186/s12936-025-05597-y that a “pre-post analysis was conducted using real-world surveillance data from clinic visits in 285 villages” in the area studied… “Although SMC was administered during peak malaria transmission weeks within each cycle, both uncomplicated and severe malaria rates remained high through December, following the fourth and final round of SMC. There was a substantial reduction in infection rates in the 3 weeks post SMC, with gradual increases in rates across the three weeks. … Uncomplicated malaria rates were lower by 41%, 95%CI (31–50%), 34% (23–43%) and 22% (12–31%) in the first, second and third weeks after administration, respectively. Severe malaria rates declined by 47% (21–64%), 47% (31–59%) and 34% (17–47%) in the three weeks post-administration.”
Ikechukwu EC & al. “assessed changes in malaria case incidence and related epidemiological outcomes among the target population of children aged 3–59 months in three SMC implementing states in Nigeria.” Comparing malaria treatment in 36 facilities, after accounting for potential confounders, malaria incidence was 50% … lower in the SMC period compared with the pre-SMC period. However, there was no change in one of the three states. The article is Impact of Seasonal Malaria Chemoprevention: A Plausibility Evaluation of Routine Data from Health Facilities in Three Implementing States in Nigeria, Malaria J, 2025 Nov 11, 24:396, https://doi.org/10.1186/s12936-025-05604-2.
While the focus of Legendre E & al., Plasmodium falciparum Carriage in a Population Under Long-Term, Intensive Malaria Control in Kedougou Region, Senegal: A 1-Year Cohort Study, Lancet Glob Health. 2025 Nov; 13(11):e1935-45. https://doi.org/10.1016/s2214-109x(25)00271-2 is not on SMC, the study’s conclusions infer an endorsement of the practice. In a survey of “763 participants from 69 households …followed up from April 13, 2021, to March 30, 2022, P falciparum prevalence was lowest in SMC-eligible children (aged <10 years) and remained below 10% across wet and dry seasons. Older age groups had similar dry season prevalence at baseline (10-15%). During the wet season, prevalence increased in individuals aged 15-24 years (32·1%) and 35-49 years (24·7%). The highest clinical burden was in participants aged 10-14 years (527 cases per 1000 person-years) and 15-19 years (631 cases per 1000 person-years), over five-fold higher than children aged 6 months to 4 years (93 cases per 1000 person-years).”
Although the topic of Center M & al., Tailoring Malaria Control Interventions to Suit Local Context: Codesign of Perennial Malaria Chemoprevention (PMC) Programmes Through the Plus Project, BMJ Glob Health. 2025 Oct 5; 10(10):e015207, https://doi.org/10.1136/bmjgh-2024-015207 is chemoprevention, the focus of the paper is on flexible implementation in different countries. See below, in Campaigns and Policies.
In what Ndambo MK & al. call “exploratory qualitative study,” the authors interviewed 31 individuals “across various stakeholder levels” regarding the WHO recommendation for “post-discharge malaria chemoprevention (PDMC) in moderate to high malaria transmission areas to reduce post-discharge mortality and readmissions.” After analyzing the responses, the authors conclude in Assessing Stakeholder Perceptions and Contextual Factors in Implementing Post-Discharge Malaria Chemoprevention in Children with Severe Anaemia in Malawi, BMC Health Serv Res. 2025 Oct 24; 25:1409, https://doi.org/10.1186/s12913-025-13577-w that their findings “underscore operational challenges such as logistical constraints, medication supply issues, and targeted health worker training. It emphasizes [sic] the importance of community engagement, strengthening supply chains, and integrating PDMC into health systems.”
“The World Health Organization recommends perennial malaria chemoprevention (PMC), generally using sulfadoxine-pyrimethamine (SP) to children at high risk of severe Plasmodium falciparum malaria. Currently, PMC is given up to age two in perennial transmission settings. However, no recommendation exists for perennial settings with seasonal variation in transmission intensity, recently categorized as ‘sub-perennial’.” Sen S & al., Rethinking a Hybrid Malaria Chemoprevention Delivery Strategy for Children in Sub-Perennial Settings: A Modelling Study Integrating Age- and Seasonally-Targeted Delivery, Malaria J, 2025 Nov 21, 24:419, https://doi.org/10.1186/s12936-025-05630-0 proposes a “hybrid malaria chemoprevention (HMC) strategy, integrating two delivery components: (1) existing PMC, and (2) additional monthly SP doses during the higher-risk rainy season, ensuring a one-month gap between any two doses.” Results of the modeling showed that two different HMP regimens would both reduce the incidence of malaria in children under age two.
Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) is designed to be administered at least three times during pregnancy to be effective in reducing malaria in pregnancy and improve boirtrh outcomes. Bayuo FB & al., Association Between Adequacy of Antenatal Care and Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy Among Women in Ghana, Malaria J, 2025 Nov 7, 24:385, https://doi.org/10.1186/s12936-025-05537-w demonstrates that optimal receipt by expectant mothers of the three-dose regimen is closely associated with the women regularly attending antenatal care (ANC). The odds of receiving at least three doses of [IPTp] were higher among those who had eight or more ANC visits [1.50], who had their first ANC visit within the first trimester [1.74], and those who received all components of ANC [1.62] …”
Other
Gene drive is the subject of Strampelli A & al., A Male-Drive Female-Sterile System for the Self-Limited Control of the Malaria Mosquito Anopheles gambiae, Nat Commun. 2025 Oct 27; 16:9446, https://doi.org/10.1038/s41467-025-64489-6. The authors “describe a self-limiting gene drive strategy called Male Drive Female Sterile (MDFS) targeting Anopheles gambiae, a major malaria vector. The MDFS genetic construct causes dominant sterility in females, while transgenic males remain fertile, allowing them to transmit the female sterility trait at super-Mendelian rates. Laboratory studies show that repeated releases of MDFS can lead to elimination of caged mosquito populations.”
