By Dr. Derick Pasternak, Ambassador, Malaria Science & Research Coordinator, MPI
Life takes us all in many directions; the time has come to say goodbye, this is my last report. It has been my great pleasure and learning experience to collate these reports since April 2020. Thanks to MPI’s leadership for giving me the opportunity to serve and to the staff members who turned them into communication over the years.
News
On 17 July, UNICEF published a 13-page pamphlet, Environmental determinants of vector-borne diseases in children. It is available at https://www.unicef.org/reports/environmental-determinants-vector-borne-diseases-children.
On 26 August, The Lancet reported that The Global Fund granted DR Congo USD 4.6 million in emergency malaria funding in July. This support is expected also to bolster its Ebola outbreak response.
On 7 September, Think Global Health, a website of the Council on Foreign Relations published an article by F. Okumu Ph.D., entomologist on the faculty of multiple universities, entitled As Malaria Spreads, Africa Needs Data on Gene-Edited Mosquitos. It is accessible at https://www.thinkglobalhealth.org/article/as-malaria-spreads-africa-needs-data-on-gene-edited-mosquitos.
On 8 September, Witwatersrand University of South Africa published a press release entitled The future of malaria control is … more mosquitoes? In which they disclose gene drive work in producing sterile male Anopheles arabiensis mosquitoes. The article can be accessed at https://www.wits.ac.za/news/latest-news/research-news/2026/2026-09/the-future-of-malaria-control-is--more-mosquitoes.html
On 10 September, WHO published its current, 494 page guidelines for malaria. It is available at https://iris.who.int/server/api/core/bitstreams/d3c6488b-3ee6-41cb-960f-ddf0202cd74d/content
PEER REVIEWED ARTICLES
The entire abstract of Abdi MS & al., Artificial Intelligence for Precision Malaria Control: Transforming Surveillance, Prediction, and Intervention Strategies, Front Digit Health. 2026 Aug 6; 8:1879638, https://doi.org/10.3389/fdgth.2026.1879638 is quoted: “Malaria elimination has stalled globally despite decades of investment, with traditional surveillance constrained by retrospective reporting and limited capacity to integrate high-dimensional, non-linear data. In this perspective, we argue that artificial intelligence (AI) encompassing machine learning and deep learning can help shift malaria control from reactive reporting toward predictive, precision public health, while cautioning that it is one enabler among many rather than a stand-alone solution. We examine AI across three interconnected domains: surveillance (understood broadly as case detection, entomological and intervention-coverage monitoring, and the data-to-response loop), prediction (outbreak forecasting and spatial risk mapping), and control (resource stratification and intervention optimisation). Reported AI diagnostics can exceed 90% accuracy, and forecasting models offer useful lead times by integrating climatic, entomological and epidemiological data. However, realising this potential depends on resolving data-quality limitations, algorithmic bias, weak digital infrastructure, and absent governance frameworks, and on locally adapted rather than uniformly generalised models. We contend that demand-driven integration into national strategies, local capacity building, and prospective trials not algorithmic novelty will determine whether AI meaningfully accelerates progress toward elimination.”
Prevention
Vaccines
Bashlakova K & al. reviewed 56 articles on the outcomes of malaria vaccination and assert in Clinical Efficacy, Immunogenicity and Safety of RTS,S/AS01, R21/Matrix-M and Candidate Malaria Vaccines in Children: A Systematic Review and Meta-Analysis, J Infect Public Health. 2026 Sep 6; 19(10):103356, https://doi.org/10.1016/j.jiph.2026.103356 that it is “the first meta-analysis to systematically synthesise efficacy, immunogenicity and safety data for all available malaria vaccine platforms in paediatric populations.” They assert in the article that the oft-quoted efficacy of 74% of the R21/Matrix M (R21/MM) vaccine occurs in only one original study, while the authors claimed to have found only one other efficacy study for that vaccine and no follow up studies of R21/MM beyond 12 months (see below). As to the RTS,S family of vaccines, their efficacy was in the range of 31-32% and their rate of serious adverse events was significantly higher than that of R21/MM (9% vs 3%). Long-term efficacy of the RTS,S vaccine gradually declined. Although the article lists references to some vaccines not approved by WHO, neither the Abstract nor the body of discussion cover those. Finally, the authors conclude that “[e]vidence from seasonal transmission settings suggests that the combination of RTS,S/AS01 + [Seasonal Malaria Chemoprevention] achieves higher protective efficacy than either intervention alone.”
In contrast to the above article, Rehman AU & al., Efficacy and Response of R21/Matrix-M in Malaria Vaccine: A Systematic Review and Meta-Analysis of Clinical Trials, Vaccines (Basel), 2026 Sep 19; 14(9):824, https://doi.org/10.3390/vaccines14090824 was sourced from eleven (11) published articles over five years, with a reported pooled efficacy rate of 73.5%. “Booster follow-up supported maintained protection, including approximately 80% efficacy during the 12 months after boosting with the 50-microgram Matrix-M regimen. Across the broader evidence base, the vaccine was generally well tolerated and elicited strong anti-CSP/anti-NANP antibody responses… R21/Matrix-M provides substantial protection against naturally acquired clinical malaria, and the central efficacy estimate is robust to alternative analytic specifications. The quantitative evidence base remains small, however, and longer-term effectiveness, severe-malaria protection, booster timing, and post-deployment safety require continued evaluation.”
Ajakaye OG investigated caregivers' willingness to vaccinate their children against malaria and the factors associated with this willingness in Determinants of Malaria Vaccine Willingness Among Caregivers of Children Under Five Years in Akoko, Southwestern Nigeria, Malaria World J, 2026 Aug, 17:20, https://doi.org/10.5281/zenodo.22045850. Questionnaires were administered to 498 caregivers of children aged 0-59 months. “Most caregivers reported appropriate malaria preventive practices, particularly mosquito net ownership, use of insecticide-treated nets, and environmental sanitation; preventive practice was significantly associated with caregiver education ... Malaria prevalence among under-five children was 10.1% … Awareness of the malaria vaccine was high (77.9%), predominantly sourced from the health system, and willingness to vaccinate was high (87.9%). The mean overall HBM score {Health Belief Model} was 48.3 ± 13.9 (out of 60). Willingness to vaccinate was significantly associated with religion, trust in vaccine information and HBM category …, respectively … caregivers who did not trust the information they received … and those whose previous vaccination experiences influenced their decision … had lower odds of willingness to vaccinate while a higher HBM score was associated with higher odds of willingness.”
In a systematic review that assesses “malaria vaccine rollout in Nigeria, focusing on implementation, awareness, acceptance, willingness to pay, and health system readiness,” Oyegbade SA & al., Malaria Vaccine Rollout in Nigeria: Current Status and Challenges, Am J Trop Med Hyg. 2026 Aug 27: tpmd260371, https://doi.org/10.4269/ajtmh.26-0371 combines information gleaned from 12 published studies. “Caregiver acceptance ranged from 76.6% in Lagos to 95.6% in Owerri, and exceeding 90% in Enugu, Ondo State, and Gombe. Among health care professionals, only 54.1% of pharmacists were willing to vaccinate their children. Caregiver awareness ranged from 9.7% in Lagos to 72.1% in Enugu. Physicians demonstrated higher adequate knowledge (68.9%) than nurses (35.9%), with 55.5% of nurses having only heard of the vaccine. Pharmacists expressed concerns about vaccine failure (53.6%), adverse effects (63.4%), and storage conditions (77.8%). Willingness to pay was moderate; median willingness in Enugu was USD $0.82 per dose; 71.2% of Lagos caregivers expressed willingness to pay; and 90% of respondents nationally preferred government-funded vaccination. Health system readiness was critically inadequate, with overall facility preparedness scores ranging from 33% to 51%.”
“Based on the 2024–25 Uganda Malaria Indicator Survey (MIS) data,” Ogidan OC & al., Patterns and Factors Associated with Mothers’ Willingness to Vaccinate Their Children Against Malaria in Uganda: Evidence from a Nationally Representative Survey, Malaria J, 2026 Aug 29, https:///doi.org/10.1186/s12936-026-06118-1 reports that among 5281 mothers aged 15 to 49, 92.7% expressed willingness to have their child vaccinated against malaria. Rural mothers were more willing than urban ones and ones with primary and secondary education were more willing than those with no education at all or higher education. “Mothers who visited health facility for antenatal care (ANC) during the index pregnancy, have higher odds of … willingness to vaccinate their children against malaria, when compared with mothers who did not have ANC visit. These results stand in sharp contrast with the findings of Asio L & al., 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, reported previously, in which the authors found only 30% of 211 healthcare workers in a particular district with positive attitudes toward the vaccine.
The “RTS,S/AS01 malaria vaccine was introduced in 2019 through Kenya’s Expanded Programme on Immunization (EPI), leveraging a robust platform with decades of experience in rolling out new vaccines.” Westercamp N & al., Setting the Scene for the RTS,S/AS01 Malaria Vaccine Implementation Programme in Kenya: A Situational Analysis of the Health System, Malaria Burden, and Immunization Platform, Malaria J, 2026 Aug 29, https://doi.org/10.1186/s12936-026-06119-0 is a “situational analysis [that] provides a comprehensive description of the demographic, epidemiologic, and health system context in Kenya, with particular attention to the eight high-burden counties where the Malaria Vaccine Implementation Programme (MVIP) was launched. It highlights the organization of the health system, the burden of malaria, ongoing control strategies, and the strength of Kenya’s immunization infrastructure as the backbone for vaccine introduction.”
