News
On 10 December 2025, WHO published an Excel file entitled Compendium of molecular markers for antimalarial resistance. It is available at https://www.who.int/tools/compendium-of-molecular-markers-for-antimalarial-drug-resistance.
Penn State University announced on 13 January that a “team of researchers from Penn State and Warwick University has been awarded a $1.6 million international Belmont Forum’s Collaborative Research Action project by the U.S. National Science Foundation and UK Research and Innovation’s Natural Environment Research Council (NERC). Led by Penn State researchers, the project will explore how building design, infrastructure and development decisions can help reduce malaria risk worldwide.”
Peer Reviewed Articles
The issue raised last month about Malaria Journal has been resolved. PubMed cites these peer-reviewed articles without the caution they express with articles in medrxiv.com and biorxiv.com; therefore, these articles are reported, just as those from other journals that publish articles first online, before final stylistic and editorial review.
Prevention
Vaccines
Based on focus group discussions with 20 caregiving parents of children aged 11-30 months, Anye JC & al., Awareness, Perception and Influences on Uptake of the RTS,S/AS01 Malaria Vaccine Among Caregivers for Children Under 5 Years in South West Region, Cameroon, Malaria World J, 2025 Dec 15, 16:21, https://doi.org/10.5281/zenodo.18008087 reports that “caregivers in the urban setting had high awareness of the malaria vaccine, though understanding was often limited and sometimes confused with other malaria interventions. Rural caregivers displayed uneven awareness but strong trust in health workers, which positively influenced acceptance. Across both settings, perceived benefits such as reduced severity of malaria episodes enhanced confidence in the vaccine. Barriers included communication gaps, misinformation, gender dynamics, long waiting times, and distance to health facilities.”
“Two licensed vaccines block Plasmodium falciparum malaria sporozoites through anti-circumsporozoite protein antibodies. In animal models, intradermal (ID) sporozoites are more readily blocked than intravenous sporozoites. [Kapulu MC & al.] hypothesized that this complicates human studies, where infectious mosquito bites deliver a mixture of ID and venous sporozoites.” They used the R21/Matrix M vaccine in their trial, described in Malaria Vaccine Protection Against Intradermal or Venous Parasites: A Randomized Phase 2b Human Challenge Trial, Nature Med. 2026 Jan 6, https://doi.org/10.1038/s41591-025-04107-6. The authors concluded that R21/Matrix-M (three injections) was highly protective against controlled human malaria infection using intradermal inoculation of sporozoites, but not against direct venous injection of sporozoites. The implication of these results is unclear.
Kone M & al., Efficacy of ProC6C-AlOH/Matrix-M Against Plasmodium falciparum Infection and Mosquito Transmission: A Phase 2, Randomised, Controlled Human Malaria Infection Study, Lancet Infect Dis, 2025 Dec 16, https://doi.org/10.1016/S1473-3099(25)00664-4 is the description of the results of a trial of a multi-stage vaccine (against sporozoite and transmission stage) in 34 African adults, (17 vaccinated and 17 receiving rabies vaccine) who underwent inoculation of P. falciparum three months after the last of three vaccine treatments four weeks apart. At 28 days afterwards, 13 of 16 control individuals and 6 of 16 vaccinated ones were found to have P. falciparum by polymerase chain reaction (PCR) testing. The authors state that this represents 54% efficacy. Side effects in both vaccinated and control groups were frequent but mild.
A number of projects aimed at creating an antimalarial vaccine more effective than the ones currently in use aim at different proteins within the parasite. Ba A & al., Genetic Diversity in the Plasmodium falciparum Next-Generation Blood Stage Vaccine Candidate Antigen PfCyRPA in Senegal, Sci Rep, 2026 Jan 18, https://doi.org/10.1038/s41598-026-36257-z is a report on one such vaccine aimed at the blood stage of P. falciparum. Based on 93 clinical isolates of the parasite, the article reports the existence of 15 different genotypes. While most of them made no difference in terms of predicted interactions with antibodies induced by the vaccine, the authors caution about proceeding with vaccine development without further identification of genetic influences.