Adeleke TO & al. found positive correlation between good knowledge about malaria and appropriate preventive practices among 797 caregivers who completed questionnaires. In their study population, good knowledge was demonstrated by 86.4% of responders. The paper is Malaria Knowledge and Preventive Practices Among Caregivers of Under-Five Children in Southwest Nigeria, Sci Rep. 2025 Oct 21; 15:36821, https://doi.org/10.1038/s41598-025-22713-9
Similarly to the above, Okafor UA, Evaluation of Knowledge, Perception, and Attitude of Malaria Burden in the Upper River Region of The Gambia, Malaria J, 2025 Nov 7, 24:384, https://doi.org/10.1186/s12936-025-05625-x found good knowledge among the 381 households and 19 other sources studied in the area defined and also indicate that “[m]alaria profile data reveal an 87% reduction in cases for individuals above 5 years old and a 45% reduction for those under five. Additionally, mortality rates have decreased by 98% and 89%, respectively, over the 12 years (2011–2023).”
Zuuri CN & al. used questionnaires with 422 pregnant women to gauge their knowledge and understanding of malaria and preventive measures against it. Their paper, Assessing the Knowledge, Attitudes and Practices Towards Malaria Prevention and Determinants of Antenatal Care Utilization Among Pregnant Women in Sekyere South District, Ghana; A Cross-Sectional Study, Malaria J, 2025 Nov 4, 24:371, https://doi.org/10.1186/s12936-025-05614-0 reports that 78% of respondents “had adequate knowledge, though misconceptions persisted (56% believed malaria could spread person-to-person). Only 48% knew the recommended ≥ 3 IPTp doses, and ITN use was 63%, with non-use linked to heat discomfort and unavailability. Knowledge of IPTp dosage was significantly associated with uptake (p < 0.001), but socio-demographic factors were not predictors of ANC attendance.”
Diagnosis
General diagnostics
“Molecular malaria diagnostic approaches present high sensitivity and detect submicroscopic parasitaemia in a patient. However, molecular techniques like polymerase chain reaction are costly, require specific equipment and the reaction read-out interpretation can require extensive experience. Hence, a simple and user-friendly loop mediated isothermal amplification molecular [LAMP] technique resolves limitations of the polymerase chain reaction.” Tegegne B & al., report on the training of 15 technicians newly assigned to performing LAMP testing in Evaluation of Laboratory Workers Competency on Loop Mediated Isothermal Amplification (LAMP) Technology for Malaria Diagnostics: A Technology Transfer Assessment Study (LAMP-TTA) During a Multi-Site Clinical Trial, Malaria J, 2025 Nov 10, 24:388, https://doi.org/10.1186/s12936-025-05631-z. Comparing performances on before and after training testing, in which the results were excellent, the authors conclude that “adequate training, support, and evaluation [are parts] of a successful technology transfer programme.”
Field diagnostics
“Loop‐mediated isothermal amplification (LAMP) amplifies DNA with high specificity, efficiency and rapidity under isothermal conditions” (Wong Y-P & al., J Appl Microbiol, 2018 Feb 12; 124(3):626–643. https://doi.org/10.1111/jam.13647). Rakotomalala Robinson D & al.’ s article, Sensitive Near Point-of-Care Detection of Asymptomatic and Submicroscopic Plasmodium falciparum Infections in African Endemic Countries, Nat Commun. 2025 Oct 10; 16:8925, https://doi.org/10.1038/s41467-025-64027-4 reports testing the diagnostic method “on 672 capillary blood samples collected at the community level in The Gambia and Burkina Faso, including 146 Plasmodium falciparum positives confirmed by” quantitative polymerase chain reaction (qPCR). They found “95.2% sensitivity … and 96.8% specificity … It also detected 94.9% (130/137) of asymptomatic infections…” The test takes 45 minutes and greatly outperformed rapid diagnostic tests (RDTs).
Raman J & al. tested almost 4500 parasite samples from two South African provinces for “drug … and diagnostic (histidine-rich protein 2/3 [hrp2/3] gene deletions) resistance markers using polymerase chain reaction testing and sequencing … protocols.” They conclude in, Very Low Prevalence of Validated kelch13 Mutations and Absence of Histidine-Rich Protein 2/3 Double Gene Deletions in South African Malaria-Eliminating Districts (2022-2024), Am J Trop Med Hyg. 2025 Oct 23: tpmd250204, https://doi.org/10.4269/ajtmh.25-0204 that while they found no gene deletions that would render histidine-rich protein (HRP) based RDTs unreliable. Please also see below, under Treatment/Drug resistance.
“Malaria diagnosis by Rapid Diagnostic Test (RDT) is challenged by the newly emerging histidine-rich protein 2 (HRP2) gene deletion in the Plasmodium falciparum species. The alternative lactate dehydrogenase (LDH)-dependent RDTs suffer from low sensitivity…” Mohamed AO & al., Clinical Evaluation of a Novel Mologic Malaria Plasmodium falciparum LDH-Dependent Lateral Flow Rapid Diagnostic Test Diagnostic Accuracy: A Cross-Sectional Study, Sudan, Malaria J, 2025 Oct 29, 24:363, https://doi.org/10.1186/s12936-025-05609-x is a report on the evaluation of “a novel, improved Mologic Malaria Pf LDH-dependent RDT for the diagnosis of P. falciparum malaria.” Results showed that the Mologic RDT performed similarly to “comparator RDT” (identified as an PfHRP2 dependent RDT). The authors acknowledge that there was no effort to identify whether any of the samples contained parasites with HRP2 deletions.