According to Pazzagli L & al., “Plasmodium falciparum sporozoite (PfSPZ) vaccines, comprised of aseptic, purified, live parasites that arrest during or just after liver stage development, show excellent safety and efficacy in humans.” {However, they have not been recommended yet for use by WHO.} In their article, Pan-African Hybridization of PfSPZ Increases Antigenic Diversity and Replicative Capacity for Malaria Vaccine Design, JCI Insight. 2026 Aug 18: e207272, https://doi.org/10.1172/jci.insight.207272, the authors aver that a cross-bred P. falciparum strain created in the laboratory provides a better base for this approach to vaccination than the wild West African strain that is currently under clinical investigation.
Joyner CJ, Vivas AR, Cheng WT, Evidence for the Multistage Malaria Vaccine Gamble, Trends in Parasit, 2026 Aug 10, https://doi.org/10.1016/j.pt.2026.07.014 appears to be a commentary on Kirtley P & al., Addition of Blood-Stage Antibody Enhances Anti-Sporozoite Antibody Protection in a Humanized Mouse Model of Plasmodium falciparum Infection, Cell Rep. 2026 Jun 22; 45(7):117573, https://doi.org/10.1016/j.celrep.2026.117573, cited in an earlier report. The abstract is sparse and the article is behind a paywall.
Please see Mim SR & al., Quantitative and Clinical Pharmacology Perspectives on Next-Generation Malaria Prevention Using Vaccines and Long-Acting Monoclonal Antibodies, Clin Transl Sci. 2026 Aug; 19(8):e70704, https://doi.org/10.1111/cts.70704 under Treatment/New Drug Research.
Vectors
“Chlorfenapyr-based indoor residual spraying (IRS) has been prequalified for malaria control. Residual efficacy (mosquito mortality) of IRS applied to houses is typically assessed using forced-contact cone bioassays. However, chlorfenapyr is a pro-insecticide that requires mosquito metabolic activity for conversion to its toxic metabolite, tralopyril.” Benson J & al., Modified Cone Bioassay Methods for Evaluating Chlorfenapyr Indoor Residual Spray, Malaria World J, 2026 Aug, 17:19, https://doi.org/10.5281/zenodo.22045349 reports that “modified cone bioassays are unlikely to provide reliable estimates of chlorfenapyr-IRS performance. Further validation is required to assess whether overnight cone tests in people’s homes can provide a more realistic measure of residual bioefficacy.”
Burkina Faso’s “National Malaria Control Programme replaced indoor residual spraying (IRS) with next-generation piperonyl butoxide insecticide-treated nets (PBO-ITNs) in several high-transmission districts.” Hien AS al. assessed the entomological impact of this transition in two districts from 2021 to 2023. “Marked temporal and spatial reductions in malaria transmission indicators were observed following IRS withdrawal and PBO-ITN deployment. Human biting rates, indoor resting densities, and EIR progressively declined over the study period…” The paper is Impact of Replacing Indoor Residual Spraying with Next-Generation PBO-Based Insecticide-Treated Nets on Malaria Transmission Drivers in Pyrethroid-Resistant Settings of Burkina Faso, Malaria J, 2026 Sep 10, https://doi.org/10.1186/s12936-026-06084-8.
Sinzinkayo D & al. assessed “the trend of entomological and epidemiological parameters over 5 years of combined IRS and standard ITNs interventions in Kiremba health district, northern Burundi and report in Entomological and Epidemiological Trends During 5 Years of Combined Indoor Residual Spraying and Standard Insecticide-Treated Nets in Kiremba, A Malaria Endemic Site of Burundi, Malaria J, 2026 Sep 27, https://doi.org/10.1186/s12936-026-06167-6 that “An. gambiae s.l. was the predominant vector species and responsible for most of the transmission in Kiremba. However, the relative abundance of malaria vectors shifted over time: An. funestus s.l. was the second most abundant species in 2017 but was surpassed by An. ziemanni from 2018 to 2020, before regaining its position in 2021… Combining IRS, and standard ITNs in Kiremba led to a change in vector species composition and the biting behavior of An. gambiae s.l. to bite more outdoors than indoors. Although temporary reduction in malaria cases (28% in 2018;26% in 2020) and test positivity rate (22% in 2018) were observed, the biting rates and malaria transmission intensity … remained high across the years.”
“Insecticide-treated nets (ITNs) are a critical vector control and malaria prevention tool. Routine monitoring of ITN physical and chemical durability is key to assessing their performance under real-world condition”. Esch K & al. conducted a “streamlined ITN durability (SDM) monitoring methodology … in Northern Region, Cameroon from 2022 to 2025. SDM can be less expensive than standard durability monitoring and focus primarily on insecticidal efficacy”. They measured the “insecticidal efficacy of pyrethroid (pyr) + piperonyl butoxide (PBO) DuraNet Plus (DNP) and pyr + chlorfenapyr (CFP) Interceptor G2 (IG2) ITNs through mosquito mortality and chemical retention testing. Secondary objectives were to monitor ITN physical integrity and estimate ITN attrition”. They conclude in Streamlined Durability Monitoring of DuraNet® Plus and Interceptor® G2 Insecticide-Treated Nets in Northern Region, Cameroon: Assessment Results in Two Sites from 2022 to 2025, Malaria J, 2026 Sep 2, https://doi.org/10.1186/s12936-026-06114-5 that IG2 ITNs ... outperformed DNP ITNs … on measures of pyr-resistant strain mortality and chemical retention. Durability monitoring data from other sites is necessary to identify trends in DNP performance under real-world conditions”.
“The widespread use of pyrethroid-only [ITNs] has contributed substantially to malaria control; however, increasing pyrethroid resistance in malaria vectors threatens their continued effectiveness … MiraNet® Combi is a novel [ITN] incorporating alpha-cypermethrin, the insect growth regulator pyriproxyfen (PPF), and the synergist piperonyl butoxide (PBO).” Kipsum M & al., Efficacy of MiraNet Combi, a Novel Alpha-Cypermethrin, Pyriproxyfen, and Piperonyl Butoxide Long-Lasting Insecticidal Net Against Pyrethroid-Resistant Anopheles funestus in Western Kenya, PLoS One. 2026 Aug 12; 21(8):e0331995, https://doi.org/10.1371/journal.pone.0331995 describes testing of this brand of ITNs against three others “for mosquito mortality and blood-feeding inhibition following 20 standardized washes, in accordance with WHO guidelines.” The authors conclude that “MiraNet® Combi provides improved personal protection and enhanced efficacy against pyrethroid-resistant An. funestus compared with existing [ITNs]. The combination of a pyrethroid, PBO, and PPF represents a promising strategy for resistance management and malaria vector control in areas with high pyrethroid resistance.”
Glover AC & al. “estimated subnational differences in ITN use, access, and retention for six countries (Burkina Faso, Ghana, Malawi, Mali, Mozambique, and Senegal) and used these to calibrate a Plasmodium falciparum transmission dynamics model ... On average, people used their ITNs for 21 months though this varied subnationally from 12 to 38 months. Shifting from triennial to biennial campaigns is projected to increase mean use across all regions from 45.4% to 53.9% and avert substantial additional cases in moderate and high transmission settings”. The authors conclude in Heterogeneity of Use, Access, and Retention of Insecticide-Treated Nets: Implications for Subnational Tailoring to Maximise Malaria Control, Elife. 2026 Aug 20; 14:RP108745, https://doi.org/10.7554/elife.108745 that although “transmission intensity remains important for subnational tailoring, other factors, such as ITN use given access, meaningfully influence optimal deployment strategies. The framework highlights how routinely collected data can aid policymakers in tailoring disease control programmes at subnational levels”.
Tilahun SW & al. interviewed 48 individuals living in an urban setting to explore their use of ITNs. They report in Acceptability of Insecticide Treated Nets in an Urban Setting in a Malarious Area: Application of Theoretical Framework of Acceptability, PLOS Glob Public Health. 2026 Aug 21; 6(8):e0006120, https://doi.org/10.1371/journal.pgph.0006120 that the participants “demonstrated a strong understanding of ITNs, expressing positive attitudes and noting a reduction in malaria cases following their introduction. However, concerns regarding the ethicality of ITNs emerged, particularly in relation to sexual assault and the discomfort experienced by pregnant women due to chemical exposure, ... Participants also voiced dissatisfaction with the short height of currently available ITNs and expressed mixed feelings about their shapes; women preferred circular shaped nets, while men favored squared ones. In addition, they reported burdens such as adverse skin and respiratory reactions. Female participants, in particular, emphasized the increased household chores associated with handling the ITNs as a part of their morning routine.”
Tandina F & al. collected mosquitoes in the rainy and dry seasons in an area where malaria is endemic. As they report in Malaria Vectors' Diversity and Seasonality in Sustaining Disease Transmission in an Endemic Area of Faladie, Mali, Trop Med Infect Dis. 2026 Aug 3; 11(8):216, https://doi.org/10.3390/tropicalmed11080216, there was wide diversity of species between the seasons. Among the three An. gambiae s.l. subspecies, only An. coluzii was the “only vector across the rainy and dry seasons that sustained malaria transmission. Plasmodium falciparum infection rates were 9.7% and 1.7%, respectively, for the rainy and dry seasons.”
“The effectiveness of malaria vector control in sub-Saharan Africa is increasingly threatened by insecticide resistance in Anopheles gambiae sensu lato (s.l.).” Diop M & al., Distribution of kdr-west and kdr-east Resistance Alleles in Anopheles gambiae s.l. Across Contrasting Transmission Settings in Central and Southern Senegal, Malaria J, 2026 Aug 24, https://doi.org/10.1186/s12936-026-05967-0 reports that mosquitoes raised from larvae collected from four sites exhibited high resistance to pyrethroid insecticides. The resistance was associated with presence of the kdr-west allele of the gene, but not with kdr-east.
