By Dr. Derick Pasternak, Ambassador, Malaria Science & Research Coordinator, MPI
Leaders
In the 4 June issue of Popular Science, Baisas, L, Scientists Engineer Mosquito STD to Combat Malaria; The Fungus is Fatal to Mosquitoes, but Harmless to Humans, https://www.popsci.com/health/mosquito-std-malaria/ refers to an article reported on these pages in February (Bilgo E, Lovett B, Millogo & al., Transmission of Transgenic Mosquito-Killing Fungi During Copulation, Sci Rep, 2025 Jan 6, 5:2181, https://doi.org/10.1038/s41598-024-83242-5) calling attention to the potential use of the fungi of Metarhizium species in controlling mosquito populations. This is of relevance in view of the article below about the effects of the same fungus against Anopheles species common in Asia.
On 25 September, Gavi, The Vaccine Network, published an article commenting on the recent start of the malaria vaccination campaign in the Republic of Guinea, a country that saw 4.3 million new malaria infections in 2023. The vaccine (RTS,S, not mentioned in the article) will be given to children aged between 5 and 23 months in four provinces, as a pilot project. https://www.gavi.org/vaccineswork/counter-first-cause-child-mortality-guinea-deploys-malarial-vaccine
University of Oxford announced on 8 October that a Phase 3 trial, led by it and “funded by Japan’s Global Health Innovative Technology Fund (GHIT), has begun to evaluate a novel fixed-dose triple artemisinin-based combination treatment (FD-TACT) for uncomplicated Plasmodium falciparum malaria [in Rwanda]. Testing a single-formulation treatment combining artemether-lumefantrine and amodiaquine (ALAQ) … trial aims to provide an easy-to-administer treatment for adults, adolescents, and children over 6 months, to address the growing threat of resistance to artemisinins, …”
On 13 October, WHO published the reference manual, Subnational Tailoring of Malaria Strategies and Interventions. It is available at https://www.who.int/publications/i/item/9789240115712.
PEER REVIEWED ARTICLES (see notes after citations from non-peer-reviewed publications)
Prevention
Vaccines
Dahiya N & al. argue in their article, Mosquito-Based Transmission-Blocking Vaccine Candidates for Malaria: Progress, Challenges, and Innovations, Mol Biol Rep. 2025 Sep 16; 52:908, https://doi.org/10.1007/s11033-025-10963-9, that so-called mosquito-based transmission-blocking vaccines currently in development are more likely to succeed in suppressing malaria in countries where it is endemic, than the current WHO-approved vaccines. However, it is unclear what “mosquito-based” means in the context of this paper.
“Several sub-Saharan African countries are launching malaria vaccination programmes for children. [Seror V & al.] assessed how attitudes to malaria vaccination for children could be better understood by considering the individual dynamics of COVID-19 vaccine intention/uptake over the 2021-2023 campaigns, with a view to highlighting barriers likely to affect malaria vaccine uptake… With regard to the individual dynamics of COVID-19 vaccination, three temporal patterns were identified: continuously strong intention (34.88% of participants), increasingly strong intention (33.40%) and increasingly less strong intention (31.72%). Along with socioeconomic factors, these patterns were explained by early levels of risk perception and trust in health authorities, and temporal fluctuations of these factors. Households where both surveyed members had continuously strong COVID-19 vaccination intention were also more likely to have strong positive attitudes to malaria vaccination for children.” The article is Attitudes to Malaria Vaccination in Children: What Can Be Learned from Their Consistency with the Temporal Dynamics of COVID-19 Vaccination Intention? A Prospective Cohort Study in Rural Senegal (July 2020-November 2023), BMJ Glob Health. 2025 Sep 8; 10(9):e019027, https://doi.org/10.1136/bmjgh-2025-019027.
Gregory OB & al. conducted a household survey in Karaga District, northern Ghana, a country where the R21 malaria vaccine is being introduced. They report in Local Attitudes Towards Malarial Disease in a High-Burden Area of Rural Ghana: A Cross-Sectional Household Survey, Trans R Soc Trop Med Hyg. 2025 Sep 22: traf099, https://doi.org/10.1093/trstmh/traf099 that 90.9% of responders “agreed they would like their children aged <5 y to take the new vaccine.” {It was a small survey of under 200 households.}
Both vaccines currently endorsed by WHO are in use in Ghana. Awutney-Hinidza DS & al., Factors Contributing to Compliance with Expanded Programme on Immunization and RTS, S/AS01 Schedules Among Children Aged 24–40 Months in Central Tongu District of Ghana, Malaria J, 2025 Oct 23, 24:359, https://doi.org/10.1186/s12936-025-05469-5 focuses on attitudes to the one developed by GSK. A matched case–control study (1:1) was undertaken between December 2021 and February 2022 among caregivers of children aged 24 to 40 months. Perhaps it is of no surprise that “[n]on-compliance with recommended EPI vaccinations, including RTS,S/AS01 was largely due to socio-economic factors, having information and knowledge about vaccines, immunization schedules, and access to immunization services.”
Limsalakpetch A & al. explored “the immunogenicity and efficacy of nucleoside-modified mRNA-lipid nanoparticle (LNP) vaccines targeting the P. vivax circumsporozoite protein (PvCSP).” As they describe in mRNA-LNP Vaccine Encoding the Plasmodium vivax Circumsporozoite Protein Is Highly Immunogenic and Confers Protection in Mice, Mol Ther Nucleic Acids. 2025 Jul 30; 36(3):102645, https://doi.org/10.1016/j.omtn.2025.102645, multiple preparations were tested, using different routes of administration to laboratory mice. The authors state that their work demonstrates the potential of this vaccine “in combating P. vivax pre-erythrocytic stage infection.”
Ryan E & al., Comparison of Major, Minor and Junctional Circumsporozoite Protein Epitopes for Malaria Vaccine Design, NPJ Vaccines. 2025 Oct 3; 10:215, https://doi.org/10.1038/s41541-025-01264-0 is a discussion of how various segments of the circumsporozoite protein may result in improved vaccine design.
Lamers OAC & al. reviewed 22 papers reporting on genetically modifying malaria parasites so that after they invade the liver, they do not progress to blood stage and using the modified parasites as a vaccine to prevent clinical infection. They conclude in The Path from Early to Late Liver Stage Arresting Genetically Attenuated Parasites as a Malaria Vaccination Strategy, NPJ Vaccines. 2025 Oct 8; 10:218, https://doi.org/10.1038/s41541-025-01265-z that genetically altered parasites are “increasingly promising vaccine candidates against malaria.” {Differently modified parasites are also the subject of research, at Seattle Children’s Hospital among others.}
“Monoclonal antibodies targeting the Plasmodium falciparum circumsporozoite protein have potential to simplify prevention. [Lyle KE & al.] assessed the safety, pharmacokinetics, and protective efficacy of MAM01, a monoclonal antibody preferentially directed against the conserved Asn-Ala-Asn-Pro (NANP) central repeat region of circumsporozoite protein.” They conducted a small study of 37 healthy adults who were give either placebo or various concentrations of MAM01 and report in Human Monoclonal Antibody MAM01 for Protection Against Malaria in Adults in the USA: A First-in-Human, Phase 1, Dose-Escalation, Double-Blind, Placebo-Controlled, Adaptive Trial, Lancet Infect Dis, 2025 Sep 23, https://doi.org/10.1016/S1473-3099(25)00481-5 that only the highest dose prevented parasitemia after P. falciparum challenge, but even at that dose, no adverse effects were noted. All the control subjects developed parasitemia.