Two articles assess the accuracy of RDT reporting: Atobatele S & al., Accuracy of Recording and Reporting of Malaria Rapid Diagnostic Tests in Nigeria, Malaria J, 2025 Nov 7, 24:383, https://doi.org/10.1186/s12936-025-05601-5 cites the analysis of 18,319 results in 16 health care facilities. “Overall, 6.2% of RDTs were misrecorded as positive and 3.7% as negative in health facility registers…” Ssewante N & al. analyzed 37,137 records in 16 public health facilities from 5 months in 2023. They report in Accuracy of Recording of Malaria Rapid Diagnostic Test Results in Uganda, Malaria J, 2025 Nov 10, 24:390, https://doi.org/10.1186/s12936-025-05637-7 that “the test positivity rate based on [outpatient] records was 61.8%. The overall agreement was strong (κ 0.81 …). Where disagreement occurred, more RDT results were misrecorded as positive (7.2%) than negative (1.9%).” In both instances the misrecording was not uniform, but higher in one region than in another. Both sets of authors recommend targeted interventions, such as RDT validation exercises and tailored refresher training.
In countries such as Ethiopia, where P. falciparum and P. vivax coexist, community health workers (CHWs) are in need of reliable field methods of diagnosing the specific organism that may be causing the patient’s illness. Oduma CO & al., First Field Evaluation of Novel LDH- and HRP2-Based Rapid Tests for Plasmodium vivax and Plasmodium falciparum Malaria Diagnosis, PLoS Negl Trop Dis. 2025 Oct 27; 19(10):e0013307, https://doi.org/10.1371/journal.pntd.0013307 compares the efficacy of four different RDTs, relying on HRP2 and LDH for P. falciparum and LDH for P. vivax. Two of the tested diagnostic kits had not been evaluated in the field previously. Controls included qPCR testing and microscopy. “Among 708 patients [tested and analyzed], 46.0% were positive by qPCR (77 P. falciparum mono-infections, 198 P. vivax mono-infections, and 51 mixed infections). Strong agreement was observed between results of the different RDTs, with no significant differences in sensitivity. At densities >20 parasites/µL by qPCR, all RDTs reached sensitivities of >96% for P. falciparum, compared to 63% by health center microscopy, and for P. vivax all RDTs reached sensitivities of >92%, compared to 72% by health center microscopy. Specificity was > 99% for all P. falciparum RDTs and >98% for all P. vivax RDTs. Only 2/53 P. falciparum infections typed carried hrp2 and hrp3 deletions, both were detected by all LDH-based RDTs.”
New diagnostic methods
Ali A & al., DANet a Lightweight Dilated Attention Network for Malaria Parasite Detection, Sci Rep. 2025 Oct 21; 15:36689, https://doi.org/10.1038/s41598-025-20402-1 is a description of an automated system of malaria diagnosis, using red blood cell smears. The authors state: “DANet provides a practical, high-performance solution for automated malaria diagnosis in resource-constrained settings. The source code of the proposed method is available at: https://github.com/asfakali/DANet.”
Treatment
Treatment results
Ciminelli F & al., Effectiveness of Dihydroartemisinin-Piperaquine for Treating Plasmodium falciparum Malaria from Sub-Saharan Africa: A Retrospective Study, Travel Med Infect Dis. 2025 Oct 15; 68:102923, https://doi.org/10.1016/j.tmaid.2025.102923 is a report of treatment of 89 patients from sub-Saharan Africa for “uncomplicated P. falciparum malaria in a single centre in Italy (2013-2024). The inclusion criteria were treatment with [dihydroartemisinin-piperaquine] (DHA-PPQ) and available data on parasitaemia at baseline and on day three.” All patients experienced clinical remission but six still had parasites in their bloodstream. There was no trend for increasing residual parasitemia over the twelve years that elapsed.
Harimanana A & al. found that both commonly used formulations of artemisinin combination therapy were essentially fully effective with only minimal side effects in the treatment of children ages 6 month to 14 years, as they report in their article, Efficacy and Safety of Artesunate + Amodiaquine and Artemether + Lumefantrine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Madagascar, 2020, Am J Trop Med Hyg. 2025 Nov 4: tpmd240844, https://doi.org/10.4269/ajtmh.24-0844.
The metabolism of lumefantrine in pregnancy is the subject of Juma E & al.’s article, Population Pharmacokinetics of Lumefantrine in Pregnant and Non-Pregnant Women with Uncomplicated Plasmodium falciparum Malaria in Western Kenya, Br J Clin Pharmacol. 2025 Oct 28, https://doi.org/10.1111/bcp.70318. Comparing pregnant and non-pregnant women who were all treated with the same artemether-lumefantrine (AL) regimen, the pregnant women had a significantly lower concentration of lumefantrine in their plasma than the non-pregnant ones. Nonetheless every woman in the study had 100% clearance of parasites from their circulation on day 28, as measured by PCR.