Rasikhanya W & al. report in The Effect of Urban and Rural Water Pollutants on the Life History of the Major Malaria Vector Anopheles arabiensis (Diptera: Culicidae), Acta Trop. 2026 Aug 23: 108295, https://doi.org/10.1016/j.actatropica.2026.108295 that exposing laboratory-reared An. arabiensis mosquitoes to pollutants prevalent in rural areas (i.e. nitrates, nitrites) enhance its larval development. However, when exposed to urban pollutants (i.e. sulphates, sulfides), they are even more enhanced. The authors conclude that An. arabiensis can “adapt to polluted environments, underscoring its potential to persist in urban areas, and withstand rising pollution in rural areas. This adaptability underscores the risk of An. arabiensis as an urban malaria vector.”
Two articles focus on An. stephensi in Djibouti. According to Haddad G, & al., there are three biological forms of the species “Type, Intermediate, and Mysorensis, [that] have different vectorial capacities and habitats…” Based on microscopic analysis, Biological Forms of Anopheles stephensi in the City of Djibouti, Horn of Africa, PLoS One. 2026 Aug 14; 21(8):e0355973, https://doi.org/10.1371/journal.pone.0355973 reports that all three forms were present, with a majority the Mysoriensis form, which has elsewhere been noted to be predominant in rural areas and less involved in malaria transmission. In Djibouti they were prominent in highly malarious urban areas as well. The second, Puinean AM & al., Characterization of Invasive Anopheles stephensi Populations in Djibouti: Understanding Population Dynamics, Biotypes and Insecticide Resistance to Guide New Vector Management Methods, Malaria J, 2026 Sep 4, https://doi.org/10.1186/s12936-026-06093-7 “provides new insights into the distribution and population dynamics of An. stephensi in Djibouti, confirming year-round presence of the vector in both urban and rural/semi-rural communities. Genetic evidence suggests that the populations show high levels of pyrethroid insecticide resistance, rendering existing vector control tools less effective and reinforcing the urgency for new vector management solutions.”
According to Mehta P & al., “morphological similarity to native African anophelines, particularly An. gambiae s.l., makes reliable field identification [of An. stephensi] difficult by field entomologists across much of Africa. In Deep Learning Convolutional Neural Networks for Morphological Identification of Field-Caught Anopheles stephensi in Ethiopia, Using Smartphone Images of Specimens, Malaria J, 2026 Sep 17, https://doi.org/10.1186/s12936-026-06122-5, the authors present an artificial intelligence program installed in VectorCam, a “a standardized field imaging device.” The program showed high sensitivity and specificity.
Conducting a survey of malaria vectors through a collection of 1149 Anopheles mosquitoes, half from urban, half from rural settings, Vulu F & al. found that “An. gambiae s.l. remains the predominant malaria vector in Kinshasa. The findings also suggest a possible contribution of An. paludis to malaria transmission in some rural settings…” The article is Malaria Entomological Surveillance in Kinshasa Province: A Longitudinal Study, PLOS Glob Public Health. 2026 Aug 5; 6(8):e0006984, https://doi.org/10.1371/journal.pgph.0006984.
“In January 2024, the World Health Organization certified the country as malaria-free; however, the risk of reintroduction persists. Maintaining malaria-free status requires continuous robust epidemiological and entomological surveillance to prevent local transmission.” According to Ferrero Gómez L & al., Evaluation of MTego and BG-Sentinel Traps for Malaria and Arbovirus Vector Surveillance in Cabo Verde, PLOS Glob Public Health. 2026 Aug 18; 6(8):e0007104, https://doi.org/10.1371/journal.pgph.0007104. “[t]his study highlights the superior performance of MTego traps for malaria surveillance in Cabo Verde” while the other traps may do a better job for other species.
“Bacillus-based insecticides are widely recognized as effective, environmentally friendly, and sustainable tools for mosquito control.” Tibebu T & al., Native Bacillus Strains Crude Culture Product Exhibits High Biocidal Activities Against Larvae and Adult Anopheles Mosquitoes, J Trop Med. 2026 Aug 27; 2026:8822832, https://doi.org/10.1155/jotm/8822832 reports on isolation of “native Bacillus strains from diverse environmental sources and [an evaluation of] their potential for mosquito control. Bacillus strains with high biocidal activity were isolated, identified, genetically characterized, and physiologically characterized. The larvicidal and adulticidal activities of culture supernatants and cell pellets were evaluated separately. Eight Bacillus strains exhibited strong biocidal activity in their culture supernatants … Laboratory bioassays demonstrated that the culture supernatants were effective against both larval and adult Anopheles mosquitoes ... The most active Bacillus preparations also showed greater activity than clothianidin under the laboratory conditions tested.”
Purpureocillium lilacinum is a common environmental mold found in soil and decaying vegetation that can act as both an agricultural biocontrol agent and an emerging opportunistic human pathogen (cf. Usuda D & al., Purpureocillium lilacinum: A Minireview, World J Clin Cases, https://doi.org/10.12998/wjcc.v13.i29.108582). Chen D & al., Larvicidal and Adulticidal Activities of Purpureocillium lilacinum Secondary Metabolites Against the Malaria Vector Anopheles gambiae, Malaria J, 2026 Sep 22, https://doi.org/10.1186/s12936-026-06146-x describe how “[m]ost fractions [on extraction] showed larvicidal activity, with the two most polar fractions exhibiting significantly greater activity than the crude extract. Purified pulixin and leucinostatins displayed potent larvicidal effects,” which led the authors to the conclusion that “[s]econdary metabolites from P. lilacinum represent promising, cost-effective, and environmentally friendly larvicides against malaria vectors. Because leucinostatin A can inhibit parasite development in adult mosquitoes, kill larvae in aquatic habitats, and kill adult mosquitoes by contact, it may provide a dual-action strategy for blocking malaria transmission.”
“Next-generation insecticide-treated nets with dual active ingredients (such as chlorfenapyr and alpha-cypermethrin) have been developed to counteract [the challenge of insecticide resistance], but their effectiveness and economic impact compared to current (pyrethroid (PY) and pyrethroid-piperonyl butoxide (PBO)) nets in varied transmission settings remain under evaluation. Shirima GS & al., Comparative Malaria Impact of Chlorfenapyr-Alpha-Cypermethrin Nets Versus Pyrethroid-Only and Pyrethroid-Piperonyl Butoxide Nets Across High and Moderate Transmission Settings in Tanzania: A Modelling Study, Curr Res Parasitol Vector Borne Dis. 2026 Aug 25; 10:100429, https://doi.org/10.1016/j.crpvbd.2026.100429 concludes after simulations derived from entomological data, that “[d]espite higher unit costs, chlorfenapyr-α-cypermethrin nets demonstrated a competitive cost per case averted compared to PBO and standard PY nets.”
Mbuba E & al. reviewed “household ITN washing agents used across Africa and compared mosquito mortality outcomes after laboratory washing with agents commonly used in Tanzania” in their article, Household Washing Agents and Insecticide-Treated Net Bioefficacy: Evidence from a Rapid Review and Laboratory Evaluation, Malaria World J, 2026 Sep, 17:22, https://doi.org/10.5281/zenodo.22898431. “Mortality declined significantly with increasing wash number regardless of washing agent… Bar soaps were the most frequently reported agents used for ITN washing across the settings in Africa included in the review. No significant differences in mosquito mortality were observed between household washing agents and [the agent recommended by WHO for laboratory analysis] in this exploratory laboratory study.”
Sande NC & al. compared the effects of nicotine extract on two different wild species of Anopheles to the effects of clothianidin, a commonly used insecticide, with water used as the control substance. “Results showed that both clothianidin and tobacco extract elicited 100% mortality in adult wild Anopheles mosquitoes and the Kisumu strain after 24 h.” They conclude in Insecticidal Effectiveness of Nicotine from Nicotiana tabacum Against Species of Anopheles gambiae Complex and Anopheles funestus group (Diptera: Culicidae) from the Luapula Province of Zambia, Malaria J, 2026 Sep 25, https://doi.org/10.1186/s12936-026-06163-w that “Nicotiana tabacum leaf extract demonstrated insecticidal activity against wild An. gambiae s.s. and An. funestus s.s. under laboratory conditions, supporting its potential for further investigation as a plant-based vector control candidate.”
Kilian ST & al. assert that “[c]ommon management strategies [to prevent malaria] such as insecticide-treated nets and residual spraying are proving to be more unreliable. As a result, novel control strategies must be developed to address the arms race between humans and the primary malaria vector, Anopheles gambiae.” In Identifying Transgenic Approaches to Mitigate Vector Transmission of Malaria by Anopheles gambiae, Cureus. 2026 Jul 27; 18(7):e113451, https://doi.org/10.7759/cureus.113451, they “delve into novel control strategies currently being used for [An.] gambiae and consider potential barriers for their use.” The article focuses on literature topics of "Anopheles gambiae", "malaria vector", "gene drive", "Wolbachia", "CRISPR", and "transgenic mosquitoes", with emphasis on studies published in the last 10 years.