Like others in Africa, Asio L & al. investigated whether the healthcare community in Uganda is ready for deployment of the malaria vaccine, now that the government has applied for the R21 vaccine. The discouraging results are published in General Knowledge and Attitude of Healthcare Professionals and Infrastructural Readiness Prior to Implementation of Malaria Vaccine in Selected Hospitals in Tororo District, Uganda: A Cross-Sectional Study, BMC Public Health. 2025 Oct 9; 25:3437, https://doi.org/10.1186/s12889-025-24545-8. Seventy percent of healthcare professionals, selected “irrespective of their role in vaccination programs,” expressed unfavorable attitudes …, many of whom expressed concerns about its affordability, accessibility and effectiveness. Knowledge on the malaria vaccine was notably low, with 99% … of respondents demonstrating poor knowledge…”
Isah A & al. report on a review of 30 articles in Costs, Delivery Strategies and Implementation Challenges for Malaria Vaccines: A Rapid Review of Literature, Trop Dis Travel Med Vaccines. 2025 Oct 7; 11:34, https://doi.org/10.1186/s40794-025-00268-x. “RTS, S/AS01 was the most commonly reported vaccine (n = 23, 76.67%), with reported efficacy rates of 30% – 75%. Cost-effectiveness estimates for the vaccines varied from $20 – $50 per DALY averted, but higher costs were reported in some settings. Delivery strategies largely involved routine immunization (n = 12, 40%), although innovative methods, including drones, showed promise in one study. Key barriers were logistical constraints, community acceptance, and healthcare infrastructure limitations.”
While technically not a vaccine approach, Steel RWJ & al.’s article, Protection from Malaria Infection Using Liver-Targeted siRNA, Mol Ther Methods Clin Dev. 2025 Jun 18; 33(3):101516, https://doi.org/10.1016/j.omtm.2025.101516 reports the formulation of an RNA molecule that interferes with the liver cell protein that enables mosquito-injected P. falciparum parasites to invade the host liver and set up the chain of events that result in clinical malaria. In this way, this work is similar to the mRNA approach to vaccines. It is unclear whether deactivating this protein has any harmful effects.
Vectors
Moiroux N & al. studied outcomes of preventive measures in small villages in Côte d’Ivoire and Burkina Faso. Three methods of prevention were studied in village clusters: Indoor Residual Spraying (IRS) and Insecticide nets (ITNs) in one cluster, behavior change communication (BCC) and ITN use in the second, and ITN alone as a control group. Data were collected for 10 months before intervention and 10 months after. The authors report in Efficacy of Non-Pyrethroid Indoor Residual Spraying or Intensive Behaviour Change Communication in Combination with Long-Lasting Insecticidal Nets for Malaria Control in West Africa: A Pragmatic, Cluster-Randomised, Controlled Trial, Lancet Glob Health. 2025 Sep; 13(9):e1605-e1616, https://doi.org/10.1016/s2214-109x(25)00216-5 that there was a “23% reduction in malaria incidence rate” in the ITN plus IRS group “and a 22% reduction” in the ITN plus BCC group compared with the control group. No IRS-related adverse effects were recorded. According to the authors, this “study provides the first trial-based evidence supporting the effectiveness of an intensive BCC intervention, which is a promising result but requires confirmation through additional studies.”
Notwithstanding the title of Alao JO & al.’s article, Socioeconomic and Educational Influences on Malaria Prevention and Treatment Behaviours in Rural Nigeria, BMC Public Health. 2025 Sep 24; 25:3079, https://doi.org/10.1186/s12889-025-24326-3, it seems to focus on prevention behaviors, and within that subject on ownership and use of ITNs. While over 97% of households interviewed owned ITNs, only about 70% acknowledged using them regularly. What the authors describe as paradox is that women with better education and higher income were less likely to sleep under the nets than others. Much of the discussion of the paper revolves around this finding.
Basiru A & al. conducted a “systematic review and meta-analysis aimed to ascertain the prevalence of ITN usage for malaria control among children in Africa” by conducting a literature search between 2013 and 2023. “The study population was children in Africa, the intervention was ITN utilization, and the prevalence of ITN use was the outcome.” As reported in Utilization of Insecticide-Treated Nets for Malaria Prevention Among Children in Africa: A Systematic Review and Meta-Analysis, Malaria J, 2025 Oct 23, 34:358, https://doi.org/10.1186/s12936-025-05599-w, the review “included 30 studies with 76,045 children, 50 households, and 1009 caregivers… The pooled prevalence of ITN utilization was 69.50% … Statistically significant heterogeneity was observed … ITN utilization was highest in Central Africa (85.44% …), followed by Southern Africa (80.7% …) and Eastern Africa (69.2% …), and lowest in West Africa (67.0%…).
Ilboudo H & al., Insecticide Resistance in Anopheles gambiae in Villages Around the Soum Agropolis in the Center-West Region of Burkina Faso, Malaria J, 2025 Sep 30, 24:297, https://doi.org/10.1186/s12936-025-05562-9 is a report on analyzing pyrethroid sensitivities in 720 collected mostly Anopheles gambiae s.l. mosquitoes. These “populations were resistant to deltamethrin, with mortality ranging from 2% … to 24.8%…” Mutations that promote pyrethroid resistance were found to be frequent.
Likewise, Tazokong HR & al. report high resistance rates to all pyrethroid insecticides they tested in various regions of Cameroon in Characterizing the Escalation of Pyrethroid Resistance and Its Impact on Bed Nets Efficacy Alongside Molecular Basis in Anopheles funestus from Cameroon, Malaria J, 2025 Sep 30, 24:308, https://doi.org/10.1186/s12936-025-05542-z. The article characterizes the genetics of resistance. The authors comment on the “inefficacy of pyrethroid-only” bed nets.
Further on overcoming insecticide resistance, Nounagnon J & al., Efficacy of Vector Guard, a Mosaic Alpha-Cypermethrin and Piperonyl Butoxide-Treated Net, for the Control of Pyrethroid-Resistant Malaria Vectors: A Non-Inferiority Experimental Hut Evaluation in Benin, Parasit Vectors. 2025 Oct 6; 18:397, https://doi.org/10.1186/s13071-025-07038-w is a report of comparison of “the entomological efficacy and wash durability of Vector Guard®, a novel mosaic alpha-cypermethrin-PBO ITN” with two WHO-approved products. The authors conclude that “Vector Guard® demonstrated superior entomological efficacy and wash durability compared to Royal Sentry® 2.0 and Olyset® Plus, and fulfilled WHO non-inferiority criteria for mosquito mortality and blood-feeding inhibition.”