Based on pharmacokinetic studies as well as clinical outcomes, Wounounou G & al. conclude in Pharmacokinetics, Safety and Efficacy of an Optimized Dose of Artemether-Lumefantrine in the Treatment of Acute Uncomplicated Plasmodium falciparum Malaria in Neonates and Infants of Less Than 5 Kg Body Weight: A Multicentre, Open-Label, Single-Arm Phase 2/3 Study (CALINA), Trop Med Health. 2025 Nov 6; 53:151, https://doi.org/10.1186/s41182-025-00828-z that for very small infants the usual ratio of the two components of AL should be modified to include a higher proportion of lumefantrine (1/12 instead of 1/10).
Side effects and complications
None this month
Guidelines
Ranjbar M & al., The 24, 2 Hours Initiative: A Game Changer in Malaria Mortality Reduction, Malaria J, 2025 Nov 11, 24:395, https://doi.org/10.1186/s12936-025-05634-w introduces an initiative to ensure “that uncomplicated malaria cases receive treatment within 24 h and that severe cases get urgently necessary pre-referral treatment followed by immediate referral, or injectable treatment and supportive care within 2 h of arrival at a health facility. Besides, it highlights importance of starting post discharge malaria services within 24 h after severe malaria cases are discharged from hospital.”
Adherence to treatment guidelines is the responsibility of practitioner and patient alike. Gashema P & al., Understanding Malaria Treatment Adherence in Rwanda: Implications for Artemisinin Resistance, Am J Trop Med Hyg. 2025 Oct 28: tpmd250061, https://doi.org/10.4269/ajtmh21-0061 documents that among 406 Rwandaise who were queried by questionnaire about febrile illness, the majority displayed good knowledge about malaria and a smaller majority owned ITNs and/or had their homes treated by IRS. Nonetheless, only 46% of those who were diagnosed and treated for malaria took the prescribed 3-day antimalarial regimen; of the others, most stopped after two days, and some persisted beyond the third day. Furthermore, 27% took antimalarials for undiagnosed fever. The authors caution that poor adherence to professional advice may enhance the expansion of artemisinin resistance.
Nowhere is adherence to published and approved guidelines more important than in the treatment of patients who are severely ill. In Akello Z & al.’s paper, Adherence to Severe Malaria Treatment Guidelines in Northern Uganda: A Mixed-Methods Study, Malaria J, 2025 Nov 21, 24:417, https://doi.org/10.1186/s12936-025-05658-2, the unfortunate result of the authors’ investigation was that among 384 severely ill patients in three hospitals, the adherence to guidelines rate “was 33.07%. Non-adherence was observed for recommended treatment with intravenous (IV) drugs followed by oral medications for severe malaria (38.3%) and treatment of only malaria confirmed (25%). Medical doctors were more likely to adhere to malaria treatment guidelines … than other professionals.”
“Late diagnosis and treatment of malaria increase the odds of severe disease by nearly 2.8 times, enhance transmission rates, compromise drug effectiveness, and trigger malaria outbreaks.” Using 177 nationally representative surveys, Lubinda J & al. “estimate delay rates among African children treated for malaria between 2006 and 2022” in Estimating Rates of Treatment Delay for Malaria Fevers Among Children in Sub-Saharan Africa 2006-2022, Nat Commun. 2025 Oct 29; 16:9534, https://doi.org/10.1038/s41467-025-64584-8. The authors “found that 60% … of treated children experienced >24 h of delay, while 29% … faced delays exceeding 48 h, affecting 33 million and 16 million children, respectively. … Somalia [had] the highest (76% …) and Tanzania [had] the lowest (35.3% …) delay rates.”
Drug resistance
Shukla S & Mani DA, The Evolving Threat of Drug-Resistant Malaria in a Globalized World, Int J Antimicrob Agents. 2025 Oct 8: 107643, https://doi.org/10.1016/j.ijantimicag.2025.107643 is a review that “highlights the molecular mechanisms of drug resistance against malaria, its global impact, and the urgent need for real-time surveillance systems.”
Li F, & al.’ s paper, Multiplex Long-Amplicon Sequencing for Comprehensive Molecular Surveillance of Plasmodium falciparum Resistance to Artemisinin and Partner Drugs in Artemisinin-Based Combination Therapies (ACTs), Parasit Vectors. 2025 Oct 21; 18:419, https://doi.org/10.1186/s13071-025-07058-6 states that given that mutations in multiple loci on the kelch13 gene may independently give rise to artemisinin resistance. Therefore they advocate the use of a technique that tests for all of them.
Raman J & al. tested almost 4500 parasite samples from two South African provinces for “drug (mutations in the kelch13, chloroquine resistance transporter [crt], multidrug resistance 1 [mdr1], dihydrofolate reductase [dhfr], and dihydropterate synthase [dhps] genes) and diagnostic … resistance markers using polymerase chain reaction testing and sequencing … protocols.” They conclude in Very Low Prevalence of Validated kelch13 Mutations and Absence of Histidine-Rich Protein 2/3 Double Gene Deletions in South African Malaria-Eliminating Districts (2022-2024), Am J Trop Med Hyg. 2025 Oct 23: tpmd250204, https://doi.org/10.4269/ajtmh.25-0204 that while markers of artemisinin partial resistance were rare, continuous surveillance was required because of resistance genes having been found in neighboring countries. Please see this paper cited also under Diagnosis/Field Diagnostics.