Chemoprophylaxis
Simo-Simo ML & al., A Scoping Review of Malaria Chemoprevention Strategies and Effectiveness Among Children Under Five in Africa, Int Health. 2026 Aug 14: ihag083, https://doi.org/10.1093/inthealth/ihag083 is a review of “[c]hemoprevention strategies, including perennial malaria chemoprevention (PMC), seasonal malaria chemoprevention (SMC),” along with other preventive services that involve medications. Based on a review of 42 publications, “PMC showed a protective efficacy ranging from 20% to 87.5%, while SMC's protective efficacy reached 88.2%. Protection was markedly enhanced when chemoprevention was combined with malaria vaccination (RTS, S/AS01E). Effectiveness was modulated by transmission seasonality, prevalence of asymptomatic parasitemia, and local transmission intensity.”
SMC “with sulfadoxine-pyrimethamine [SP] and amodiaquine (AQ) has been implemented in Africa since 2012 to prevent malaria among children ages 3 to 59 months old.” Zhang T & al., conducted “analyses of SMC delivery quality and its associations with key SMC outcomes” and report that the quality of communication during the delivery of SMC medications influence the compliance of caregivers with Day 2 and Day 3 AQ administration. The paper is Understanding the Dimensions of Caregiver-Perceived Seasonal Malaria Chemoprevention Delivery Quality in Nigeria: A Structural Equation Modeling Analysis of Door-to-Door Seasonal Malaria Chemoprevention, Am J Trop Med Hyg. 2026 Aug 25: tpmd250661, https://doi.org/10.4269/ajtmh.25-0661.
SMC “reduces malaria incidence in children under five in Sahelian countries. However, transmission persists at substantial levels and incidence is re-increasing” Kazanga B & al. refer to the sum of clinical plus asymptomatic infections as “P. falciparum carriage” in Plasmodium falciparum Carriage in Central and Northern Mali amid Seasonal Malaria Chemoprevention Implementation, Malaria J, 2026 Sep 11, https://doi.org/10.1186/s12936-026-06128-z. In their study, persistence of parasite carriage in children who received [SMC] was as high as 33%. In children under age 5, who were the target of SMC, more than half of these were asymptomatic; in older children, the prevalence was as well as the proportion of clinical malaria were much higher. The authors advocate emphasizing preventive measures beyond SMC.
Please see Cissoko M & al., Evaluation of Two Delivery Strategies to Improve Coverage and Adherence to Seasonal Malaria Chemoprevention (SMC) in Mali, Malaria J, 2026 Sep 25, https://doi.org/10.1186/s12936-026-06161-y below, under Campaigns and Policies.
Angute CO & al. interviewed 384 pregnant women toward the end of their pregnancies regarding their use of intermittent preventive treatment of pregnancy (IPTp). They report in Factors Associated with the Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy in Nambale Sub-County Hospital, Kenya, Matern Health Neonatol Perinatol. 2026 Aug 14; 12(1):41, https://doi.org/10.1186/s40748-026-00278-3 that 60% received three doses of IPTp, much below the WHO target of 80%. “… participant age 21-30 years … belief in > 3 doses of IPTp preventing [malaria in pregnancy] … and having tertiary education … were associated with uptake of ≥3doses of IPTp. … attendance of ANC at least 4 times … and uptake of IPTp-SP at 14-17 gestation weeks … independently associated with optimal utilization of IPTp…”
Segala FV & al. studied the outcomes of IPTp in a setting of parasite resistance to the drugs used. Only women who were found to have parasitemia during pregnancy were included in the study, Effect of Sulfadoxine-Pyrimethamine Resistance on Birthweight and Parasite Persistence Among Women Receiving Intermittent Preventive Treatment for Malaria in Pregnancy in Northern Uganda: A Directed Acyclic Graph-Guided Analysis, Clin Microbiol Infect. 2026 Aug 13: S1198-743X(26)00452-0, https://doi.org/10.1016/j.cmi.2026.08.006. Their infective agents were typed for genetic markers for resistance. The women in question also received standard antimalarial treatment. There were no significant differences in outcomes such as low birthweight and persistent infection between those who had resistant parasites and those who did not.
Diagnosis
General diagnostics
According to Igwe MC & Alum EU, “[m]ixed malaria infections, involving concurrent Plasmodium species and/or multiple genetically distinct parasite clones, remain under-measured in routine malaria programmes…” In their paper, Mixed Malaria Infections: A Critical Review and Detect-Characterise-Act Surveillance Framework, Curr Res Parasitol Vector Borne Dis. 2026 Aug 10; 10:100425, https://doi.org/10.1016/j.crpvbd.2026.100425, they contribute “four clarifications: distinguishing mixed-species infection, within-species multiplicity, and within-host resistance-associated variation; integrating pfhrp2/pfhrp3-mediated diagnostic escape; clarifying the staged interpretation of minority resistance-associated variants in Africa; and reframing mixed infection as a marker of programme maturity.”
Sawadogo PM & al. report on “the accuracy of routine malaria microscopy in selected laboratories in Ouagadougou, Burkina Faso” in Quality Assessment of Malaria Microscopy in Ouagadougou Laboratories, Burkina Faso: Accuracy of Thick and Thin Blood Smears, Malaria J, 2026 Aug 29, https://doi.org/10.1186/s12936-026-06121-6. They “re-examined 1000 malaria blood smears initially read by 29 laboratory providers using independent expert microscopy. The slides examined were the same as those used for routine diagnosis … expert microscopy was performed using double reading to comply with the WHO standard.” While the original “[r]outine microscopy classified 184/1000 slides (18.4%) as positive and 816/1000 (81.6%) as negative, … expert re-reading identified 115/1000 (11.5%) as positive and 885/1000 (88.5%) as negative.” The authors conclude that “[r]outine malaria microscopy performance in the participating laboratories was limited by false-positive readings, highlighting the need for strengthened quality assurance and continuous competency-based training.”
“Molecular methods [of diagnosing malaria] are more sensitive and specific than conventional methods and can detect submicroscopic infections. PCR {polymerase chain reaction} techniques are the most widespread molecular methods. However, they require sophisticated equipment, specific purification procedures, and a cold chain for reagent maintenance, which makes their use very limited in many endemic areas. Loop-mediated isothermal amplification (LAMP) was first described in 2000 … as a new molecular method that amplifies DNA with high specificity, efficiency, and rapidity under isothermal conditions.” Martín-Ramírez A & al., Loop-Mediated Isothermal Amplification (LAMP) Assessment for Malaria Diagnosis in Equatorial Guinea, Pathogens. 2026 Aug 20; 15(8):872, https://doi.org/10.3390/pathogens15080872 compares the performance of these methods in a diagnostic facility in-country against a reference laboratory in Spain. The authors conclude that that Dual-LAMP-Pspp and [PCR] are suitable methods for malaria diagnosis in [Equatorial Guinea]. However, the Dual-LAMP-Pspp assay was easy to perform and interpret and provided results in a shorter time” than PCR. {While the Abstract does not mention this, the LAMP assay is genus specific as per the Article; i.e. the species infecting the patient is not identified, which has certain implications as to the treatment.}
Ntibabara SS & al., Trends and Facility-Level Factors Associated with Malaria Diagnostic Testing in Six Regions of Differing Endemicity, Mainland Tanzania, 2021–2023, Malaria J, 2025 Sep 21, https://doi.org/10.1186/s12936-026-06149-8 is a report of “a repeated cross-sectional analysis of routine health facility data from six malaria-endemic regions of mainland Tanzania” over 36 months. Data from between 1300 and 1550 facilities were examined, depending on the dates. “Facilities located in low- and very low-endemic strata consistently demonstrated lower malaria testing rates compared with those in high-endemic areas. Health centres had higher testing rates than dispensaries, while hospitals showed persistently lower testing performance. Although mRDT availability was generally adequate and overstocking increased over time, this did not translate into improved testing rates.”
Field diagnostics
Baina MT & al. studied “healthcare workers' (HCWs) knowledge, attitudes, and practices regarding [the use of RDTs] … and aimed to identify the key barriers that must be addressed to improve diagnostic malaria practices” in Congo/Brazzaville. They administered questionnaires to 211 HCWs from 36 public and private facilities. “Among participants, 96% reported using mRDTs {malaria RDTs}, though only 36% had received specific training. General malaria knowledge was low, with just 9% scoring good. Most (90%) had poor understanding of target antigens and diagnostic procedures. However, 97% and 59% perceived mRDTs as easy to use and reliable, respectively. In practice, 85.8% used both mRDTs and microscopy, but only 7.6% followed national guidelines. Following negative mRDTs in symptomatic patients, 39% requested microscopy, and 27% prescribed antimalarials based on clinical suspicion. No significant associations were found between knowledge, attitudes or practices and demographic or professional characteristics.” The article is Low Practical Knowledge but High Willingness to Use Malaria Rapid Diagnostic Tests Among Healthcare Workers in the Republic of Congo, BMC Public Health. 2026 Aug 11; 26:2330, https://doi.org/10.1186/s12889-026-28761-8.
“Accurate malaria test results are a prerequisite for effective malaria case management. The accuracy of routine Rapid Diagnostic Test [RDTs] and microscopy at lower level health centers (HC) in Uganda was determined” by Mpimbaza A & al. and reported in Diagnostic Accuracy of Routine Malaria Tests and Antimalarial Prescription Practices at Health Facilities in a[n] Endemic Setting in Uganda, Malaria J, 2026 Sep 14, https://doi.org/10.1186/s12936-026-06134-1. Among the 3981 patients in the analysis, the overall accuracy of diagnosis, as compared to thick smear study by experts, was 77%. The results in private health clinics were significantly lower than in governmental clinics. Age of patients was not associated with any variability.