“Control measures, such as insecticide-treated bed nets (ITNs), have been particularly successful for reducing malaria transmission because they exploit the nocturnal biting behaviour of the Anopheles spp. that vector malaria. However, shifts in biting behaviour to earlier or later hours when people are unprotected can undermine the efficacy of ITNs.” Oke CE & al., Biting Time of Day in Malaria Mosquitoes is Modulated by Nutritional Status, Malaria J, 2025 Sep 30, 24:307, https://doi.org/10.1186/s12936-025-05550-z shows that female Anopheles mosquitoes raised and fed in the laboratory have different propensities to bite during the day, specifically that those under nourished sought to bite during the day and night, while the well-nourished ones sought to bite only during the second half of the night. The authors comment on the potential beneficial side effects of sugar baits in this context.
While studying the genome of An. funestus, Boddé M & al. concluded that while “[v]ector control has resulted in strong signals of selection, with some resistance alleles shared across populations through gene flow and others arising independently, … a promising gene drive target in Anopheles gambiae is highly conserved in An. funestus. These insights will enable more strategic insecticide usage and gene drive deployment, supporting malaria elimination.” The article is Genomic Diversity of the African Malaria Vector Anopheles funestus, Science. 2025 Sep 18; 389(6766):eadu3596, https://doi.org/10.1126/science.adu3596.
Using data from seven different official surveys over 13 years, ending in 2020, Eshofonie F & al., Mapping of Access and Usage of Insecticide-Treated Nets in Nigeria, Malaria J, 2025 Oct 3, 24:315, https://doi.org/10.1186/s12936-025-05457-9 reports that there are “significant geographic and temporal variations in access to and use of bed nets, with notable disparities between northern and southern regions. For women of reproductive age, access to bed nets increased over time, particularly in northern states; however, usage remained generally low, especially in the south. Pregnant women exhibited similar patterns, with higher access in northern states but low usage overall, particularly in the southern regions. For children under five, usage increased in some northern states but remained low in the south, creating a clear north–south divide. Additionally, bed net availability at the household level remains low overall.”
Baykemagn ND & al. used machine learning algorithms to predict bednet usage among women and report in their article, Leveraging Machine Learning to Predict Mosquito Bed Net Utilization Among Women of Reproductive Age in sub-Saharan Africa, Malaria J, 2025 Oct 6, 24:317, https://doi.org/10.1186/s12936-025-05563-8, that “[a]ge above 34, being employed, frequent social media use, higher education, institutional deliveries, and female-headed households increased (sic) bed net use, while fewer ANC visits and being divorced decreased (sic) its use.”
Iwashita H & al. “focused on the importance of [ITNs] in malaria control in a study area where socio-economic disparities are widening. The objective was to assess the effectiveness of [ITN] ownership when nets were available for no more than two people, controlling for differences in socio-economic status (SES).” The authors found that in “middle SES households, sufficient [ITN] ownership was significantly associated with lower malaria infection status compared with insufficient [ITN] ownership (OR 0.32, 95% CI 0.12–0.92). In the low SES group, a similar trend was observed, although it was not statistically significant (OR 0.59, 95% CI 0.15–2.91). When middle and low SES groups were combined, sufficient [ITN] ownership remained significantly associated with lower incidence…” The article is Long-Lasting Insecticidal Net Ownership and Malaria Infection by Socio-Economic Status: A Cross-Sectional Household Study in an Area Along Lake Victoria, Kenya, Malaria J, 2025 Oct 22, 24:355, https://doi.org/10.1186/s12936-025-05528-x
Liu X & al., Comprehensive Lethal Effects and Transgenerational Impact of Metarhizium anisopliae on Anopheles sinensis Across All Life Stages, Pest Manag Sci. 2025 Sep 20, https://doi.org/10.1002/ps.70224 presents evidence that when mosquitoes are infected with Metarhizium anisopliae (Ma421), the results are “reduced hatching rates, impaired larval pupation and adult emergence, and … morphological deformities in newly emerged adults-such as malformed wings and legs-ultimately leading to mortality. Further analysis of Ma421 revealed a significant suppression of blood-feeding behavior, reduced egg-laying, and lower hatching, pupation and adult emergence rates in the next generation. These findings indicated that Ma421 induced transgenerational effects by decreasing reproductive success in subsequent generation, which is an important finding with promising implications for sustainable mosquito control.” Please also see Leaders above on this topic.
Sabtiu ARM & al. collected larvae in 15 locations in Accra and report in Larval Habitat Diversity, Physicochemical Characteristics and Their Effect on the Larval Density of Malaria Vectors in the City of Accra, Ghana, Malaria J, 2025 Sep 30, 24:299, https://doi.org/10.1186/s12936-025-05540-1 that the “sites were divided into five categories: irrigated urban farming (IUF); Lower Socio-economic Status (LS); Middle Socio-economic Status (MS); High Socio-economic Status (HS); and, Peri-urban (PU) areas … Drainage ditches were the most common habitat type … The highest abundance of An. gambiae s.l. was found in IUF sites …, especially during the rainy season … The predominant malaria vector was Anopheles coluzzii … Additionally, the presence of invasive Anopheles stephensi was detected in this study.”
Kailembo D & al. studied the effects of intermittent (3* per year, depending on rainfall), larviciding campaigns using two species of larvopathogenic bacteria over a 22-month period. They report in Large-Scale Intermittent Larviciding Intervention and Associations with Key Malaria Epidemiological Parameters in Tanga Region, Tanzania, Malaria J, 2025 Oct 17, 24:350, https://doi.org/10.1186/s12936-025-05548-7 that there was no significant drop in malaria incidence, nor any change in other epidemiologic parameters over the period. The authors raise the question whether continuous larviciding may yield different results. A companion piece to this article by the same group of authors is Diarra S & al., A Costing Analysis of an Intermittent Biolarviciding Intervention with Limited Epidemiological Effect in Tanga Region, Tanzania, Malaria J, 2025 Oct 23, 24:352, https://doi.org/10.1186/s12936-025-05553-w in which the “total cost of this intermittent biolarviciding intervention in the three councils over the two years was 3,354,672,133 TZS (1,397,198 USD), with an average cost pppy [per person protected per year] of 1,583 TZS (0.66 USD). … the cost of the procurement of biolarvicide had the greatest impact on the total cost. Continuous application of biolarviciding for six rounds per year would result in a cost pppy of 2,716 TZS (1.13 USD).”
Yared S & al. highlight the role of environmental variability in Anopheles stephensi Larval Habitat Superproductivity and Its Relevance for Larval Source Management in Ethiopia, Malaria J, 2025 Oct 22, 24:357, https://doi.org/10.1186/s12936-025-05589-y. The authors found that a relatively few urban water collections harbored the large majority of An. stephensi larvae in their study of an Ethiopian city in the Somali region.