Fairhurst KJ & al. studied whether drug resistance emerges in the malaria parasite after use of prophylaxis in individuals treated with anti-retrovirals. They report in Impact of Trimethoprim-Sulfamethoxazole and Chloroquine Prophylaxis on Drug-Resistant Plasmodium falciparum Mutations in Adults with HIV in Malawi, Am J Trop Med Hyg. 2025 Oct 30: tpmd250136, https://doi.org/10.4269/ajtmh.25-0136 that they could not detect mutations associated with drug resistance. {The article is unavailable for review and the abstract is silent on how long the prophylactic regimens were administered.}
Kalalagh KF & al., Safeguarding Artemisinin: Integrating Bioproduction Innovation and Resistance Management for Malaria Eradication, Malaria J, 2025 Nov 19, 24:414, https://doi.org/10.1186/s12936-025-05648-4 is a review of the current status of emerging parasite resistance to artemisinins. The authors claim that by “bridging production and resistance paradigms, this review outlines a sustainable malaria control roadmap, advocating interdisciplinary collaboration to ensure ART’s enduring efficacy.”
New drug research
Mondal P & al. describe several potential drugs within an organic chemical category. They state that four compounds studied are “promising new antimalarial agents effective against sensitive and drug-resistant P. falciparum.” The article, Synthesis, Computational, and Biological Evaluation of Novel Indolophenyl Carboxamides as Potential Antimalarial Agents, Future Med Chem. 2025 Oct 18: 1-17, https://doi.org/10.1080/17568919.2025.2575755 also mentions that the compounds are not toxic to human cells.
Bravo P & al. also describe a compound different from most antimalarials that inhibits both sensitive and resistant P. falciparum in the laboratory in A Novel Antimalarial Agent that Inhibits Protein Synthesis in Plasmodium falciparum, Angew Chem Int Ed Engl. 2025 Oct 20: e202514085, https://doi.org/10.1002/anie.202514085. The drug was non-toxic to human cells. However, the authors also identified a mutation in the parasite that renders it resistant to this drug.
Flatworm infections, especially schistosomiasis, occur in geographically overlapping areas with malaria in Africa. “While there is preliminary evidence that certain anti-malarial drugs exert a clinically important effect on Schistosomes, little is known on whether praziquantel (PZQ), the only licensed drug to treat schistosomiasis, has activity against Plasmodium parasites.” Mischlinger J & al. conducted small, placebo-controlled study to determine whether PZQ has any effect on P. falciparum.” As described in Efficacy of Praziquantel for Treatment of Plasmodium falciparum Infection in Asymptomatic Gabonese Adults: A Double-Blind Placebo-Controlled Randomized Phase IIb Clinical Trial, J Infect Dis. 2025 Oct 29: jiaf544, https://doi.org/10.1093/infdis/jiaf544, the findings “demonstrate a statistically significant anti-malarial activity of PZQ; however, the observed effect is only moderate compared to current first-line anti-malarial treatments.” The authors recommend future research to “investigate the synergistic potential of combining PZQ and antimalarial drugs in malaria and schistosomiasis control.”
Egza TF & al. review the progress made by embedding an effective malaria-preventive combination in nanoparticles for more effective bioavailability and effectiveness in Advancing Malaria Treatment with Magnetic and Mesoporous Silica Nanoparticles Loaded with Sulfadoxine-Pyrimethamine: A Review, Discov Nano. 2025 Nov 5; 20:199, https://doi.org/10.1186/s11671-025-04311-w.
Plant extracts and traditional treatments
Feretia apodanthera is an African plant extensively used in folk medicine. Boni SI & al. assessed the “antiplasmodial activity of F. apodanthera leaf, stem bark and root extracts … in vitro … and in vivo with Plasmodium berghei NMRI-infected mice … Toxicity was evaluated in mice and red blood cells, Their paper, Harnessing the Potential of Medicinal Plants in the Malaria Fighting: In vitro and in vivo Antiplasmodial Activities of Feretia apodanthera Delille (Rubiaceae), J Ethnopharmacol. 2025 Oct 9:120729, https://doi.org/10.1016/j.jep.2025.120729 concludes that “all three organs of F. apodanthera exhibited antiplasmodial activity both in vitro and in vivo while remaining non-toxic. The leaf demonstrated superior chemosuppressive and schizonticidal activity, along with strong trophozoitocidal effects, whereas the root and stem bark excelled in trophozoitocidal activity. These findings support the traditional use of F. apodanthera in malaria treatment and highlight its potential for developing antimalarial phytomedicines.”
Other
When an individual returns with malaria shortly after completing treatment, it is important to know whether that is a new infection or treatment failure, especially in view of reports of drug resistance. Holzschuh A & al., Rapid Multiplexed Nanopore Amplicon Sequencing to Distinguish Plasmodium falciparum Recrudescence from New Infection in Antimalarial Drug Trials, Sci Rep. 2025 Oct 22; 15:36941, https://doi.org/10.1038/s41598-025-20925-7 includes a way of distinguishing the specific genotypes of the original and recurrently infecting parasites. The authors recommending the method, which may be too cumbersome and expensive for routine use, for clinical trials of new drugs and combinations.
Campaigns and Policies
The Plus Project, apparently sponsored by Swiss sources, is focused on implementing malaria chemoprophylaxis in a number of sub-Saharan countries. Center M & al., Tailoring Malaria Control Interventions to Suit Local Context: Codesign of Perennial Malaria Chemoprevention (PMC) Programmes Through the Plus Project, BMJ Glob Health. 2025 Oct 5; 10(10):e015207, https://doi.org/10.1136/bmjgh-2024-015207 describes the process by which the four countries (Benin, Côte d’Ivoire, Cameroon, Mozambique) designed four different ways of implementing perennial malaria chemoprevention among very young children.