Bogale A & al. studied blood samples from 384 febrile patients suspected to have malaria. By qPCR, 113 of them were proven to have falciparum malaria, another 54 either vivax or mixed infections. Positivity was much lower (69 falciparum) with RDT testing. Forty-four samples were tested for gene deletion, with 11% dual gene deletions found. The paper is Molecular Evidence of pfhrp2/pfhrp3 exon 2 Deletions and Potential HRP2-Based RDT Diagnostic Failure in Southern Ethiopia, Malaria J, 2026 Sep 21, https://doi.org/10.1186/s12936-026-06135-0.
There is much written about false negative RDTs; Nantalaga KC & al., Recent Antimalarial Treatment Predicts Positive HRP2 Rapid Diagnostic Tests in Children with No Parasites Detectable by PCR: Direct Evidence of Antigen Persistence from the 2024–25 Uganda Malaria Indicator Survey, Malaria J, 2026 Sep 25, https://doi.org/10.1186/s12936-026-06132-3 explores issues related to false positive RDTs as proven by negative PCR testing. Based on reviewing almost 7000 records from the survey quoted in the title, the authors conclude that “[i]n children with no parasites detectable by PCR, recent antimalarial treatment doubled the odds of a positive HRP2 RDT. Earlier clinical studies inferred antigen persistence from comparisons against microscopy, which cannot exclude submicroscopic infection; by using a molecular reference standard … parasitaemia detectable by PCR is excluded. Separately, microscopy missed a substantial number of PCR confirmed infections, cautioning against its use as a sole gold standard. Treatment history should inform interpretation of a positive HRP2 result, and RDT derived prevalence estimates should not be treated as interchangeable with those from other methods.”
New diagnostic methods
“In clinical settings, [malaria is diagnosed by] experienced parasitologists [who] perform microscopic examinations of thick/thin blood slides. This method is labour-intensive and is adversely affected by inter- and intra-observer variability among the microscopists.” Kumari K & al., Image Processing and Deep Convolutional Neural Network Method for Automated Malaria Parasite Detection in Thin Blood Slide Images, Diagnostics (Basel). 2026 Jul 3; 16(13):2091, https://doi.org/10.3390/diagnostics16132091 is a description of a “malaria screening algorithm using computer vision to identify and classify malaria parasite-infected red blood cells (RBC) from microscopic blood slide images.” The authors state that their method yielded 99+% accuracy in diagnosis.
“Although blood-based detection [of malaria] remains the mainstream diagnostic modality, its use is constrained by the need for trained personnel, sterile procedures, patient discomfort, and reduced sensitivity for low-parasitemia and asymptomatic infections. Recent advances in sensing and diagnostics, increasingly integrated with machine learning and artificial intelligence, have created new opportunities for noninvasive malaria detection using accessible biological samples and physiological signals.” Hong SG & al., Noninvasive Malaria Detection Beyond Blood Sampling, Sens Diagn. 2026 Jul 21, https://doi.org/10.1039/d6sd00085a “synthesizes recent progress in noninvasive malaria detection across nonblood sampling matrices, biophysical detection mechanisms, and data-driven analytical approaches. {The authors] examine diverse sampling matrices, including urine, saliva, exhaled breath, and skin-emitted volatile organic compounds with attention to their associated biomarkers, biological relevance, and operational feasibility.”
Treatment
Treatment results
Ashley EA & al. pooled and analyzed individual patient data from 31 studies of [6761] patients with uncomplicated falciparum malaria treated with various [artesunate-mefloquine (AS-MQ)] regimens (target mefloquine dose 25 mg/kg), conducted in Asia, Africa and South America and conclude in The Effect of Mefloquine Dose on Outcome of Uncomplicated Falciparum Malaria Treated with Artesunate-Mefloquine: A WWARN Systematic Review and Individual Patient Data Meta-Analysis, Malaria J, 2026 Aug 25, 25:308, http://doi.org/10.1186/s12936-026-05963-4 that “AS-MQ administered over three days is a highly efficacious ACT in low to moderate transmission areas without artemisinin resistance. While further optimisation of the mefloquine dose in the coformulation in children aged 1–5 years could be considered, dose-related early vomiting is highest in this age group and may preclude this.”
In view of reports of artemisinin partial resistance in several African countries, Ayuen DS & al. studied the effectiveness of two first-line artemisinin combination treatments among 390 children, ages 6 to 59 months in four regions. They report in Efficacy and Safety of Artesunate-Amodiaquine and Artemether-Lumefantrine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in South Sudan: A Multi-Site Therapeutic Efficacy Study, 2024–2025, Malaria J, 2026 Sep 1, https://doi.org/10.1186/s12936-026-06127-0 that aside from a 13.4% 3-day positivity in one location, all outcomes at 28 days were at least 93.3% effective among the 350 children available for follow up. The authors conclude that while the first line treatment remains effective, further study of possible artemisinin partial resistance is warranted in one location.
“Azithromycin mass drug administration (MDA) has been shown to promote child survival in high mortality settings. Azithromycin has antimalarial effects, and one possible mechanism behind mortality reduction with azithromycin may be reduction in malaria. [Ihamuotila R & al. tested] the effect of a single dose of azithromycin on malaria prevalence and parasite load in infants” by analyzing data from a clinical trial on infant mortality in Burkina Faso. The findings of A Single Dose of Azithromycin Versus Placebo for Malaria in Infants: A Cluster-Randomized Trial, PLOS Glob Public Health. 2026 Aug 20; 6(8):e0006518, https://doi.org/10.1371/journal.pgph.0006518 “do not conclusively support, but are consistent with, a hypothesis that a single dose of azithromycin reduces malaria prevalence and parasite load among infants in a malaria-endemic West African setting”.
Bouzayene A & al. report that PCR tests may remain positive after successful treatment for falciparum malaria in Persistence of Plasmodium falciparum DNA Detection After Antimalarial Treatment and the Implication of Gametocytes: A Prospective Cohort Study in a Non-Endemic Setting, Microbiol Spectr. 2026 Sep 2: e0231226, https://doi.org/10.1128/spectrum.02312-26. In a prospective cohort of 100 successfully treated patients, [the authors] analyzed 379 blood samples collected up to day 28 (D28) post-treatment… 61% of samples remained qPCR positive at D28… Persistent P. falciparum DNA detection post-treatment in a non-endemic setting predominantly reflects non-viable parasites or residual genetic material and a minority of circulating mature gametocytes. This highlights a key diagnostic pitfall: post-treatment PCR positivity does not equate to treatment failure. Results must be interpreted with clinical context, timing, and assay targets.”
Mombo-Ngoma G & al. conducted “secondary data analysis of … a prospective multicenter single arm open-label phase IIIB/IV study assessing the safety and efficacy of pyronaridine–artesunate.” Of the 1678 cases reviewed in Association Between Number of Previous Malaria Episodes and Treatment Failure Among Children and Adults with Laboratory-Confirmed Plasmodium Infection Treated with Pyronaridine-Artesunate in Gabon: A Retrospective Cohort Study, Malaria J, 2026 Sep 17, 25:336, https://doi.org/10.1186/s12936-026-06147-w, 77.4% were children. There were recurrences in 129 (7.7%) instances, of which 22 (1.3%) were recrudescence (i.e. treatment failure). For each year increase in age, there was a decrease in recurrences. Hence the authors’ conclusion that “[p]revious malaria episodes may constitute a surrogate marker for increased risk of recurrence and recrudescence, particularly in younger children. This association may reflect increased vulnerability or transient alterations in host immunity, although other unmeasured factors may also contribute.”
Side effects and complications
“Substandard and falsified (SF) medicines pose a major threat to maternal, newborn, and child health (MNCH) and malaria control in Africa. yet their true burden remains uncertain.” Based on articles published between 2010 and 2025, Rusatira JC & al. quantify the problem in Nearly One in Five Essential Medicines Fail Quality Standards in Africa: A Systematic Review and Meta-Analysis of MNCH Medicines and Antimalarials, PLOS Glob Public Health. 2026 Sep 2; 6(9):e0006326, https://doi.org/10.1371/journal.pgph.0006326. When it comes to antimalarials, failure rates in quality studies ranged between 15 and 20 percent. “Western and Central Africa had the greatest regional burdens, whereas Southern Africa showed lower pooled estimates but with sparse data. Substandard medicines accounted for most poor-quality products (pooled prevalence 12.8%), while falsified medicines were less common (1.2%).”
Guidelines
Hwang J & al. report on a new CDC guideline for treatment of P. falciparum infection in Extending the Duration of Artemether-Lumefantrine Treatment for Uncomplicated Plasmodium falciparum Malaria: Updated US Centers for Disease Control and Prevention Guidance Based on Review of Surveillance, Consultations, and Published Data, Clin Infect Dis. 2026 Aug 19: ciag456, https://doi.org/10.1093/cid/ciag456. The extension for the recommended duration of artemisinin combination therapy was in response to multiple reports of recurrence of P. falciparum in individuals who had been to Africa but stayed in the United States after treatment.
Getachew D & al. “evaluated the effectiveness of a joint clinical and laboratory strategy on the quality of inpatient test-and-treat malaria case-management… The effectiveness evaluation comprised two cross-sectional assessments: baseline at the beginning of the first annual cycle and endline after its completion.” As they report in Improving Quality of Inpatient Test-and-Treat Malaria Case-Management Using Joint Clinical and Laboratory Strategy in Kano State, Nigeria, Malaria J, 2026 Sep 9, https://doi.org/10.1186/s12936-026-06104-7, “[c]omposite test-and-treat compliance increased by 42.4%, from 13.0% … to 55.4% … both in public (11.9% ….) to 55.8% …] and private hospitals (29.7% … to 51.1% …), and for paediatric (12.2% … to 64.2% …) and adult inpatients (14.7% ,,, to 40.7%...).” The authors warn that to “maintain and further optimise performance, continuation of the intervention with repeated assessments is required.”