Hamza DAA & al. queried 222 health workers (almost half pharmacists) in Sudan about their knowledge and attitude toward vaccination against malaria. Their results were troubling: “Only 9% (n = 20) demonstrated adequate knowledge of malaria vaccination, and 21.6% (n = 48) displayed positive attitudes. While 66.2% (n = 147) had heard of malaria vaccines, 71.2% (n = 158) were unaware of WHO recommendations, and 76.6% (n = 170) did not know the vaccine’s target parasite. Negative attitudes were reported by 78.4% (n = 174), particularly concerning safety, affordability, and trust in authorities. Positive attitudes were more common among males, HCWs with > 5 years of experience, and those in the private sector…” The paper is Preliminary Insights into Knowledge and Attitudes Toward Malaria Vaccination Among Sudanese Healthcare Workers: An Exploratory Cross-Sectional Study, Malaria J, 2025 Dec 20, 24:454, https://doi.org/10.1186/s12936-025-05758-z
Puleh SS & al., Caregivers Awareness, Knowledge, Attitudes, and Perceptions Towards Malaria Vaccine in Kole and Kwania Districts, Northern Uganda, Malaria J, 2026 Jan 23, https://doi.org/10.1186/s12936-026-05789-0 is another article probing the public’s perception of the new program of vaccinating children against malaria. Based on interviews with 574 caregivers of children, the authors found that between 55 and 60 percent of responders displayed a positive attitude, despite their knowledge about the R21/Matrix-M vaccine used in Uganda being incomplete. While these results are better than those reported in Sudan (above), the authors emphasize “five central themes: caregivers’ knowledge and awareness of the malaria vaccine; enduring community misconceptions; mixed attitudes reflecting trust, and fear; and perceptions related to vaccine’s safety, effectiveness, and value for child-health.”
Welaga P & al. report on household medical conditions prior to malaria vaccination, as they were prior to the introduction of the RTS,S vaccine in 2019, as part of WHO sanctioned pilot study. Their report, The Malaria Vaccine Implementation Programme Study Area In Ghana: Results of a Household Survey Prior to the Introduction of the RTS,S/AS01 Vaccine, Malaria J, 2026 Jan 12, https://doi.org/10.1186/s12936-025-05778-9 is based on an extensive sample of over 6000 households. “About 87%, … of all households owned at least one [insecticide-treated net (ITN)], and 62%, 95%CI (59–64) of children aged 5–48 months slept under an [ITN] the night before the survey. Additionally, 22%, … of children reported having fever in the two weeks preceding the survey; among those with reported fever, 72%, … sought advice or treatment, 40% … were tested for malaria, and 42% … of those with fever took an antimalarial drug. … Coverage of [routine] vaccines was > 90%.”
Vectors
Using immunologic markers in 568 children, Traore I & al. investigated the efficacy of insecticide treated nets (ITNs) in 30 villages over three years. They found high usage (75%), but deterioration of durability especially in one brand of ITNs. The evidence, as reported in their paper, Durability and Effectiveness of Insecticide-Treated Nets in Mali: A Longitudinal gSG6-P1 Biomarker-Based Assessment of Children’s Exposure to Anopheles Bites, Malaria J, 2025 Dec 29, 24:456, https://doi.org/10.1186/s12936-025-05677-z was that antibody levels in children using the less durable nets were higher at the end of the study than in users of the other. That signified a higher number of bites by Anopheles mosquitoes.
Nkya TE reviews the history of insecticide resistance by malaria vectors in Tanzania over the past 11 years in Insecticide Resistance Management in Malaria Vectors in Tanzania Mainland (2015-2024): A Scoping Review, Trop Med Int Health. 2025 Dec 3, https://doi.org/10.1111/tmi.70063, based on ten articles on the subject. “Pyrethroid resistance was consistently reported, largely driven by knockdown resistance (kdr) mutations and metabolic mechanisms. DDT resistance was common, while moderate resistance to carbamates appeared in about half of the studies. Organophosphates, particularly pirimiphos-methyl, remained effective and new insecticides such as clothianidin and chlorfenapyr showed high efficacy with no resistance detected.”
“As insecticide resistance spreads in Africa, next-generation insecticide-treated nets (ITNs) are increasingly being deployed to protect vulnerable populations against malaria. While these nets provide greater entomological efficacy against resistant mosquitoes, their effectiveness against malaria transmission also depends on other factors, such as durability, access, usage, and activity patterns of hosts and vectors.” Champagne C & al., Cascades of Effectiveness of Next-Generation Insecticide-Treated Nets Against Malaria, from Entomological Trials to Real-Life Conditions, Nat Commun. 2025 Dec 16; 16(1):11162, https://doi.org/10.1038/s41467-025-66130-y quantifies “the impact of two next-generation ITNs, namely Interceptor®G2 (chlorfenapyr-pyrethroid) and Olyset® Plus (piperonyl butoxide-pyrethroid), in a cascade from entomological efficacy to population-level effectiveness. …. [The authors] found that, beyond entomological factors, operational factors including functional survival, ITN use and in-bed exposure critically impact ITN effectiveness overall and per ITN types.”
Oruni A & al. tested several second generation ITNs in settings of high mosquito resistance to pyrethroid insecticides. They report in Chlorfenapyr Bednets Effectively Overcome Pyrethroid Resistance Escalation in Highly Resistant Anopheles Malaria Vectors in Uganda, Sci Rep. 2026 Jan 2, https://doi.org/10.1038/s41598-025-34493-3 that their “findings support Interceptor G2 as a promising intervention for regions dominated by both highly resistant An. funestus s.l. and An. gambiae s.l. Piperonyl butoxide and [pyripoxyphen] nets emerge as a good alternative for areas mostly dominated by resistant An. gambiae s.l. populations.”