Zhang SH & al. analyzed 160 narrative accounts from GiveDirectly’s online repository of recipient stories from five sub-Saharan African countries. They report in Malaria in Their Words: Thematic Analysis of Online Narratives from Sub-Saharan Africa, Int J Equity Health. 2025 Oct 9; 24:264, https://doi.org/10.1186/s12939-025-02570-8 that “[t]wo major thematic domains emerged from the analysis: perceived vulnerability contexts and experienced consequences. In their accounts of vulnerability contexts, participants associated malaria with housing conditions, particularly homes with compromised structures, and with occupational settings such as agricultural work and pre-dawn labor. Regarding consequences, participants detailed how malaria treatment created severe financial burdens, forcing tradeoffs between healthcare and basic needs.” The authors conclude that “effective malaria interventions should extend beyond traditional public health approaches to include socioeconomic support and infrastructure improvements. These results emphasize the need for integrated strategies that address both the direct health impacts and broader socioeconomic consequences of malaria in endemic communities.”
Many projects aiming to improve outcomes of anti-malaria efforts include media messages. Mwebesa E & al. explored whether these messages accomplish the desired end and report in Effect of Exposure to Malaria Messages on Insecticide-Treated Net Use Among Women and Under-Five Children in Uganda: A Propensity Score Matched Analysis, Malaria J, 2025 Nov 10, 24:386, https://doi.org/10.1186/s12936-025-05629-7 that among 8868 women and 6915 children whose data were available, 69.3 % and 71.8% respectively slept under an IGTN the night before the survey. From this and comparing usage among those who were exposed to messages (37.3%) and those who were not, the authors conclude that the messages were effective. {However no ITN usage data before the messages are cited.}
In order to improve the results of the fight against malaria, “Liberia implemented a subnational tailoring (SNT) approach. This approach involved stakeholder engagement, data review, and advanced analytics to update transmission risk assessment, optimize intervention targeting, and revise the national operational plan.” Koko VS & al., Epidemiological Stratification and Sub-National Tailoring of Malaria Interventions in Liberia, Malaria J, 2025 Nov 14, 24:398,
https://doi.org/10.1186/s12936-025-05536-x reports on how “[e]pidemiological stratification was conducted based on modelled parasite prevalence (PfPR), incorporating results from the 2022 Malaria Indicator Survey, to inform intervention strategies. Additional indicators relevant for decision-making, such as insecticide resistance, historical malaria interventions, and access to healthcare, were also stratified.” The authors conclude that “subnational malaria stratification for Liberia effectively informed the targeting of eight key interventions and highlighted data gaps for future refinement.”
Many malaria elimination projects and campaigns rely in part on mass media “messages” to motivate the population toward the use of preventive measures. Ajaero ID & al. set out to measure ”the predictive influence of exposure to malaria messages on the use of mosquito nets” by children under age five in four countries. Based on data obtained from national malaria surveys, they report in A Comparative Analysis of the Predictive Influence of Access to Malaria Messages on Utilization of Mosquito Nets by Under-Five Children in West Africa, BMC Public Health. 2025 Nov 6; 25:3815, https://doi.org/10.1186/s12889-025-25270-y that in three of the countries, the effects were moderately to significantly positive, while in Nigeria, statistical analysis showed apparent negative correlation between the messages and ITN use. While the article mentions a number of potentially confounding factors, the discrepancy remains unexplained.
Gervas HE & al. modeled the effects of malaria prevention and treatment interventions at various dimensions in settings of various levels of vector resistance to insecticides. They come to the unsurprising conclusion that “[c]ompared to ITNs alone, combining ITNs with IRS and/or biolarvicides greatly improves malaria control at low to moderate intensities of pyrethroid resistance but yields no additional benefits at high resistance intensities. However, integrating these vector control strategies with immunization and effective case management using artemisinin-based combination therapy (ACT) further enhances impact by reducing both parasite transmission and the infectious reservoir.” The paper is Modelling the Impact of Different Intervention Packages for Malaria Control Under Varying Intensities of Pyrethroid Resistance, Malaria J, 2025 Nov 19, 24:411, https://doi.org/10.1186/s12936-025-05633-x.
Epidemiology
Climate change, biodiversity and environment
Kim S & al. quantified the associations between temperature and rainfall and risk of developing symptomatic malaria [in Eastern Uganda and] investigated whether these associations varied by age group.” They found “a lag of 2 to 8 weeks between exposure to rainfall exceeding 200 mm/week and a significant increase in the risk of developing symptomatic malaria; no statistically significant lagged association was found with temperature. Additionally, the risk in school-aged children was less sensitive to climate variables compared with the other age groups.” The paper is Quantifying the Lagged Effects of Climate Variables on Malaria Risk in Eastern Uganda, Am J Trop Med Hyg. 2025 Oct 7: tpmd250031, https://doi.org/10.4269/ajtmh.25-0031.
Hussain SSA & al., Hybrid Models Combining Trend and Seasonality Components with Machine Learning Algorithms Provide Accurate Forecasting of Malaria Incidence, PLOS Glob Public Health. 2025 Oct 17; 5(10):e0004500, https://doi.org/10.1371/journal.pgph.0004500 is another article on modeling to predict malaria incidence; this one with adding seasonality data.
Likewise, Ippolito MM & al. claim in their article, Malaria Outbreak Prediction at the Sub-District Level in Zambia Using Remote Sensing Satellite Data, Malaria J, 2025 Nov 17, 24:404, https://doi.org/10.1186/s12936-025-05644-8, that the “weather-driven forecasting approach accurately predicted malaria outbreaks up to four months ahead in a low-transmission setting. Such predictions could inform targeted stock management and preemptive resource mobilization, thereby reducing the risk of commodity shortages during outbreak periods.”