Chemoprophylaxis
“Seasonal malaria chemoprevention (SMC) is a widely implemented malaria prevention strategy for children under five in the Sahel and sub-Sahel regions of Africa. [Owosu R & al.] aimed to estimate the full opportunity costs associated with SMC implementation in Mali, Burkina Faso and Senegal, addressing a gap in existing research that often focused solely on health system costs… Both financial and economic costs were analysed using an ingredients approach, encompassing direct and indirect costs…Total annual costs per child receiving four doses ranged from US$3.97 to US$6.05 for financial costs and US$11.85 to US$12.57 for economic costs. Notably, indirect costs, mainly related to productivity losses among caregivers, volunteers and healthcare workers, constituted 50%-66% of total economic costs.” The paper is Estimating the Opportunity Cost of Seasonal Malaria Chemoprevention Implementation in Burkina Faso, Mali and Senegal, BMJ Glob Health. 2025 Oct 2; 10(10):e018042, https://doi.org/10.1136/bmjgh-2024-018042.
“Seasonal Malaria Chemoprevention (SMC) and Vitamin A supplementation (VAS) are effective interventions that can be delivered through integrated health campaigns to reduce [child] mortality.” Oresanya OB & al. assessed ”the cost implications of integrating these two interventions among under-5 children in Northeast Nigeria” and found that “[i]ntegrating VAS with SMC campaigns increases the cost by US$0.24 per child [as compared to the cost of SMC alone], a modest increment considering the potential health benefits.” The authors do not comment on the cost per child incurred by VAS alone. The article is A Cost Analysis Comparing Seasonal Malaria Chemoprevention with and Without Vitamin A Supplementation Among Under-5 Children in Nigeria, PLoS One. 2025 Oct 8; 20(10):e0315655, https://doi.org/10.1371/journal.pone.0315655
Other
“Despite years of focus on malaria by Uganda’s Ministry of Health, the malaria incidence rate increased from 206 to 271 cases per 1,000 population between 2012 and 2022.” Fuller B & al. report in, From Endemic to Epidemic: A Qualitative District-Level Assessment of an Increase in Malaria Cases in the Elgon Region of Uganda, Am J Trop Med Hyg. 2025 Sep 25: tpmd250133, https://doi.org/10.4269/ajtmh.25-0133 that in the ten districts with the highest malaria rates, there were significant failures of prevention with seven of ten districts showing inadequate access to ITNs and three of ten not having effective IRS programs. In addition, eight of the ten districts also had a shortage of diagnostic kits.
Diagnosis
General diagnostics
None this month
Field diagnostics
“The introduction of malaria rapid diagnostic tests (RDTs) has expanded the parasitological confirmation of malaria …. However, concerns persist regarding healthcare worker adherence to RDT outcomes and the accuracy of RDT results recorded in health facility registers. Electronic RDT readers have been proposed to improve the consistency of interpretation and reporting.” Lindblade KA & al., Evaluating the Performance of an Artificial Intelligence-Based Electronic Reader for Malaria Rapid Diagnostic Tests Across Benin, Côte d’Ivoire, Nigeria and Uganda, Malaria J, 2025 Sep 30, 24:302, https://doi.org/10.1186/s12936-025-05522-3 is a report on assessing the performance of “an RDT reader using an artificial intelligence (AI) computer vision algorithm…” Over 100,000 RDT images were subjected to the reader, which “demonstrated high accuracy (96.8%) … compared with [an expert] panel interpretation.” However, the reader did not do well with invalid test results and there was apparent variation in the results obtained in the various countries. The authors recommend further refinement of the reader.
The reliability of RDTs based on the presence of histidine-rich protein (HRP) is challenged by the occurrence of gene deletions in parasites that lead to the absence of HRP. Mediavilla A & al., Analysis of pfhrp2 and pfhrp3 Gene Deletions, and the Structure and Variability of PfHRP2 and PfHRP3 Proteins: Implications for the Performance of Malaria Rapid Diagnostic Tests in Cubal, Angola, Malaria J, 2025 Sep 30, 24:296, https://doi.org/10.1186/s12936-025-05523-2 is a report on the prevalence of these gene deletions in parasite obtained from patients with malaria in a particular hospital. In this population, presumably from various points in the region, the prevalence of deletions was very low, with no double gene deletions at all. The authors consider the use of RDTs in this region justified but suggest continuing monitoring of deletions.
On the other hand, Louis JM & al. found that among 391 specimens of P. falciparum obtained from patients in two locations 15.0% and 10.4% respectively, were negative for both pfhrp genes. “All dual-deleted samples were false negative by RDT but were positive by microscopy and qPCR.” Apparently, these deletions had not been reported from Malawi before this time. “The presence of these deletions may compromise the performance of HRP2-based RDTs, indicating the need to reassess diagnostic strategies in affected regions.” The article is First Report of pfhrp2 and pfhrp3 Gene Deletions Compromising HRP2-Based Malaria Rapid Diagnostic Tests in Malawi, Infect Dis Poverty. 2025 Oct 9; 14:98, https://doi.org/10.1186/s40249-025-01368-8
New diagnostic methods
Ye Y & al., Advanced Clinical Diagnosis of Malaria Using a Simple Red-Emissive Smart Fluorescent Probe, Anal Chem. 2025 Oct 16, https://doi.org/10.1021/acs.analchem.5c04953 is a report on “DNA-specific fluorescent probes coupled with flow cytometry techniques [which have] emerged as … promising cost-effective diagnostic platform[s] for highly sensitive rapid detection of malaria … The DNA-specific fluorescent probe MR-1 revealed excellent cell permeability and localized in the cellular nucleus of both live and fixed cells.”
Treatment
Treatment results
Therapeutic efficacy studies in “Liberia conducted from December 2017 to May 2018 reported a PCR-corrected adequate clinical and parasitological response (ACPR) of 90.2% in Bensonville and 92.7% in Saclepea for artesunate–amodiaquine (ASAQ), and 100% in Kakata and Sinje for artemether-lumefantrine (AL).” Koko VS & al. conducted follow up studies in the communities on 305 children ages 6 to 59 months and report that among the 152 children treated with AL and 153 treated with ASAQ, parasitological testing at 3 days and at 28 days showed equal or greater than 94.4% clearance for ASAQ and 95.9% for AL, depending on the communities in the study. The authors mention that there were no side effects noted. The paper is Efficacy and Safety of Artemether-Lumefantrine (AL) and Artesunate-Amodiaquine (ASAQ) for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Liberia, 2022–2023, Malaria J, 2025 Oct 6, 24:319, https://doi.org/10.1186/s12936-025-055
Hanson H & al. conducted a single-arm (i.e. without controls) study of ASAQ treatment in 173 children agesd 2 to 11 years. Their article, Efficacy of Artesunate-Amodiaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria Among Children Aged 2–11 Years in the Asante Akim North Municipality, Ghana: A Single-Arm Open Trial, Malaria J, 2025 Oct 15, 24:341, https://doi.org/10.1186/s12936-025-05490-8, reports that by day 3 all children were parasite free and after 28 days, there was 92.07% of “adequate parasitological response.” Little over 8% of children experienced vomiting as a side effect. The authors also conducted genetic testing, and while they found no instances of kelch13 mutations (associated with artemisinin resistance), mutations associated with partial lumefantrine resistance were present in over 27% of specimens studied.