Insecticide resistance has “become a major challenge in the fight against malaria transmission.” Ciss O & al. conducted an experimental hut study in five huts, using a sixth one as controls, to assess the long-term efficacy of a second generation of chemicals used in indoor residual spraying. They report in Residual Efficacy of Indoor Residual Spraying Using Clothianidin (Sumishield 50WG) Under Experimental Huts and Field Conditions in Senegal, Malaria J, 2026 Jan 20, https://doi.org/10.1186/s12936-025-05703-0 that mortality rates of exposed mosquitoes exceeded 95% in every month tested, but testing most months disclosed 100% effectiveness up to 12 months.
Anopheles stephensi is becoming an increasingly important vector of the Plasmodium parasite in many countries in Africa. One way to reduce its prevalence is by traps that are baited with attractants. Hosseini SZ & al., Comparative Evaluation of Synthetic Attractants Against an Important Malaria Vector, Anopheles stephensi (Diptera: Culicidae) Mosquitoes in Laboratory Conditions, J Med Entomol. 2025 Dec 29, tjaf181, https://doi.org/10.1093/jme/tjaf181 is a report of laboratory work that identified a “promising blend [that] contained 3-methyl-1-butanol and hexanoic acid. This blend has potential for use in odor-baited mosquito traps, but further field research is required to evaluate its effectiveness.”
Ngaffo KL & al. collected Anopheles mosquitoes in a high endemic area and report in Beyond Anopheles gambiae sensu lato: Exploring the Impact of Non-Dominant Anopheles Species on Malaria Persistence in High-Transmission Endemic Areas of Burkina Faso, Parasit Vectors. 2026 Jan 5, https://doi.org/10.1186/s13071-025-07210-2 that five species other than An. gambiae were present, four of which were found infected by Plasmodium parasites. The authors discuss the significance of the findings, especially as they may relate to insecticide resistance.
Habtewold T & al. previously demonstrated that genetic manipulation of Anopheles gambiae in the laboratory prevents it from transmitting laboratory-grown Plasmodium falciparum. (Hancock PA & al., The Potential of Gene Drives in Malaria Vector Species to Control Malaria in African Environments. Nat Commun, 2024, 15:8976). Their current article, Gene-Drive-Capable Mosquitoes Suppress Patient-Derived Malaria in Tanzania, Nature, 2025 Dec 10, 649:442–48, https://doi.org/10.1038/s41586-025-09685-6 focuses on parasite samples obtained from infected patients. “…the generation of a transgenic strain [of local A. gambiae under containment] equipped with non-autonomous gene drive capabilities … robustly inhibits genetically diverse P. falciparum isolates obtained from naturally infected children. These genetic modifications were efficiently inherited by progeny …”
Dael L & Simões ML, Beyond the Static Lab: Environmental Variability in Genetically Modified Mosquito Target Gene Identification for Malaria Control Curr Opin Insect Sci, 2026 Jan 17:101489, https://doi.org/10.1016/j.cois.2026.101489 highlights possible limitations on genetic modifications of Anopheles mosquitoes. They argue that “natural variations in environmental factors influence Anopheles and Plasmodium biology, and mosquito innate immunity responses, with consequences for vector competence and malaria transmission. Insufficient consideration of environmental variability during the initial gene discovery phase risks developing [genetically modified mosquitoes] where the intended function of the genetic modification may be compromised by environmental stress.”
“In 2019, the Government of Tanzania endorsed a nationwide scale-up of mosquito larviciding. Prior to full implementation, a pilot project was conducted in the Tanga Region from June 2022 to April 2024. The intervention targeted three councils representing high, moderate, and low malaria epidemiological risk strata. Six rounds of larvicide application were conducted, each lasting eight weeks…” Gavana T & al., A Large-Scale Mosquito Larviciding in Tanga Region, Tanzania, Reduced Mosquito Densities to Varying Degrees Across Malaria Transmission Risk Strata, Sci Rep. 2025 Nov 27; 15:42461, https://doi.org/10.1038/s41598-025-26675-w reports that using Bacillus thuringiensis israelensis and Bacillus sphaericus, “[l]arviciding was generally associated with lower densities of late-stage Anopheles larvae across strata, … Anopheles gambiae sensu lato densities were also reduced in moderate- and low-risk strata, while no significant reductions were observed in Anopheles funestus populations.”
Mutagwaba E & al. demonstrated potent larvicidal properties of lemongrass stalk essential oils (EOs) against An. gambiae s.s. larvae in Comparative Larvicidal Efficacy of Essential Oils from Cymbopogon citratus Stalks and Leaves Against Anopheles gambiae sensu stricto, Malaria J, 2025 Dec 19, 24:444, https://doi.org/10.1186/s12936-025-05675-1. “EOs isolated from lemongrass stalks demonstrated greater larvicidal activity than those obtained from lemongrass leaves, with LC50 values of 146.6 ppm and 209.5 ppm, respectively.”