As the result of a 60-year analysis of 11 articles on the influence of temperature on malaria in Africa and Asia, Murugan Y & Shrivastav V, Association Between Temperature and Malaria (1959-2019): A Systematic Review and Meta-Analysis, Arch Public Health. 2025 Oct 23; 83:255, https://doi.org/10.1186/s13690-025-01750-w concludes that “[t]emperature, particularly minimum temperature, significantly influences malaria transmission across diverse epidemiological settings. The stronger association with minimum temperature is concerning, given that climate change disproportionately affects nighttime temperatures. … These findings support integrating temperature monitoring, especially minimum temperature thresholds, into malaria surveillance systems and early warning programs as climate change progresses.”
Chombo S & al., Associations of Temperature and Precipitation with Malaria in Children Under 5: A Multi-Country Study in Sub-Saharan Africa, PLoS One. 2025 Oct 27; 20(10):e0335031, https://doi.org/10.1371/journal.pone.0335031 addresses the same question as above, but comes to somewhat different conclusions after a study of 15,000 records of malaria incidence in six countries, representing West, East, and Southern Africa over 12 months. Presumably based on variances in geography, the authors report that “a one-degree Celsius rise in temperature increased malaria risk by 1.77-fold …, while a one-unit rise in squared temperature reduced risk by 1% … Children living in regions with annual precipitation between 250-500 mm faced a 72% higher risk of malaria than those in areas receiving over 500 mm…, highlighting the nonlinear influence of climate on malaria transmission among vulnerable populations.”
Sanna F & al., A Malaria Seasonality Dataset for Sub-Saharan Africa, Sci Data. 2025 Oct 28; 12:1703, https://doi.org/10.1038/s41597-025-05996-5 is a “geolocated dataset of historical timeseries describing malaria seasonality published since 2000 for sub-Saharan Africa. [The authors] used three approaches to assemble the dataset: i) an extensive literature review that included novel natural language processing to accelerate screening of published articles, ii) extractions from a routine surveillance dataset that contains geolocated data from all malaria-endemic countries, and iii) cross-referencing and incorporation of timeseries from a key entomological dataset. The resulting data include malaria prevalence, incidence, mortality, and entomological timeseries; and a novel assembly of qualitative descriptions of malaria seasonality extracted from published literature.”
Musakwa W & al. aimed to “explore the link between climate change, environmental factors, and malaria incidences, from 2010 to 2022,” as they report in Climate Change and Malaria in Chiredzi District, Zimbabwe: Emerging Evidence and Pathways Towards Malaria Prevention, Malaria J, 2025 Nov 6, 24:377, https://doi.org/10.1186/s12936-025-05624-y. “Key results from the study show evidence of climate change in Chiredzi district manifesting through an increase in rainfall, increase in temperature, change in seasons and extreme weather patterns. Furthermore, there is a positive relationship between changes in climate and an increase in malaria incidence. However, in some years the relation is negative, and this can be attributed to other factors. Similarly, malaria incidence is also related to other socioeconomic and environmental factors such as poverty and migration which are further exacerbated by climate change. Malaria incidence is also attributed to other environmental and socio-economic factors.” With these caveats, the authors propose that studies that “span a longer period need to be carried out.”
Filho WL & al. analyzed “the trends of malaria in the last two decades and assess the influences of climate change on the transmission of malaria in Africa.” They concluded that “mean temperature is the main climatic factor affecting the transmission of malaria in many countries, … Warmer temperatures generally increase the risk of malaria transmission, except in Ghana, where higher temperatures are associated with a decreased risk. Precipitation has a significant negative association with malaria incidence in Burkina Faso and Uganda…” The article is Climate Change and Malaria: An Old Enemy of Africa Is Back, BMC Public Health. 2025 Nov 4; 25:3774, https://doi.org/10.1186/s12889-025-24555-6.
Risk factors
Lakew G & al. used a national database to report on risk factors for malaria in children under age five in Individual and Community Level Factors of Malaria Among Under-Five Children in Kenya: Based on the Kenya Demographic and Health Survey, PLoS One. 2025 Oct 27; 20(10):e0335346, https://doi.org/10.1371/journal.pone.0335346. They found that the “prevalence of malaria among under-five children in Kenya was 22.72% … Maternal age between 25-34 … years [protective], richest wealth of family … [protective], treated mosquito bed net … [protective], mothers who are breast feeding [protective] and community level poverty … [exacerbating] were … associated factors of malaria among under five children in Kenya.” However, a confounding finding was also reported. Families with no bed nets had apparently lower than average risk!
According to Kakaire G & al., the transmission of malaria “is influenced by a complex interaction of socioeconomic, environmental, maternal, and child health factors. Traditional analytic approaches often fail to capture these multifaceted relationships.” The authors propose a new technique in Structural Equation Modelling (SEM) for Malaria Prevalence and Risk Factors in Uganda, Malaria J, 2025 Nov 7, 24:382, https://doi.org/10.1186/s12936-025-05627-9. The “SEM framework was constructed comprising four latent constructs: Socioeconomic Status (SES), Environment, Maternal Health, and Child Health. Each construct was defined by multiple observed variables, and the outcome of interest was the malaria status of the child. Factor loadings and regression coefficients were estimated using standardized model parameters… Child Health had the strongest positive association with malaria status …, followed by a marginal negative association with the Environment construct … Socioeconomic Status and Maternal Health were not statistically significant predictors… The findings underscore the importance of child-level health conditions and environmental factors, while pointing to the limited direct effect of socioeconomic and maternal health variables.”