The synthetic artemisinin arterolane maleate has been in use for over a decade, though its use is apparently not widespread, despite the fact that it can be used once daily in combination with piperaquine, while other preparations require multiple doses per day. Awodele O & al., Arterolane and Piperaquine Vs. Artemether and Lumefantrine in Uncomplicated Malaria: A Randomized Study in Nigeria, Int J Infect Dis. 2025 Sep 29: 108084, https://doi.org/10.1016/j.ijid.2025.108084 is a Phase IV (i.e. post-introduction) study, comparing it to the more standard AL regimen. The results in 350 adolescents and adults split in two groups indicated comparable outcomes at 28 and 42 days, i.e. both regimens with over 98% clearance. There were no significant adverse effects noted.
Side effects and complications
“Adding single low-dose (0.25 mg/kg) primaquine (SLDPQ) to block Plasmodium falciparum transmission is now a WHO recommendation. Whether SLDPQ increases haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) patients, leading to increased folate demand and impaired haemoglobin (Hb) recovery is unknown.” Ajayi S & al. sought to answer this question. They report in Plasma Folate Dynamics in Plasmodium falciparum-Infected African Children Treated with Artemisinin Combination Therapy and Single Low-Dose Primaquine or Placebo, Malaria J, 2025 Oct 15, 24:342, https://doi.org/10.1186/s12936-025-05567-4 that among 408 children studied, “SLDPQ and G6PD status did not compromise posttreatment plasma folate concentrations in young children with acute uncomplicated falciparum malaria, providing additional evidence of SLDPQ safety and supporting its use without G6PD testing.”
Guidelines
Muyokani BN & al., The Effect of Non-Adherence to Treatment Guidelines, Quantification and Distribution Practices on Antimalarial Commodities Inventory Levels in Healthcare Facilities at Turkana County, Kenya, Malaria J, 2025 Sep 30, 24:298, https://doi.org/10.1186/s12936-025-05560-x reports that among 132 health care facilities in the area studied, only 35 (25.6%) adhered to treatment guidelines, based on answers to questionnaires. “The facilities that adhered to test and treat [guidelines] had lower average months of stock (9.5) of commodities in all categories, compared to those that treated more patients than those confirmed malaria-positive (13.2).” The article does not reflect on patient outcomes.
Drug resistance
Sulfadoxine-pyrimethamine is the WHO-recommended regimen for IPTp and is used in other chemoprevention regimens as well. Yet as of late, resistance of P. falciparum to this regimen has been noted. Bungei J & al., Regional Variation in Sulfadoxine-Pyrimethamine Resistance Genotypes and Haplotypes of Plasmodium falciparum Dihydrofolate Reductase and Dihydropteroate Synthase Genes in Western Kenya, Malaria J, 2025 Oct 1, 24:310, https://doi.org/10.1186/s12936-025-05570-9 is a description of detailed genetic study of the parasites in a variety of regions of Kenya, with the results that show that the mutations causing resistance are present to variable extent in all regions.
Investigating the causes of artemisinin resistance in Rwanda, Muvunyi CM & al. discovered that in different parts of the country, different mutations of the same gene (kelch13) were prevalent. In response, the primary drug combinations used against uncomplicated P. falciparum infections were tailored according to regions. In their article, Strategies for Mitigating Emerging Artemisinin-Based Antimalarial Drug Resistance in Rwanda: A Promising Approach for Managing Therapies in Malaria-Endemic Countries, BMJ Glob Health. 2025 Oct 2; 10(10):e020884, https://doi.org/10.1136/bmjgh-2025-020884, the authors recommend similar investigations and response in other African countries where resistance arises.
“… the kelch13 gene [is] the primary known determinant of artemisinin resistance. Although extensive surveillance data on these markers is available, it is distributed across many literature studies and open databases.” Balmer AJ & al. aggregated “spatiotemporal data for 112,933 P. falciparum samples collected between 1980 and 2023 into a single resource, providing the most comprehensive overview of kelch13 markers to date. [The authors] outline the history and current status of these mutations globally, with particular focus on their emergence in Southeast Asia and East/Northeast Africa. They conclude in Understanding the Global Rise of Artemisinin Resistance: Insights from Over 100,000 Plasmodium falciparum Samples, Elife. 2025 Oct 2; 14:e105544, https://doi.org/10.7554/elife.105544 that the recent increases in artemisinin resistance in Africa “mirror patterns observed in Southeast Asia 10-15 years ago. [The authors] examine factors that may influence its spread, including fitness costs, treatment strategies, and local epidemiological dynamics, before discussing potential scenarios for how resistance may spread in Africa in coming years.”
Studying blood samples from 1582 patients in various healthcare facilities, Mazigo E & al. found new patterns of drug resistance in P. falciparum samples. As they report in Emergence of Chloroquine-Sensitive Plasmodium falciparum and Rising Resistance to First-Line Artemisinin Partner Drugs in Malawi, Emerg Microbes Infect. 2025 Oct 8: 2572679, Https://Doi.Org/10.1080/22221751.2025.2572679, “[n]o resistance-associated mutations were detected in pfk13 and pfcrt genes, supporting continued susceptibility to artemisinin derivatives and chloroquine (CQ). However, the pfmdr1-NFD haplotype, linked to reduced lumefantrine (LUM) susceptibility, was present in [42.9% of] isolates. Notably, the [mutation], associated with high-level sulfadoxine-pyrimethamine (SP) resistance, was found [in 87.5%] of isolates. These findings highlight the ongoing risk of declining efficacy of LUM partner drugs in artemisinin-based combination therapies (ACT) and reduced SP effectiveness for intermittent preventive treatment in pregnancy (IPTp).”
New drug research
Handford MJ & al., Discovery of Amodiachins, a Novel Class of 4-Aminoquinoline Antimalarials Active Against Multidrug-Resistant Plasmodium falciparum, J Med Chem, 2025 Oct 2, https://doi.org/10.1021/acs.jmedchem.5c00936 describes the studies the authors conducted with the experimental drug against P. falciparum in the laboratory as well as the tests against the mouse model of malaria. The conclusions included “antiparasitic activity, metabolic stability, and in vivo efficacy … [as well as] minimal cytotoxicity,…”
Although not a report on new drugs, Mombo-Ngoma G & al., Making the Most of Existing Antimalarial Medicines: A Single Dose Cure with Sulfadoxine–Pyrimethamine Plus Artesunate–Pyronaridine, Malaria J, 2025 Sep 30, 24:300, https://doi.org/10.1186/s12936-025-05559-4 espouses the use of single dose treatment with the drug combination mentioned in the title of the article. The authors cite compliance problems and resistance problems with the current three-day regimen of artemisinin combination therapy and suggest intensive study of the outcome of their proposed regimen.