“When individuals are forcibly displaced into malaria endemic areas, the risk of severe disease and mortality can be high. Novel vector control tools suited to the emergency context, for which conventional interventions suffer from biological and operational limitations, are urgently needed to interrupt vector-borne disease transmission among the world's most vulnerable. [Allan RJ & al.] aimed to evaluate the effectiveness of spatial repellent emanators against malaria during a protracted humanitarian crisis.” In The Effectiveness of Long-Lasting Spatial Repellent Emanators Against Malaria in Humanitarian Crisis Settings in Northern Nigeria: A Two-Arm Pragmatic, Open-Label, Controlled Trial, Lancet Infect Dis. 2026 Jan 8: S1473-3099(25)00684-X https://doi.org/10.1016/s1473-3099(25)00684-x, they report on a six-month trial of installing emanators in “households” of unclear description in a cluster of refugee camps. Compared to camps where there were no emanators, the authors report a decrease of 22.5% of “first time” malaria infections in the intervention camps. “Spatial repellent emanators also significantly reduced pyrethroid-resistant female Anopheles gambiae sensu lato density … and blood feeding…”
Chemoprophylaxis
“To improve uptake of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP),” Koita K & al. conducted “a cluster-randomised implementation trial of 'integrated IPTp-SP delivery' through seasonal malaria chemoprevention (SMC) alongside antenatal care (ANC) … in Mali and Burkina Faso. This nested study assessed ANC provider acceptability and feasibility of the integrated strategy and whether the training they received as part of the intervention ('enhanced facilities') improved IPTp-SP delivery effectiveness.” Their article, Effectiveness of Antenatal Care Delivery of Intermittent Preventive Treatment in Pregnancy with Sulfadoxine-Pyrimethamine in the Context of an Integrated Strategy with Seasonal Malaria Chemoprevention in Mali and Burkina Faso, BMJ Glob Health. 2026 Jan 8; 11(1):e019153, https://doi.org/10.1136/bmjgh-2025-019153 reports that while the integrated model resulted in more adherence to the prophylactic regimen in both countries, overall adherence was higher in Mali than on Burkina Faso.
Lin IF & al. state that in “malaria-endemic regions, escalating sulfadoxine-pyrimethamine (SP) resistance has raised concerns about the effectiveness of intermittent preventive therapy (IPTp) in pregnant women. Consequently, exploring IPTp alternatives has become an urgent priority in this population. Azithromycin (AZ) has garnered attention in this aspect due to its capability to treat sexually transmitted infections and its established safety profile.” They reviewed eight articles that report the results of adding AZ to the standard IPTp-SP regimen recommended by WHO. They report that while this resulted in reduced (but not absent) parasitemia at delivery, it made no difference in secondary outcomes such as frequency of low birthweight infants. Still, they conclude in Safety and Efficacy of Azithromycin-Containing Regimen as an Intermittent Preventive Therapy for Malaria in Pregnant Women: A Systematic Review and Meta-Analysis Of Randomized Controlled Trials, J Travel Med. 2026 Jan 7; 33(1):taaf112, https://doi.org/10.1093/jtm/taaf112 that “[a]dding AZ to the standard IPTp-SP regimen holds promising potential considering the escalating SP resistance, the safety profile of AZ and its additional coverage of sexually transmitted pathogens.”
“… school-aged children (SAC) [are] increasingly recognized as a high-risk group due to asymptomatic infections [of malaria] that sustain transmission. In Tanzania, where malaria prevalence varies widely by region, SAC experience substantial malaria-related school absenteeism… To address this, the National Malaria Control Programme introduced Intermittent Preventive Treatment for schoolchildren (IPTsc) using dihydroartemisinin-piperaquine (DP) in high-endemic districts” Kidumule FM & al. report that “[m]alaria-related absences declined from 27.8% to 11.3%, and attendance increased by 6.7%. Most pupils [318 (91.9%)] received all three IPTsc doses. The paper is The Impact of Intermittent Preventive Treatment for Malaria on School Absenteeism Among Primary School-Aged Children in Handeni District Council, Tanzania: Quasi-Experimental Study, Malaria J, 2026 Jan 8, https://doi.org/10.1186/s12936-025-05739-2.