Rosenthal PJ & al. advise continuing intravenous artesunate treatment for children with severe malaria even in the context of partial artemisinin resistance in How Should We Treat Severe Malaria in the Setting of Artemisinin Partial Resistance? Am J Trop Med Hyg. 2026 Sep 1: tpmd260514, https://doi.org/10.4269/ajtmh.26-0514.
Drug resistance
Woime AW, Effects of Drug Resistance on the Global Spread of Malaria: A Systematic Literature Review, Health Sci Rep. 2026 Aug 31; 9(9):e73113, https://doi.org/10.1002/hsr2.73113 is a review of 22 articles between 2011 and 2025 selected by rigid criteria on the subject, after having screened hundreds of thousands of them(!) The results are reported as follows: “Drug resistance reduces treatment effectiveness and increases transmission. Artemisinin resistance, primarily associated with kelch13 mutations, is established in Southeast Asia (prevalence: 5%-47%; …) and emerging in Sub-Saharan Africa and South Asia. Resistance to partner drugs and older antimalarials remains widespread. Resistant strains increase treatment failure from 5% to 15%-20%, prolong infections, and enhance gametocyte carriage by 2-3-fold and mosquito infection rates.”
Khote FL & al. found no evidence of drug resistance mutations in the kelch13 gene in 1193 specimens of P. falciparum obtained from the DR Congo and Tanzania, two countries where falciparum malaria is very prevalent. Nonetheless they advocate continuing surveillance in the conclusion of Genomic Profiling of Drug Resistance Markers in Plasmodium falciparum Samples from the Democratic Republic of the Congo (2017) and Tanzania (2020-2021), J Antimicrob Chemother. 2026 Sep 1; 81(10):dkag309, https://doi.org/10.1093/jac/dkag309.
Bohissou FET & al., Changes in Molecular Markers of Plasmodium falciparum Drug Resistance Between 2017 and 2024 in Southern Benin, Int J Parasitol Drugs Drug Resist. 2026 Sep 1; 32:100670, https://doi.org/10.1016/j.ijpddr.2026.100670 is another article reporting on the search for drug resistance and not finding any in the geographic area studied.
Laranjinha J & al. “report recurrent Plasmodium falciparum infection following standard artemether-lumefantrine treatment in a patient with metabolic comorbidities carrying mutant parasites presenting pfkelch13 and pfmdr1 variants” (mutations that are associated with partial artemisinin resistance and lumefantrine resistance, respectively. The authors of Co-Occurrence of pfkelch13 and pfmdr1 Variants in a Recurrent Plasmodium falciparum Infection Following Standard Artemether-Lumefantrine Treatment, Int J Infect Dis. 2026 Sep 1: 109078, https://doi.org/10.1016/j.ijid.2026.109078 underscore “the need for genomic surveillance of antimalarial resistance and further investigation of host factors that may influence antimalarial drug exposure.”
Towanou Bohissou FE & al. “conducted a systematic review and meta-analysis of studies [of molecular markers of resistance to antimalarials] published between 2010 and 2024 in sub-Saharan Africa.” Close to 350 articles were reviewed, showing three mutations of the kelch13 site “expanding primarily in East Africa, reaching prevalences of 10-25% in Rwanda, Uganda, and Tanzania. In Central Africa, emergence was observed in 2021 at low levels (below 5%), while West Africa reported only sporadic low-prevalence (below 1%) detections. In contrast, resistance to some partner drugs declined substantially across Africa…” The article is Spatio-Temporal Trends of the Prevalence of Plasmodium falciparum Antimalarial Drug Resistance Markers Across Sub-Saharan Africa from 2010 to 2024: A Systematic Review and Meta-Analysis, BMC Infect Dis. 2026 Sep 3; 26:1605, https://doi.org/10.1186/s12879-026-14233-2.
Pica K & al. synthesize “the pharmacokinetics (PK) and pharmacodynamics (PD) of key antimalarial agents, evaluating how these properties influence the performance of current pharmacological regimens. Findings in the literature indicate that artemisinin-based combination therapies (ACTs) achieve rapid parasite clearance by using short-acting artemisinin derivatives paired with longer-acting partner drugs.” Their paper, Pharmacokinetics and Pharmacodynamics of Antimalarial Agents: Optimizing Combination Therapies to Overcome Resistance Mechanisms, J Clin Pharmacol. 2026 Sep; 66(9):e70291, https://doi.org/10.1002/jcph.70291 demonstrates through modeling “that well-matched half-lives and sustained post-treatment exposure are critical to prevent functional monotherapy-related resistance… Collectively, the evidence suggests that refining combination regimens through PK/PD-guided dose optimization is crucial for maintaining efficacy and preventing resistance.”
New drug research
Cabamiquine is a novel drug, effective against malaria as a single dose, which has been cited in several of these reports within the past two years. Two recent articles deal with the drug: Demarta-Gatsi C & al., In vitro Pharmacodynamics of the Antimalarial Drug Cabamiquine, Antimicrob Agents Chemother, 2026 Sep 9: e0080226, https://doi.org/10.1128/aac.00802-26 documents that in the laboratory, “results confirm that cabamiquine is a potent and fast-acting inhibitor of parasite protein translation, inducing complete arrest of the translational machinery within 6 h of drug exposure… translational arrest occurs well before parasite death. Prolonged inhibition of protein synthesis drives parasite exhaustion, followed by irreversible cell death within 48 h, preceding the parasite clearance observed in patients.” Demarta-Gatsi C & al. In-life Chemical Inactivation of Plasmodium Parasites by Cabamiquine Induces Long Lasting Immune Protection, J Infect Dis, 2026 Aug 11: jiag402, https://doi.org/10.1093/infdis/jiag402 is a report of experiments in mice. ”CBQ treatment during liver-stage infection induced durable protective immunity against homologous and heterologous sporozoite challenge, reduced disease severity, and was associated with liver-resident memory CD8+ T cells. CBQ administered with pyronaridine during blood-stage infection elicited stage-specific immunity that limited parasitemia and protected against severe malaria following homologous or heterologous challenge.”
Elemental Zinc (Zn2+) has been shown to have anticancer and antiinfective properties, possibly through enhancement of the host’s immune response. Rajendran V & al., Elemental Zinc Inhibits Plasmodium falciparum Blood-Stage Forms and Enhances the Efficacy of Standard Antimalarial Drugs in vitro, J Parasit Dis. 2026 Sep; 50(3):777-783, https://doi.org/10.1007/s12639-025-01881-5 tested Zn2+ in the laboratory against P. falciparum and found that even without a host with an immune system, it inhibited the growth of the parasite and even more so in combination with chloroquine (CQ) or dihydroartemisinin (DHA). “This study is the first to show that elemental Zn2+ alone impedes blood-stage parasites in a time- and stage-dependent manner and its combination with CQ or DHA improves antimalarial treatment effectiveness.”
“Blasticidin S is a microbially produced natural product that broadly inhibits … protein synthesis.” Fike KR & al. “explored the potential for improving the antimalarial potency and selectivity of the blasticidin S scaffold with semisynthetic analogs … The two best analogs were 2 orders of magnitude more potent than blasticidin S against Plasmodium falciparum drug-sensitive and -resistant lines while displaying low cytotoxicity toward mammalian cells.” The authors conclude that their “studies demonstrate the feasibility of generating blasticidin S analogs with potent antimalarial activity…” The paper is Development of Semisynthetic Blasticidin S Analogs with Potent and Fast-Killing Antimalarial Activity, ACS Infect Dis. 2026 Aug 14; 12(8):2788-2798, https://doi.org/10.1021/acsinfecdis.6c00362.
Asiki H & al., New Thinking for the Next Generation of Antimalarials, EMBO Mol Med. 2026 Sep 2, https://doi.org/10.1038/s44321-026-00515-4 is a review of the “discovery and development of next-generation antimalarials, including advances in phenotypic and target-based screening, omics-enabled target discovery and emerging therapeutic modalities such as long-acting agents, targeted covalent inhibitors and host-directed therapies. [The authors] further evaluate the opportunities and limitations of drug repurposing and discuss how artificial intelligence and data-driven approaches are reshaping target identification, compound optimisation and clinical development. Finally, [they] argue that future success will depend not only on scientific innovation but also on interdisciplinary collaboration, equitable partnerships, open science and the development of accessible therapies tailored to malaria-endemic populations.”
Andong BA & al. investigated the possible use of sirolimus, an immunosuppressive drug used for kidney transplant recipients, as an antimalarial agent by itself or in combination with an artemisinin derivative antimalarial. In Repurposing Sirolimus as a Single and Combination Therapy for Malaria: in silico, in vivo and Pharmacokinetic Studies, J Parasit Dis. 2026 Sep; 50(3):604-613, https://doi.org/10.1007/s12639-025-01888-y they describe experiments that resulted in direct effects on Plasmodium in the laboratory, as well as effects on Plasmodium-infected mice and suggest that “Sirolimus possesses suppressive antiplasmodial potential particularly when administered early in infection, and can be combined with Artemether to increase the curative activity of the latter.” {However, the abstract does not comment on the potential serious side effects of sirolimus in humans and the full article is unavailable for review.}
Monoclonal antibodies (mAbs) act through the immune system, yet they are not vaccines because they don’t induce the production of immunity in the host. Sullivan DJ, Monoclonal Antibody CIS43LS Sets the Bar for Long-Acting Malaria Protection, J Clin Invest. 2026 Aug 17; 136(16):e209790, https://doi.org/10.1172/jci209790 states that a particular antibody, designated in the title of the article has induces “a high level of durable protection in controlled human malaria infections. [This establishes] a solid benchmark for mAb protection, demonstrating 80% protection from liver-stage invasion for 4-6 months.” The author suggests that “[c]ombining both mAbs and long-acting malaria drugs may improve efficacy and reduce resistance.”