Plant extracts and traditional treatments
“Medicinal plants have long been used as a primary healthcare resource for treating malaria and other diseases globally.” In a literature review by Wassie AT & al., Plant-Derived Secondary Metabolites for Malaria Treatment: Extraction, Mechanisms, and Therapeutic Potential, Z Naturforsch C J Biosci. 2025 Sep 10, https://doi.org/10.1515/znc-2025-0037, a “total of 34 medicinal plants were identified, along with details on extraction techniques and factors influencing metabolite efficacy. Key secondary metabolites include alkaloids, flavonoids, terpenoids, and their derivatives (e.g., quinine, artemisinin, quercetin, chalcones). This review highlights their mechanisms of action and their promise as templates for developing novel drugs to combat both drug-sensitive and drug-resistant malaria strains.”
Chamomile has been used since Greek and Roman times throughout the world as a medicinal herb. Applying modern research technology, Farzaneh Z & al. combined an extract of the plant with magnesium oxide nanoparticles into “quasi-spherical MgO NPs with particle sizes ranging from 30 to 80 nm.” They applied these against laboratory strains of P. falciparum. Their paper, Antimalarial Potential of Matricaria chamomilla-Derived MgO Nanoparticles Against Plasmodium falciparum Strains: An Experimental Study, BMC Complement Med Ther. 2025 Oct 8; 25:360, https://doi.org/10.1186/s12906-025-05081-9 reports that “green-synthesized MgO NPs exhibited in vitro antiplasmodial activity against both chloroquine-sensitive and chloroquine-resistant P. falciparum strains. These findings support further investigation into their potential applications as antimalarial agents in preclinical models.”
de Mendonça Lima T & al. report on eight studies, published between 2001 and 2022 about the anti-Plasmodium effects of cannabis-derived products. “Most in vitro studies focused on assessing antimalarial activity through half-maximal inhibitory concentration (IC50), which ranged from 0.16 to 4.1 μg/mL, indicating mild to high activity. For the in vivo studies, all reported positive effects, including moderate antimalarial activity and disease tolerance. The toxicity profile of these compounds has not been extensively studied…” The article is Cannabis-Derived Compounds Against Plasmodium sp.: A Systematic Review of Preclinical Studies, Trop Med Int Health. 2025 Oct 15, https://doi.org/10.1111/tmi.70044
Other
Most of the articles reviewed by Agimas MC & al. in their article, Prevalence and Associated Factors of Delay in Seeking Malaria Treatment Among Under Five Children in the Horn of Africa: A Systematic Review and Meta-Analysis, PLoS One. 2025 Sep 26; 20(9):e0333593, https://doi.org/10.1371/journal.pone.0333593, originated in Ethiopia. All the same, the findings seem congruent with other articles published on the subject from other parts of the world including risk for delay was greater in families with female heads, history of prior child death, greater than 3000 m from treatment facility, poverty, and lack of formal education. Overall, the authors calculated a 48% rate of delay (defined as more than 24 hours after onset of illness) in diagnosis and treatment.
Akinrinade OT & al. studied 301 families with children under five, with respect to their knowledge about malaria and behavior when suspecting that their child may have malaria. While 84.4% of caregivers identified infected mosquito bites as the cause of malaria, and 98.3% recognized fever as a main symptom, only 51.2% demonstrated good overall knowledge of malaria and symptoms in under-five children. Although 94.0% of caregivers suspected malaria in their under-five children within 12 months prior to the study, … only 9.3% visited a health facility for treatment of their under-five children. In contrast, 37.4% purchased drugs from patent medicine vendors and pharmacies, while 25.2% used herbs for home management.” (It is unclear what the other 28% did.) The article is Care-Seeking Behaviour of Caregivers for Suspected Malaria in Under-Five Children in a Southwestern State of Nigeria, Malaria J, 2025 Oct 6 24:318, https://doi.org/10.1186/s12936-025-05433-3.
In East Africa, Ochieng G & al. report on the same issue in Determinants of Timely Malaria Treatment Among Under-Five Children Attending Public Health Facilities in Kisumu East Sub-County, Kenya: A Health Facility-Based Cross-Sectional Study, Malaria J, 2025 Oct 15, 24:344, https://doi.org/10.1186/s12936-025-05420-8. In their study of the caregivers of 434 children with malaria, close to 40% sought medical care after 24 hours of the onset of symptoms. While that is not as troublesome as the results of Akinrinade & al., the authors rightly call for “relevant stakeholders to … educate caregivers about under-five malaria symptoms in order to promote timely malaria treatment.” Findings included the following: “Belief in use of appropriate malaria drugs was associated with higher odds of timely treatment … Additionally, having health insurance cover was associated with higher odds of timely treatment … Those who visited herbalists before seeking care were less likely to receive timely treatment … Fear of drugs’ side effects reduced the odds of timely treatment.”
Campaigns and Policies
“Low-income and middle-income countries continue to face challenges in financing health programmes due to budgetary constraints and decreased donor funding. Off-budget financing has become crucial for controlling diseases like malaria, HIV/AIDS and tuberculosis (TB).” Ngadaya FD & al. gathered insights on how toc deal with this situation “from 76 purposely selected stakeholders, including policymakers, programme managers, regional health managers, district health managers and healthcare workers and report in Stakeholders’ Perspectives on Funding Malaria, HIV/AIDS and Tuberculosis Services in Tanzania Through Domestic Resources Mobilisation: A Qualitative Study, BMJ Public Health. 2025 Sep 29; 3(2):e001861, https://doi.org/10.1136/bmjph-2024-001861 that the “proposed alternative domestic funding strategies included establishing universal health insurance, reducing beneficiaries of service exemptions, establishment of disease-specific funds and taxation of certain products. Implementation challenges for the proposed strategies included poor awareness, conflicting political promises and accountability issues.”
Delivering healthcare services and supplies faces serious barriers in an environment of high conflict, such as that in parts of Nigeria, is the subject of Adeniyi L & al., Delivering an Insecticide-Treated Net Campaign in a Complex Operating Environment: Lessons from Anambra State, Nigeria, Malaria J, 2025 Oct 2, 24:313, https://doi.org/10.1186/s12936-025-05529-w. As a result of meticulous planning, “11 out of the 21 [local government areas (LGAs)] in Anambra state were classified as high security risk. The adapted campaign strategy was implemented across all 11 LGAs. During the campaign 3,850,316 ITNs were delivered to 1,245,548 households across all 21 LGAs in the state. Engaging with community leaders and security agencies during the planning and implementation phases was critical for ensuring the safe delivery of ITNs to households in high-risk areas.”