Other
Abong'o B & al. conducted a field study to assess “the feasibility of sustainable housing modifications via passive cooling approaches and vector proofing. Forty houses were randomly allocated to four arms: cool-roof, cross-ventilation, mat-ceiling or control. Doors, windows and eaves of the intervention houses (not control) were screened for malaria mosquito vectors. Indoor temperature and humidity were monitored continuously..” They report in Housing Modifications for Heat Adaptation, Thermal Comfort and Malaria Vector Control in Rural African Settlements, Nature Med. 2026 Jan 5, https://doi.org/10.1038/s41591-025-04104-9 that the Heat Index (HI) “in cool-roof houses was the lowest … Mat-ceiling houses lowered daytime HI but increased nighttime HI compared to control. No differences in HI were observed for cross-ventilation houses. Screening reduced the number of female Anopheles funestus mosquitoes by 77% and the number of Culex mosquitoes by 58% compared to control houses. …. Cool-roofs combined with vector proofing is an effective, practical and sustainable housing modification for heat adaptation and for reducing indoor mosquito numbers in rural African households.”
Treatment
Treatment results
Mondal A & al. reviewed four published studies on comparing the treatment with a novel combination of antimalarials with the customary first-line artemisinin combination therapy (ACT). Their report, A Systematic Review and Meta-Analysis of Clinical Trials Comparing Arterolane-Piperaquine vs. Artemether-Lumefantrine for the Treatment of Uncomplicated Falciparum Malaria, J Postgrad Med. 2025 Nov 24, https://doi.org/10.4103/jpgm.jpgm_393_25 states that one of the studies had a “high risk of bias.” Nonetheless, they analyzed all four studies and found that the results from both regimens were comparable, both in terms of efficacy and side effects.
Laminou IM & al. used polymerase chain reaction (PCR) diagnostics and genetic testing of parasites to distinguish treatment failure from reinfection at 28 days post-treatment in four villages in Niger. They report therapeutic efficacies of 93.5% or over in their paper, Therapeutic Efficacy of Artemether-Lumefantrine and Molecular Markers of Antimalarial Resistance in Niger, 2022, Malaria J, 2025 Dec 29, 24:448, https://doi.org/10.1186/s12936-025-05679-x. Further, none of the parasites studied manifested the genetic marker associated with artemisinin resistance.
Hang JW & al. used methylene blue to treat cerebral malaria (CM) infected monkeys with good results. They also report that they found “nine genes associated with CM severity.” The paper is Methylene Blue Treatment of Fatal Cerebral Malaria and Identification of Potential Blood Biomarkers, Nat Commun. 2025 Nov 26; 16:10534, https://doi.org/10.1038/s41467-025-65552-y.
Tangara B & al. report on the results of two alternative treatments for malaria in patients who also have COVID in their article, Artemether-Lumefantrine Versus Pyronaridine-Artesunate for the Treatment of Malaria in Patients with Mild to Moderate COVID-19 in Kenya and Burkina Faso: A Randomised Open-Label Trial (MALCOV), EClinicalMedicine, 2026 Jan 3:91:103735, https://doi.org/10.1016/j.eclinm.2025.103735. Thei conclusion is that “[p]yronaridine-artesunate in COVID-19 patients co-infected with malaria was associated with slower viral clearance than standard treatment with artemether-lumefantrine but similar symptom resolution. Both treatments were highly effective as antimalarials and should continue to be considered first- or second-line treatment options for uncomplicated malaria in patients with mild to moderate COVID-19.”
Side effects and complications
None this month
Guidelines
Itoh M & al. studied the care received by 713 patients with severe malaria. As they conclude in Using Sentinel Surveillance System Data to Characterize Severe Malaria Illness and Quality of Malaria Case Management Among Hospitalized Patients in Kenya, 2017–2024, Malaria J, 2026 Jan 14, https://doi.org/10.1186/s12936-025-05738-3, in addition to delay in seeking care, “gaps in diagnostic accuracy and adherence to treatment protocols for severe malaria were observed during chart review. These findings point to the importance of behaviour change strategies as well as messaging in the community that promote timely care-seeking, referrals and follow-up, especially for the youngest children. Potential malaria over-diagnosis underscores the need for strengthening quality assured microscopy programs with adequate training of microscopists and properly functioning microscopes and reagents, as well as an external quality assurance programme that routinely provide feedback on performance and identify areas for improvement.”
Drug resistance
Bungei J & al., Comparative Molecular Surveillance of Polymorphisms in Chloroquine Resistance Transporter, Multidrug Resistance 1, and kelch 13 Genes Associated with Antimalarial Drug Resistance in Plasmodium falciparum Isolates from Western Kenya, Malaria J, 2025 Dec 19, 24:453, https://doi.org/10.1186/s12936-025-05755-2 is a comparative analysis “to assess mutation frequencies, genetic diversity, and selection pressure on molecular markers associated with antimalarial drug resistance between the Lake-endemic region and the highland epidemic-prone region.” The study revealed multiple mutations in both genetic loci, including dome novel ones, indicating trends that favor the increase in artemisinin resistance.