Mim SR & al. state that “[c]linical studies demonstrate robust protection from both vaccines and mAbs, supporting complementary combination strategies. Forward-looking approaches integrate vaccines and long-acting mAbs to leverage broad, durable immunity from vaccines and immediate, predictable protection from antibodies, particularly during seasonal peaks or in high-risk groups. The article is Quantitative and Clinical Pharmacology Perspectives on Next-Generation Malaria Prevention Using Vaccines and Long-Acting Monoclonal Antibodies, Clin Transl Sci. 2026 Aug; 19(8):e70704, https://doi.org/10.1111/cts.70704. This article could also be cited under Prevention/Vaccines
Rashid MA & al. synthesize “evidence from primary immunology studies, translational research, clinical trials and review articles to provide an updated overview of Plasmodium falciparum immunity and monoclonal antibody-based interventions” in The Promise of Monoclonal Antibody Interventions in Malaria: A Narrative Review, Clin Microbiol Infect. 2026 Aug 22: S1198-743X(26)00472-6. https://doi.org/10.1016/j.cmi.2026.08.023. The article “highlights key immunological mechanisms and biomarkers associated with protective immunity, including functional antibody responses, cell-mediated immunity, cytokine regulation, and immune memory. It further summarizes the clinical development of leading monoclonal antibodies, … which have demonstrated favorable safety profiles, prolonged serum half-lives, and high levels of protection against P. falciparum infection in controlled human malaria infection and field trials. The findings support monoclonal antibodies as promising tools for malaria prevention.
Plant extracts and traditional treatments
Azadirachta indica (neem tree) and Cryptolepis sanguinolenta (“Ghanian quinine”) are “herbs commonly used together in polyherbal products in Ghana for the treatment of malaria.” Korsah S & al.’s article, Synergistic Combination of Cryptolepis sanguinolenta (Lindl.) Schlechter (Apocynaceae) and Azadirachta indica (A. Juss) (Meliaceae) Against 3D7 and DD2 Strains of Plasmodium falciparum, Adv Pharmacol Pharm Sci. 2026 Aug 31; 2026:1273876, https://doi.org/10.1155/adpp/1273876 is a report of the investigation of the “combined effects of Azadirachta indica and Cryptolepis sanguinolenta extracts against chloroquine-sensitive (3D7) and resistant (DD2) strains of Plasmodium falciparum.” Aqueous extracts of the two plants in combination were effective in the laboratory against both strains of the parasite. The authors state that the “extracts are desirable when used in combination rather than alone.”
Other
Otsyula N & al. conducted extensive interviews in three countries to understand delays in care-seeking, diagnosis and incomplete treatment of malaria. As they describe in their article, Understanding Barriers to Effective Malaria Diagnosis and Treatment: A Mixed-Methods Study in Uganda, Nigeria, and Ivory Coast, PLOS Glob Public Health. 2026 Aug 17; 6(8):e0006921, https://doi.org/10.1371/journal.pgph.0006921, “[o]ne-third (33%) of adults and caregivers reported delayed care-seeking from a healthcare facility when experiencing symptoms. Over a third (36%) reported not being offered a diagnostic test to confirm their diagnosis when they last sought care for malaria. 56% reported prematurely discontinuing their antimalarial medication, with 41% stating that treatment can be stopped once symptoms subside.” According to the authors, key barriers, include “difficulty in identifying symptoms specific to malaria, lack of specified responsibility in testing and difficulties adhering to treatment.”
Aga W & al. define “[e]arly malaria treatment-seeking behavior … as seeking appropriate malaria treatment within 24 h of recognizing the onset of malaria-related symptoms.” Over a month and a half, they studied 422 children’s cases, among whom 214 were brought to treatment by their caregivers within 24 hours. As they report in Caregivers’ Early Malaria Treatment-Seeking Behavior for Under-Five Age of Children in Hawa Gelan District, Ethiopia 2024: A Facility-Based Cross-Sectional Study, Malaria J, 2026 Sep 21, https://doi.org/10.1186/s12936-026-06153-y, “[s]maller family size <6 …, being a farmer …, mothers who delivered in health facilities …, higher household income ≥7500 ETB …, and shorter distance to the health facility … were associated with early malaria treatment-seeking behavior.”
The endoplasmic reticulum is an intracellular organelle in all cells with a nucleus. Blank A & al, The Long and Winding Road: On the Endoplasmic Reticulum of Plasmodium and Implications for Pathogenesis, PLoS Pathogens, 2026 Aug 25, https://doi.org/10.1371/journal.ppat.1014539 is an article that reviews its particularities in two species of Plasmodium. The article is included in this report because the authors’ “hope that discussing the Plasmodium ER as both a conserved cellular hub and a source of parasite-specific biology offers promising opportunities for antimalarial strategies.”
Campaigns and Policies
In an Editorial, Christie AC & Pelletier J review “the major drivers of under-five mortality due to malaria, including low coverage of malaria prevention interventions, poor access to prompt diagnosis and appropriate treatment, and persistent socioeconomic and health system challenges. It also identifies gaps in health services, the supply chain, and human resources that hamper the implementation of current malaria control strategies.” Reducing Malaria-Related Under-Five Mortality in Nigeria Through Scalable Prevention and Treatment Strategies, Cureus. 2026 Jul 30; 18(7):e113652, https://doi.org/10.7759/cureus.113652 “recommends three feasible and scalable interventions: scaling up seasonal malaria chemoprevention, integrating malaria vaccination into routine childhood immunization services, and improving community-based case management.”
Sillah-Kanu M & al. conducted a “nationwide analysis in Sierra Leone using routine DHIS2 surveillance data, 2019-2023.” As they report in A Nationwide Study of Community- Versus Facility-Based Management of Malaria in Sierra Leone from 2019 to 2023, Public Health Action. 2026 Aug 24; 16(3):141-144, https://doi.org/10.5588/pha.25.0050, “initiation of [artemisinin combination therapy] within 24 h of reported fever onset was higher among community-managed cases (72.1%) compared with facility-managed cases (61.8%) …” The authors caution that “these findings should be interpreted cautiously, given that it is an observational design and the reliance on routinely collected surveillance data.”
Pandey AK & al. reviewed 56 relevant publications between 2000 and March 2006 on the subject of drug stock-outs worldwide. As they report in their article, Drug Stock-Outs in HIV, Tuberculosis, and Malaria Programs: A Systematic Review, EClinicalMedicine. 2026 Jul 31; 98:104119, https://doi.org/10.1016/j.eclinm.2026.104119, “[k]ey causes of stock-outs included supply chain inefficiencies, procurement delays, inadequate funding, weak governance, and poor demand forecasting. Consequences included treatment interruptions, increased drug resistance, and higher morbidity and mortality, along with increased out-of-pocket costs and emergency procurement burdens. Mitigation strategies ranged from short-term responses, such as emergency purchasing and redistribution, to long-term system strengthening, including improved procurement systems, buffer stocks, supplier diversification, and digital inventory management.”
Abdi MS & al. “argue that artificial intelligence (AI) encompassing machine learning and deep learning can help shift malaria control from reactive reporting toward predictive, precision public health, while cautioning that it is one enabler among many rather than a stand-alone solution. [The autghors] examine AI across three interconnected domains: surveillance (understood broadly as case detection, entomological and intervention-coverage monitoring, and the data-to-response loop), prediction (outbreak forecasting and spatial risk mapping), and control (resource stratification and intervention optimisation)” in Artificial Intelligence for Precision Malaria Control: Transforming Surveillance, Prediction, and Intervention Strategies, Front Digit Health. 2026 Aug 6; 8:1879638, https://doi.org/10.3389/fdgth.2026.1879638. “Reported AI diagnostics can exceed 90% accuracy, and forecasting models offer useful lead times by integrating climatic, entomological and epidemiological data.”
Mao Z & al. “analyzed four rounds of Malaria Indicator Survey (MIS) data (2012-2021) to evaluate: 1) proportion of all-ages individuals with fever who sought treatment from a formal provider, 2) proportion of individuals going to CHWs {Community Health Workers} over time, among those who sought treatment at a formal provider, 3) time duration between fever onset and treatment seeking at a formal provider, and 4) proportion of children <5 with malaria that received Artemether-Lumefantrine (AL) treatment.” They found that “[l]onger walking time to the nearest health facility was associated with lower odds of treatment seeking, whereas CHW density was not associated with treatment seeking or AL receipt. Children who did not go to formal providers had lower odds of AL receipt than those who sought treatment from CHWs.” Their conclusion in Access to Malaria Diagnosis and Treatment in Zambia in the Context of Scaling-Up Community Case Management: Results from Repeated National Cross-Sectional Surveys, PLOS Glob Public Health. 2026 Sep 8; 6(9):e0007216, https://doi.org/10.1371/journal.pgph.0007216 is that “while [community case management] coverage should be maintained and further expanded, additional complementary interventions are also needed to overcome remaining access barriers.”