Kyei C & al. found that while “[t]esting and treating for malaria were high among health facilities in the three zones [of Ghana studied by the authors], tracking of patients was very low across the zones. Their study, reported in Adherence to The Test, Treat and Track Malaria Policy Among Selected Health Facilities in Ghana: The Clients’ Perspective, Malaria J, 2025 Oct 14, 24:339, https://doi.org/10.1186/s12936-025-05467-7 relied on interviews with “590 patients and 30 health facility managers … from 30 facilities in 6 districts across the three zones… Health facilities in the southern zone of Ghana had 2.87 increased odds of adhering to the T3 policy compared to the middle zone … Males were more likely not to return to the health facility for review or more likely to miss home visit”
Although primarily focusing on immunology, Kofi Tey P & al.’s article, Increased Plasmodium falciparum EBA175RIII-V Antibody Titres Despite a 13-Month Malaria Mass Testing, Treatment, and Tracking Intervention in a High Malaria Endemic Community in Ghana, Malaria J, 2025 Oct 14, 24:340, https://doi.org/10.1186/s12936-025-05514-3 also reports that despite the extended malaria mass testing, treatment, and tracking (MTTT) intervention, the incidence of malaria over the study period was high (67.5% among 314 participants) and the prevalence was reduced from 56.2% at baseline only to 46.8% at the end of the study. Furthermore, the authors detected no significant effect on naturally acquired immunity.
“[T]he experiences of many countries in [sub-Saharan Africa] show that the implementation of various packages of malaria control interventions in areas of low to moderate transmission can achieve a significant reduction in the disease burden but ultimately fail to interrupt malaria transmission… [B]ased on evidence from the literature focusing on Uganda,” Ranjbar M & Opigo J, Integrated Vector and Parasite Management for Malaria Control in High-Endemic Areas: Pummel and Pin Strategy to Prevent Malaria Setbacks, Malaria J, 2025 Oct 17, 24:349, https://doi.org/10.1186/s12936-025-05538-9 “presents a novel approach—the Integrated Vector and Parasite Management (IVPM)—for endemicity reduction and maintaining hard-earned gains following reduction of malaria endemicity intensity in high-endemic areas. In line with IVPM, the article also proposes the ‘Pummel and Pin’ strategy, outlining an implementation framework for IVPM. The IVPM Pummel-and-Pin model emphasizes the need to reduce both the parasite reservoir and vectorial capacity, highlighting the often-neglected Pin strategy as essential to sustaining achieved reductions in endemicity without any lag.”
Even though it includes data derived from interview’s, Chestnutt EG & al.’s article, Accelerating Nigeria Towards Malaria Elimination Requires Moving Away from Business as Usual: Insights from a Political Economy Analysis, Int Health. 2025 Oct 7: ihaf113, https://doi.org/10.1093/inthealth/ihaf113 is more a position paper than research report. The authors state: “Achieving meaningful progress in malaria elimination in Nigeria requires predictable financing from sustained political will. Demand from citizens is essential to encourage political prioritisation. Programs and partners must also be better coordinated to maximise impact with limited resources. Establishing high-level malaria advocacy groups and integrating malaria priorities into the national development plan would support these efforts.”
Epidemiology
Climate change, biodiversity and environment
Chivasa T & al., reviewed “the literature to synthesise historical and current evidence regarding the impact of climate change on malaria transmission and management” in Zimbabwe. Their article, Impact of Climate Change on Malaria Transmission and Management in Zimbabwe: A Scoping Review of the Literature, Health Serv Insights. 2025 Sep 17; 18:11786329251374245, https://doi.org/10.1177/11786329251374245 includes infromation from 22 relevant published articles. “Most reviewed studies have consistently demonstrated that climate change is shifting the geographic distribution, trends, timing, and intensity of malaria transmission in Zimbabwe. However, others have emphasised the key role of non-climatic human, ecological, and health system factors and intervention coverage in shaping malaria transmission dynamics. Overstretched health systems and the uncertain effectiveness of existing interventions in a changing climate pose significant challenges to malaria management.”
Amara MF & al. collected Anopheles mosquitoes and classified them, followed by analyzing the Plasmodium species they carried in the wet and dry seasons in a Sahel country. As they report in Influence of the Dry and Humid Seasons on the Assessment of Human Exposure to Malaria Vector Bites in Bobo-Dioulasso, Burkina Faso, Acta Trop. 2025 Oct 9: 107866, https://doi.org/10.1016/j.actatropica.2025.107866, “three species of the An. gambiae complex were identified: An. arabiensis (91.20%), An. coluzzii (5.09%), and An. gambiae (3.71%), with the latter absent during the dry season. Plasmodium falciparum infections were detected year-round, with 0.16% of mosquitoes carrying dual infections (Plasmodium falciparum and Plasmodium malariae) in July.”
Risk factors
As other articles in the past, Nikiema M & al., Housing and Household Characteristics Associated with Malaria Vectors Abundance and Clinical Malaria Incidence in a Semi-Urban and a Rural Area of Burkina Faso, Malaria J, 2025 Sep 26, 24:292, https://doi.org/10.1186/s12936-025-05520-5 reports that while “… the number of infected mosquitoes, and the presence of human malaria cases didn’t vary significantly according to wall type, roof type, the presence of breeding sites, and the use of ITN. However, the vegetation around the houses was positively associated with mosquito abundance …, vector infection …, and the presence of malaria cases … The presence of children under five years of age …, female householder … were also significantly associated with the human malaria cases.”
Aguti M & al. surveyed 2728 pregnant women in the course of a study of IPTp over 42 months and found that “38.1% had parasitemia at enrolment, 6.5% had parasitemia following initiation of IPTp, 6.4% had high-grade placental malaria, and 6.8% of live births had low birth weight. Parasitemia at enrolment was more common in those 16-21 years of age …, primigravida …., and living in traditional houses.” Their paper, Maternal and Household Risk Factors for Malaria in Pregnancy and Low Birthweight: A Prospective Cohort Study from Uganda, Res Sq. 2025 Sep 17: rs.3.rs-7514414, https://doi.org/10.21203/rs.3.rs-7514414/v1 is published in Research Square, an electronic publication of papers that have not undergone peer review.
Fakih BS & al. report that among 7286 individuals who had not traveled off the island of Zanzibar, 2.6% tested positive for malaria by qPCR. They report in Determinants of Locally Acquired Malaria Infections in Zanzibar: A Cross-Sectional Study, Malaria J, 2025 Oct 16, 24:346, https://doi.org/10.1186/s12936-025-05524-1 that Individuals living in neighbouring or nearby index households had significantly lower odds of malaria infection … compared to those residing in the index households. Individuals aged 5–15 and 16–25 years had higher odds of malaria infection compared to older age groups …. Locally acquired infections were more likely in people living in houses with windows open …, but significantly lower among members of households with bed nets …, higher in those going to sleep early and in people living in areas with a moderate local index of wetness.”