Two genetic studies on drug resistance were recently published. Ajibaye O & al., Molecular Surveillance of Malaria in Nigeria Reveals a Low Frequency of Antimalarial Resistance Markers and Clonal Expansion of Chloroquine-Sensitive Infections, Open Forum Infect Dis, 2026 Jan 16; 13:ofaf719, https://doi.org/10.1093/ofid/ofaf719, reports that while none of the almost 900 specimens of P. falciparum collected from patients contained the genes responsible for resistance to artemisinins, most were resistant to sulfadoxine-pyrimethamine. On the other hand, only about 40% of specimens contained one or another genotype associated with resistance to chloroquine. Bamikole OJ & al., Molecular Surveillance of Antimalarial Drug Resistance Genes in Nigeria: A Systematic Review and Roadmap to Malaria Elimination, BMC Med Genomics. 2025 Dec 18; 18:195, https://doi.org/10.1186/s12920-025-02246-w is a meta-analysis of 26 studies on the subject conducted in Nigeria. Its conclusions are similar to those of Alibaye O & al., with the additional note that resistance to chloroquine was highly variable by region.
New drug research
Favuzza P & al. state in MK-7602: A Potent Multi-Stage Dual-Targeting Antimalarial, EBioMedicine, 2025 Dec 6, 123:106061, https://doi.org/10.1016/j.ebiom.2025.106061 that “MK-7602, a clinical candidate, acts as a dual sub-nanomolar inhibitor of plasmepsins IX and X in multiple Plasmodium species. It exhibits favourable pharmacokinetic properties and a promising safety profile. MK-7602 demonstrates activity against liver and blood life-cycle stages of the parasite and blocks transmission to mosquitoes. Importantly, it shows a high barrier to resistance development and lacks cross-resistance with Plasmodium falciparum strains resistant to other antimalarials. MK-7602 effectively inhibits both wild-type parasites and those with increased plasmepsin expression, highlighting its potential to overcome existing resistance mechanisms.”
Imikdazolopiperazines are veterinary medicines used to treat animals for parasites. Maiga FO & al., Imidazolopiperazines as Next-Generation Antimalarial Agents: A Scoping Review Of Efficacy, Mechanisms of Action and Resistance; Prospects for Future Development, Ther Adv Infect Dis. 2025 Dec 23; 12:20499361251401771, https://doi.org/10.1177/20499361251401771 is a report on a literature review of research on this class of drugs as antimalarials. The authors conclude that they have “strong potential as next-generation antimalarial agents, particularly for combination therapies. Future research should prioritize clarifying mechanisms of action, monitoring resistance pathways, and optimizing clinical deployment strategies to address the ongoing challenges of antimalarial drug resistance…”
Monoclonal antibodies are not really drugs; they confer passive immunity (something like the serum given to people who have been bitten by possibly rabid animals). Verma K & al. reviewed the current literature of the research on monoclonal antibody treatment against malaria and state in Efficacy and Safety of Monoclonal Antibodies in Malaria Protection and Prevention of Transmission: A Systematic Review, Clin Ther. 2025 Dec 13: S0149-2918(25)00390-X, https://doi.org/10.1016/j.clinthera.2025.11.006 that in seven studies encompassing 776 patients, three different preparations were between 66% to 88% efficacious in protecting against P. falciparum up to six months. Two of these preparations was given intravenously and one subcutaneously. A fourth preparation was reported to be significantly less effective. All preparations were safe, in that aside from local reactions at the injection sites, very few side effects were noted. The authors recognize that “[f]urther large-scale trials assessing long-term efficacy, operational feasibility, and cost-effectiveness in diverse settings, including children and pregnant women, are required and will govern the feasibility of its use in wider community settings.”
Plant extracts and traditional treatments
None this month
Other
Issa A & al. conducted a study “among children admitted [to a secondary treatment center] with severe malaria. Data on sociodemographics, household decision-making, presentation timing, and outcomes were collected and analyzed. Delayed presentation was defined as arrival >24 hours after symptom onset.” They report in Influence of Sociodemographic Factors and Household Decision-Making on the Delayed Presentation of Childhood Severe Malaria at a Secondary Facility in North-Central Nigeria, Sage Open Pediatr. 2025 Nov 20; 12:30502225251393787, https://doi.org/10.1177/30502225251393787 that delays were mainly attributable to adverse socioeconomic status and to awaiting father’s decision about whether to seek care.
In a study covering events six years ago, Wan C & al.’s paper, Predictors and Characteristics of Malaria Treatment-Seeking in Malawi: A Longitudinal Cohort Study, Malaria J, 2025 Dec 18, 24:442, https://doi.org/10.1186/s12936-025-05640-y concluded that among the 962 participants studied, “[d]espite free access to malaria care, barriers to treatment persist.” Fever was associated with a visit to a health care facility, but the finding of Plasmodium was not. Visit rates were “significantly lower among older children, adults, males, and households farther from health facilities.”