General epidemiology
Biostatistical models have been used by epidemiologists to predict the spread of malaria under a variety of scenarios. Agbata BC & al., Analysis of Fractional-Order Model for the Transmission Dynamics of Malaria Via Caputo-Fabrizio and Atangana-Baleanu Operators, Sci Rep. 2025 Oct 17; 15:36359, https://doi.org/10.1038/s41598-025-20191-7 is a paper that advocates the use of one such model, described in the text.
Okereke PU & al. investigated the “extent to which mobile-app-based surveillance systems are integrated with vector control strategies,” based on a review of 152 published articles on the subject, of which 20 met the authors’ criteria for inclusion. Their paper, Mobile App-Based Malaria Surveillance and Vector Control Integration: A Scoping Review of Evidence from Endemic Settings, Malaria J, 2025 Nov 19, 24:412, https://doi.org/10.1186/s12936-025-05656-4, concludes that Mobile surveillance systems such as [four cited] significantly improved the timeliness of case reporting and enabled more precise vector control responses. [Other] tools supported hotspot identification and real-time intervention planning. Community-based platforms like FeverTracker enhanced case detection and local engagement. However, challenges such as poor internet access, low digital literacy, and limited national policy integration impeded sustainability and scalability. Only a few platforms were institutionalized within national malaria strategies.”
The protective effect of sickle cell trait (SCT) against malaria has been recognized for a long time Silva R, & al., Association Between Sickle Cell Trait and Plasmodium falciparum Infection: Evidence for Age-Specific Protection in a Cross-Sectional Study in Guinea-Bissau, Int J Infect Dis. 2025 Oct 18: 108135, https://doi.org/10.1016/j.ijid.2025.108135 reports what may modify this conclusion. In their study, “DNA from 601 dried whole blood samples collected in the 2017 national malaria prevalence survey underwent β-globin genotyping. SCT (HbAS) and HbAA distributions were examined across health regions and ethnic groups. Associations with P. falciparum, parasitaemia, anaemia, and fever were evaluated… SCT carriers (32.0%) were … more likely to have microscopic P. falciparum infection than non-carriers in unstratified … and age-stratified analyses … but, among infected children under five, they had lower parasitaemia and higher haemoglobin levels…SCT offered protection against severe outcomes in young children yet increased microscopic infection risk in older individuals, underscoring the paradox and complexity of SCT-mediated protective mechanisms…”
In what is largely a reprise of a previous article (Alexander A & Knols Bart GJ, Malaria World J, 2025, 16:10, https://doi.org/10.5281/zenodo.15389413), Alexander A, Why and when Successful Rural Malaria Control Became a Local Problem – Palestine 1922, Malaria World J, 2025 Nov 1, 16:18, https://doi.org/10.5281/zenodo.17512696 focuses more on the economics and ethno-political aspects of the control efforts of 1922 in Palestine.
In many countries in Africa, families bypass doctors and rely on pharmacies to diagnose and treat illness. Logio V & al., Exploring Documentation and Reporting Practices in Malaria Tracking: A Mixed-Methods Study Among Formal Drug Retail Shops in Hohoe Municipal, Ghana, Malaria J, 2025 Nov 14, 24:399, https://doi.org/10.1186/s12936-025-05645-7 describes an attempt to gather data on malaria prevalence by addressing infromation from local pharmacies. After reviewing documentation available from 57 drug dispensing sites, the authors found that of “the 57 shops, 51 (89.5%) lacked documentation and reporting tools.”
Robert PK & al., Optimal Control Analysis of Malaria Infection in Children Under 5 Years and Pregnant Women Under the Influence of Temperature, Malaria J, 2025 Nov 17, 24:405, https://doi.org/10.1186/s12936-025-05622-0 reports that based on modeling, when “three control strategies were tested individually, treatment of infectious humans was found to be more effective than either spraying insecticides or using [ITNs] alone. In combined strategies, the use of [ITNs] together with treatment emerged as the most effective control approach. Notably, applying all three controls simultaneously did not yield a significant improvement compared to the combination of [ITNs] and treatment… These findings highlight the importance of integrating personal protection and prompt treatment in malaria control programs, particularly in high-transmission settings.”
Although the background of Kaura T & al., Detection of Subpatent Malaria Among Febrile Mobile and Migratory Population Individuals: A Strategy for Malaria Elimination, Trans R Soc Trop Med Hyg. 2025 Oct 30: traf118, https://doi.org/10.1093/trstmh/traf118 is Punjab, India, the findings reported in the article are highly relevant in all areas subject to malaria, whenever dealing with refugees and other migrant populations. If the individuals tested harbor the parasite but at a density not detected by either RDT or microscopy, they may still contribute to the spreading of disease. In the case of the authors’ study, a little under 2% (3 of 176) of those studied were febrile, but the presence of Plasmodium parasites was detected only by PCR testing.
Spatiotemporal studies
Dana DD & al., Retrospective Analysis of Malaria Surveillance Data in the Former Southern Nations, Nationalities, and Peoples’ Region, Ethiopia (2017-2021), BMC Public Health. 2025 Oct 27; 25:3616, https://doi.org/10.1186/s12889-025-24946-9
Axame WK & al., Clinical Malaria in Three Ecological Zones in the Volta and Oti Regions of Ghana, Malaria J, 2025 Nov 10, 24:387, https://doi.org/10.1186/s12936-025-05618-w
Abubakr M & al., Epidemiological Trends of Malaria in Sennar State, Sudan, Malaria J, 2025 Nov 10, 24:389, https://doi.org/10.1186/s12936-025-05635-9