General epidemiology
Based on analysis of blood specimens from two blood donor centers, Sawadogo S & al. conclude that this population may form the basis of more broad-based estimates of parasite prevalence in the community. To quote from their article (not the abstract), Blood Donors as a Sentinel Population for Real-Time Malaria Surveillance Using the Sysmex XN-31: A One-Year Review from the National Blood Transfusion Centre in Burkina Faso, Malaria J, 2025 Sep 23, 24:288, https://doi.org/10.1186/s12936-025-05588, “[a]lthough blood donors are not fully representative of the general population due to demographic selection biases, they may still be useful for identifying trends within their communities, especially when sampled consistently across time and space.” {Given the inherent self-selection of blood donors and would-be donors, this reviewer has difficulty accepting this premise.}
Zhang X & al., Human Genetic Variations Conferring Resistance to Malaria, J Transl Med. 2025 Sep 24; 23:997, https://doi.org/10.1186/s12967-025-07017-w reviews human genetic variations such as sickle cell hemoglobin that confer some resistance to malaria. The authors hold out hope that better understanding of the mechanisms by which the resistance is conferred to the host, more broadly-based resistance may be stimulated in the general population.
Hou MM & al. conducted human experiments to study the immunity that individuals develop to clinical P. vivax reinfections, even while the parasite may reinfect but not cause clinical disease. In Development of Clinical Immunity to Plasmodium vivax Following Repeat Controlled Human Malaria Infection, Nat Commun. 2025 Sep 25; 16:8385, https://doi.org/10.1038/s41467-025-63104-y, the authors conclude that while no antibodies to the parasite are discernible on reinfection, cellular mechanisms of immunity protect against the disease. The protection does not extend to infection with P. falciparum.
Munsey A & al. examined whether collecting malaria-related information during first antenatal visits of pregnant women (ANC1) compares reasonably with household (HH) surveys, which are resource-intensive. Their conclusion, described in Antenatal Care Surveillance for Monitoring Malaria Prevalence and Intervention Coverage: A Multicountry Analysis, BMJ Glob Health. 2025 Sep 30; 10(9):e018572, https://doi.org/10.1136/bmjgh-2024-018572, is that “[e]stimates of malaria prevalence and ITN coverage derived from ANC1 attendees correlate well with HH survey estimates and may be useful in monitoring malaria prevalence and prevention efforts. In contrast, data on treatment-seeking does not appear useful.”
“Malaria control in sub-Saharan Africa is typically focused on Plasmodium falciparum (Pf), but non-falciparum species like P. ovale curtisi (Poc) and P. ovale wallikeri (Pow) appear to be rising in prevalence, especially in parts of East Africa.” Carey-Ewend K & al., Seasonal Variation and Interspecies Dynamics among Plasmodium falciparum and ovale Species in Bagamoyo, Tanzania, J Infect Dis. 2025 Sep 30: jiaf498, https://doi.org/10.1093/infdis/jiaf498 reports that “P. ovale species in coastal Tanzania … [are] frequently present when P. falciparum recedes, but also co-infect the same hosts during the short wet season. Meanwhile, the individual Poc and Pow species often co-exist within individuals, perhaps due to co-transmission or concurrent relapse.”
Bardoe D & al. studied 456 pregnant women in a single municipality in Ghana and report in Malaria in Pregnancy: A Holistic Exploration of Synergistic Association Through Environmental, Sociocultural, and Socioeconomic Lenses in Pru East Municipality, Ghana, Malaria J, 2025 Oct 2, 24:314, https://doi.org/10.1186/s12936-025-05575-4 that 21.5% were positive for malaria, about 2/3 of them caused by P. falciparum. Key environmental (proximity to stagnant water, refuse sites, Volta Lake, livestock shelters), sociocultural (spiritual attribution, illness confusion, plant repellents, outdoor sleeping), and socioeconomic (rural residence, delayed ANC initiation, limited media exposure, [ITN] use, IPTp-SP uptake, health insurance) factors were strongly associated with” the presence of malaria in these women. The authors recommend that malaria control strategies “should go beyond biomedical interventions to incorporate community-based environmental management, sociocultural engagement, and socioeconomic empowerment. Such a multidimensional approach is essential to achieving sustainable reductions in malaria burden among vulnerable populations and improving health outcomes.”
In order to conduct epidemiologic surveillance, there must be trust in the accuracy of diagnosis. Ngufor C & al., Are Malaria Rapid Diagnostic Test Results Stable Over Time to Support Verification of Surveillance Data? Malaria J, 2025 Oct 22, 24:356, https://doi.org/10.1186/s12936-025-05595-0 tested over 45,000 RDT kits that gave positive and negative results to determine whether examining them one month after their field application they were still showing the same result. The Positive Predictive Value of a positive result at one month was 96.3%, while the Negative Predictive Value of a negative result was 93.8%. The authors conclude that one month after diagnostic testing, the RDT kits may be used for surveillance purposes.
Spatiotemporal studies
Blanford JI & Kioko C, A Multidimensional Space-Time Geospatial Analysis for Examining the Spatial Trends of Vector-Borne Diseases: 20 Years of Malaria in Kenya, Acta Trop. 2025 Sep 12: 107839, https://doi.org/10.1016/j.actatropica.2025.107839
Yitageasu G & al., Malaria Prevalence and Its Determinants Across 19 Sub-Saharan African Countries: A Spatial and Geographically Weighted Regression Analysis, Malaria J, 2025 Sep 30, 24:305, https://doi.org/10.1186/s12936-025-05573-6
Challe DP & al., Temporal and Spatial Trends of the Prevalence of Infections Caused by Plasmodium Parasites Among Rural Community Members in Three Regions with Varying Transmission Intensities in Mainland Tanzania, Malaria J, 2025 Sep 30, 24:301, https://doi.org/10.1186/s12936-025-05530-3
Challe DP & al., Prevalence and Risk Factors Associated with Infections Caused by Plasmodium Parasites at Micro-Geographic Level in Three Villages of Muheza District in Tanga Region, North-Eastern Tanzania, Malaria J, 2025 Oct 1, 34:312, https://doi.org/10.1186/s12936-025-05506-3
Tchiekoi NB & al., Malaria Epidemiology in the Korhogo Area, Northern Côte d’Ivoire: Baseline Assessment Prior to a Randomized Controlled Trial, Malaria J, 2025 Oct 1, 24:309, https://doi.org/10.1186/s12936-025-05571-8
Abesig WJ & al., Trend of Malaria Test Positivity Rate Among Pregnant Women, Savannah Region, Ghana, 2018-2022, BMC Pregnancy Childbirth. 2025 Oct 8; 25:1051, https://doi.org/10.1186/s12884-025-08157-z
White SJ & al., Epidemiology of Ovale, Vivax and Falciparum Malaria in the Highlands of Cameroon: An Integrated Community Survey of Human Infection and Vector Abundance, PLoS Negl Trop Dis. 2025 Oct 10; 19(10):e0013549, https://doi.org/10.1371/journal.pntd.0013549