Mekonen EG & Aemro A, Determinants of Delay in Treatment-Seeking Among Malaria Patients Attending Health Facilities in Ethiopia from 2010 To 2024: A Systematic Review and Meta-Analysis, Malaria J, 2026 Jan 7, https://doi.org/10.1186/s12936-025-05783-y is a review of twelve articles, covering 4511 patients. “Lack of malaria knowledge, living far from a health facility, expensive health care costs, lack of transportation access, being a farmer, the practice of self-medication, not having a previous history of malaria infection, low family income, not being a member of community-based health insurance, large family size, having no formal education, fear of side effects of malaria treatment drugs, and no history of death from malaria among their family members were determinants of delay in treatment-seeking among malaria patients.”
Campaigns and Policies
While Osoro CB & Hill J, African Leaders and Regional Institutions Need to Take the Bull by the Horns: A Perspective on the Impact of the 2025 Funding Cuts to Malaria Programmes, Malaria J, 2025 Dec 18, https://doi.org/10.1186/s12936-025-05736-5 contains facts about the severe funding constraints caused by diminished support by the United States and West European countries, it reads primarily as an opinion piece about what African governments must do.
Akotionga EA & al. demonstrate “the impact of funding on malaria morbidity and mortality, and diverse local risk of death from malaria in children under 5” in Funded Investments Contributed to the Reduction of Malaria Morbidity and Mortality in Children Under Five: Fifteen Years Retrospective Study from 2009 to 2023 in Burkina Faso, Malaria J, 2026 Jan 9, https://doi.org/10.1186/s12936-025-05779-8. “In fifteen years, Burkina Faso invested USD13,545 million in the health sector, including 15.3% against malaria. These efforts yielded several benefits in health services including: the reduction of distance travelled by the population to health facilities from 7.2 to 6.0 km; the number of new contacts per capita for children under 5 per year increased from 0.8 to 2.1; the malaria case fatality rate decreased from 3.4% to 1.3% in children under 5.”
“In 2022, Cameroon was ranked the 11th of the 11 high-burden countries responsible for 70% of the global malaria burden largely due to sustained conflict in the Southwest and Northwest regions since 2018. From May 2021 to April 2024, a mixed-methods study was conducted of three community-based, co-created interventions, a community dialogue approach called the Community Health Participatory Approach (CoHPA)…” Ebob EO & al.’ s article, The Role of Community Co-Designed Interventions for Malaria Prevention and Control in Conflict-Affected Communities in Cameroon’s Southwest and Littoral Regions, Malaria J, 2026 Jan 14, https://doi.org/10.1186/s12936-025-05692-0 describes “perceptions of knowledge and attitudes to care-seeking, information and communication channels, community leadership roles and malaria service capacity and quality and care pathway functionality” through focus group discussions. The authors conclude that “[i]nterventions were perceived to have improved prevention and health-seeking awareness and behaviours, community health service utilization and treatment access. Participants felt empowered to create and evaluate solutions.”
Epidemiology
Climate change, biodiversity and environment
Okafor UA & al. examined “how climatic variables correlate with malaria incidence” in the Eastern regions of The Gambia. They report in Evaluation of the Significant Association Between Climatic Variables and Malaria Cases in the Upper River Region of the Gambia, J Therm Biol. 2025 Dec 4; 134:104350, https://doi.org/10.1016/j.jtherbio.2025.104350 that the main variables found to have significant influence were humidity, which had a direct correlation with malaria infection (i.e. higher humidity associated with more malaria), and maximum temperature, which had an inverse correlation (i.e. increasing temperature associated with lower incidence).
Zablon JO & al. analyzed data from 23 Kenyan counties for mosquito prevalence, malaria incidence, and climatic variability. They report in Mapping Mosquito Diversity in Kenya Correlating Species Distribution with Malaria Prevalence Across Varied Climatic Parameters, Malaria J, 2026 Jan 5, https://doi.org/10.1186/s12936-025-05713-y that “[m]alaria prevalence was highest in the Lake Endemic (19%), followed by the Coastal Endemic (5%), semi-arid seasonal (2%), and low-risk (0.9%) malaria epidemiologic zones in 2020. Mosquito species distribution varied, with distinct ecological preferences observed with Anopheles gambiae dominated coastal and semi-arid areas, while Anopheles funestus was highest in the highland and lake zones .,, a combination of environmental factors and public health interventions, including [ITN] coverage, was an important predictor of malaria prevalence. However, the relationship between these factors and malaria prevalence varied across regions and time periods.”
Risk factors
In addition to the diagnostic issues (see above, Diagnosis/General diagnosis), based on a natonwide survey, Zhang M & al. also conclude in Molecular Investigation of Plasmodium spp. in Sierra Leone: Recommendations on Diagnostic Methods for Malaria Control in High-Epidemic Regions - A Nationally Representative Cross-Sectional Epidemiological Survey, BMJ Glob Health. 2025 Dec 3; 10(12):e020287, https://doi.org/10.1136/bmjgh-2025-020287 that Plasmodium infections rend to decrease above age 60, males, and those under age 20 had the highest rate of infection, and somewhat unexpectedly, there was no significant difference in infection rates among rural and urban populations.
General epidemiology
Garba MN & al. reviewed 31 articles originating in West African countries and report in Circulation of Non-Falciparum Malaria Species in West Africa: A Literature Review from 2000 to 2024, Malaria World J 2025 Dec 15, 16:20, https://doi.org/10.5281/zenodo.17938329 that “P. falciparum was reported in 29 (93.5%), P. malariae in 25 (80.6%), P. ovale in 24 (77.4%), P. vivax in 11 (35.5%).”
“Genotyping Plasmodium falciparum polymorphic merozoite genes to describe parasite genetic diversity and the complexity of malaria infections (COI) is routinely used to assess the effectiveness of malaria control interventions. They are also utilized in anti-malarial drug therapeutic efficacy studies (TES) to differentiate recrudescent parasites from new infections.” Based on 185 samples obtained from two regions, Abade NA & al.’s paper, Characterizing Plasmodium falciparum Genetic Diversity and Complexity of Infections in Clinical Malaria Infections in Western and Coastal Kenya Using the Poly-Alpha Microsatellite Marker, Malaria J, 2025 Dec 19, 24:452, https://doi.org/10.1186/s12936-025-05745-4 concludes that there is “high genetic diversity of malaria parasites in Busia and Kilifi. These findings define the genotypes (fragment sizes) observed in the two Kenyan populations, providing a proof of concept for the utility of poly-α in TES studies as a molecular correction tool and for the evaluation of the effectiveness of malaria interventions in Kenya.”
Dana DD & al.’ s article, Epidemiological Investigation of a Possible Malaria Outbreak in Arba Minch Town, Gamo Zone, Southern Ethiopia, 2023, Malaria J, 2026 Jan 13, 25:29, https://doi.org/10.1186/s12936-025-05714-x is interesting in that it describes a surge of malaria cases in a geographic area where malaria is endemic. They support their contention that this was a trues epidemic by statistical data. Steketee RW, Malaria Outbreaks in Endemic Settings? Malaria J, 2026 Jan 13, 25:28, https://doi.org/10.1186/s12936-025-05741-8 is an accompanying editorial in which the author supports the contention that epidemics may occur in endemic settings and that the above situation qualifies as such.
Common themes are evident in Rajaofera MJN & al., Understanding Inequities in the Malaria Landscape of Madagascar: A Scoping Review of Current Evidence, Malaria J, 2026 Jan 14, https://doi.org/10.1186/s12936-025-05718-7, based on review of relevant literature. “Disparities in malaria prevention and treatment between urban and rural areas are evident, with remote regions experiencing a higher disease burden. Geographic diversity leads to varied transmission patterns, necessitating region-specific interventions. Rural healthcare infrastructure is insufficient for timely diagnosis and treatment. Key interventions include insecticide-treated nets (ITNs), indoor residual spraying (IRS), and seasonal malaria chemoprevention (SMC). Case management primarily uses Artemisinin-based Combination Therapies (ACTs) and rapid diagnostic tests (RDTs). Social and behavior change communication (SBCC) has improved awareness but faces cultural barriers. SMC has shown promise, though logistical challenges remain. Drug resistance and diagnostic failures, along with socioeconomic inequalities, hinder effective malaria control.”
Spatiotemporal studies
Mulugeta SS & al., Exploring Spatial Variation and Multilevel Modeling of Malaria Prevalence Among Children Aged 6-59 Months Based on RDT in Niger: Insights for Public Health Decision-Making, PLoS One. 2025 Dec 1; 20(12):e0336022, https://doi.org/10.1371/journal.pone.0336022
Kassahun GB & al., Malaria Trends, Burden, Seasonal Variation, and Interventions in Western Tigray, Ethiopia, J Trop Med. 2025 Dec 12; 2025:3197517, https://doi.org/10.1155/jotm/3197517
Aminou YY & al., Burden of Malaria in Young Adults in Niger: A Prospective Study in a Military Setting, Acta Trop. 2025 Dec 27: 107958, https://doi.org/10.1016/j.actatropica.2025.107958
Abdo SS, Spatial Analysis of Malaria Incidence and Environmental Determinants in Hadiya Zone, Ethiopia, Sci Rep. 2025 Dec 30, https://doi.org/10.1038/s41598-025-33236-8
Tugbeh RS & al., Geographic Variation in Malaria Prevalence Among Children Under Five in Coastal and Inland Counties of Liberia: Analysis of the 2022 Malaria Indicator Survey, Malaria J, 2026 Jan 15, https://doi.org/10.1186/s12936-026-05784-5
Endalu T & al., A Five-Year (2020–2024) Malaria Surveillance Data Analysis of Mattu Karl Specialized Comprehensive Hospital, Oromia region, Southwest Ethiopia, Malaria J, 2026 Jan 23, https://doi.org/10.1186/s12936-026-05788-1