“Seasonal Malaria Chemoprevention (SMC) involves a 3-day regimen of sulfadoxine-pyrimethamine plus amodiaquine administered to children once a month during the high malaria season. WHO guidelines recommend that SMC distributors administer or observe treatment on the first day and leave the remaining doses for caregivers to administer (“standard SMC”). In some countries distributors return on day 2 and again on day 3 so that all doses can be directly observed (“3-day DOT”), …” Cissoko M & al. “investigated whether 3-day DOT improves SMC coverage and adherence, and reduces malaria incidence, compared to standard SMC, and whether a modified strategy, whereby standard SMC is supplemented using local community volunteers who are trained to follow-up … is as effective as 3-day DOT… Each of the three strategies was implemented in 2 health areas over 4 months.” The results, reported in Evaluation of Two Delivery Strategies to Improve Coverage and Adherence to Seasonal Malaria Chemoprevention (SMC) in Mali, Malaria J, 2026 Sep 25, https://doi.org/10.1186/s12936-026-06161-y did not support improved compliance (which was high to begin with) with the 3-day DOT. “However, SMC coverage, the percentage of children receiving at least the first dose in all four months, was higher with the community strategy than standard SMC. … Strategies to identify children who missed SMC on the first day, such as the community approach, can improve coverage at lower cost than 3-day DOT.”
Tague C & al., Malaria Elimination in Suriname, Timor-Leste and Georgia: Strategic Lessons for Sub-Saharan Africa, J Trop Med. 2026 Sep 2; 2026:2927281, https://doi.org/10.1155/jotm/2927281 “describes and synthesises malaria elimination experiences in Suriname, Timor-Leste and Georgia, all three certified malaria-free by the World Health Organization in 2025, to identify strategic lessons and contextual factors that may inform elimination efforts in malaria-endemic countries, including those in Sub-Saharan Africa… : The three countries share several common determinants of success: strong and sustained political commitment, robust epidemiological surveillance systems, active community mobilisation and consistent financial support. Strategies were adapted to context: involvement of indigenous communities and cross-border control in the Amazon basin (Suriname), universal coverage and extensive partner support in a postconflict setting (Timor-Leste) and institutional resilience and postelimination vigilance in a context of political transition (Georgia).”
Epidemiology
Climate change, biodiversity and environment
According to Cruz-Laufer AJ & al., “[m]ost malaria control efforts focus on freshwater mosquito vectors, leaving saltwater-tolerant vector mosquitoes inhabiting coastal ecosystems like mangrove forests understudied. Historically, the role of mangrove forests as breeding grounds for malaria vectors often motivated their destruction. However, mangroves provide crucial ecosystem services, and their impact on malaria transmission remains poorly understood.” Based on studies from 27 Afrfican countries, their paper, Malaria Prevalence near African Mangroves: Negative Association with Mangrove Extent, but Positive Association with Mangrove Greenness, Glob Chang Biol. 2026 Sep; 32(9):e71058, https://doi.org/10.1111/gcb.71058 states that “increasing mangrove land cover is associated with decreasing malaria prevalence at coarse spatial resolution, refuting the traditional view of mangroves as disease-promoting environments … [yet] at fine and coarse spatial resolutions, increasing mangrove health (i.e., greener vegetation) is associated with increasing malaria prevalence.” This paradox may be driving the authors to state that the “precise impact of mangrove vegetation likely depends on the geographic location, configuration of the forests, and the identity and competence of host and vector species.”
Chivasa T & al. developed a “climate-sensitive transmission model integrated with 11 years of clinical surveillance and facility-level spatial risk data was applied to assess malaria elimination prospects in Zimbabwe's Mberengwa District.” They state in Predictive Modelling of Climate-Driven Malaria Transmission for Optimal Control Using a Coupled SEIR-SEI and GIS Framework, Public Health Chall. 2026 Sep 15; 5(3):e70375, https://doi.org/10.1002/puh2.70375 that using “mid-century warming in a high-emission scenario, the peak infectious prevalence is projected to increase by more than 4-fold, and the duration of high-intensity transmission will increase from 213 to 250 days per year. … Simulations indicate that high-coverage spraying alone can achieve elimination, and a fully integrated strategy, including bed nets, spraying and gametocyte-targeting therapy, can reduce transmission by 85%. Spatial mapping of 37 health facility catchments highlighted five high-priority hotspots concentrated in the southern and south-eastern health facilities…” {It is unclear whether this journal subjects articles to pre-publication peer review}.
The capacity of Anopheles stephensi “to exploit anthropogenic water storage containers—cisterns, water tanks, wells, and discarded tires—enables adaptation to urban and peri-urban environments independent of seasonal rainfall, thereby representing a growing and novel threat to vector control strategies. In Benin, favorable environmental and demographic conditions suggest a potential risk of ecological establishment …” Sominahouin A & al., Risk Mapping and Determinants of the Potential Presence of Anopheles stephensi in Benin: A Geostatistical and Logistic Regression Approach, Malaria J, 2026 Sep 19, https://doi.org/10. 1186/s12936-026-06152-z “aimed to identify the determinants associated with the ecological suitability for An. stephensi and to map the spatial distribution of predicted potential occurrence risk across all 77 municipalities of Benin.” The article “identifies urban and peri-urban municipalities of Benin as zones of highest ecological suitability for An. stephensi, primarily driven by human population density and swine husbandry. The absence of associations with rainfall and temperature is consistent with the distinctive ecology of An. stephensi, which is independent of seasonal rainfall and insensitive to high temperatures. These findings provide prioritization tools for entomological surveillance and preventive interventions, with particular attention to the distinct characteristics of urban, peri-urban, and rural biotopes.”
Although Tanış C, The Relationship Between Swamps and Malaria: A Review of the Studies Titled The Sanitary and Social Geography of Turkey, Philos Ethics Humanit Med. 2026 Sep 1; 21:23, https://doi.org/10.1186/s13010-026-00230-5 deals with the distant past and is not focused on Africa, its conclusions about the complexity of the influence of the environment, including agriculture, on the incidence of malaria is of interest.
Risk factors
Wand H & al. “used pooled Demographic and Health Survey data (2017-2023) from 10 sub-Saharan African countries to assess malaria positivity among children under five. Geospatial smoothing models were used to describe sub-national variation and identify areas of higher malaria positivity.” They report in Public Health Implications of Geospatial Targeting to Prevent Malaria Infection in Under-Five Children Across Sub-Saharan Africa, Public Health. 2026 Aug 28; 259:106457, https://doi.org/10.1016/j.puhe.2026.106457 that “[r]ural residence ... [s]tructural factors including lack of piped-water, electricity, household-amenities, and maternal education were consistently linked to higher malaria risk in all countries…. Child anemia …, recent fever, and inadequate antenatal care were also strong predictors of infection.”
Two papers from Uganda address socioeconomic risk for children developing malaria. Oliveira CG & al., Socioeconomic Determinants of Malaria in Ugandan Children: An Interpretable Machine Learning Approach for Public Health Policy, PLOS Digit Health. 2026 Sep 3; 5(9):e0001152, https://doi.org/10.1371/journal.pdig.0001152 seems to concentrate on the methodology of finding the determinants rather than the socioeconomic risk factors. Musoke D, & al. Barriers and Opportunities to Addressing Social Determinants of Malaria in Wakiso District, Uganda, PLOS Glob Public Health. 2026 Sep 9; 6(9):e0006922, identifies “three key barriers and two opportunities to addressing the social determinants of malaria. The barriers were: 1. a curative-focused approach in national policies and private healthcare highlighting minimal commitment in addressing these determinants; 2. inadequate coordination among government institutions and partner organisations in addressing social determinants of malaria; and 3. complacency at both community and government levels due to malaria's endemic nature. The opportunities identified were: 1. the presence of multiple stakeholders actively involved in malaria control including the Ministry of Health and other entities such as NGOs; and 2. the existence of robust government structures at national, district, and community levels including CHWs, health inspectors, malaria focal persons and the model homes initiative which provide a strong foundation to address social determinants of malaria in the country.”
Park S & al. found that children who have circulating antibodies to blood-stage Plasmodium are less likely to become ill with malaria, and the ones who do come down with it, tend to have lower parasite count than children with low levels of antibody. The article is Antibodies Targeting Blood Stage Antigens of Plasmodium falciparum are Associated with Resistance to Malaria Infection and Disease, Clin Infect Dis. 2026 Sep 4: ciag544, https://doi.org/10.1093/cid/ciag544
General epidemiology
Based on a study of “254 children aged 7-9 years [who] underwent neurocognitive assessment and Pf detection by microscopy at baseline, 4, and 8 weeks,” McHenry MS & al., Association of Asymptomatic Plasmodium falciparum Infections and Its Treatment with Short-Term Cognitive Performance in School-Aged Children: A Prospective Cohort Study in Western Kenya, J Infect. 2026 Aug 19: 106831, https://doi.org/10.1016/j.jinf.2026.106831 reports a significant “decline in a composite cognitive score over time …, while treatment of microscopy-detectable infections correlated with improvement … Higher levels of the inflammatory cytokine CXCL11/ITAC were associated with lower cognitive performance…” leading to the authors’ conclusion that “[a]symptomatic [P. falciparum] parasitaemia may negatively influence short-term cognition in young schoolchildren living in an area of intense malaria transmission. Low-level inflammation may play a role in this effect.”
Abate AY & al. looked at the implementation of a new national strategy for malaria surveillance and reporting. As described in Evaluation of the “1–3–7” Surveillance and Response Approach for Malaria Elimination and Challenges Faced in Its Initial Phase of Implementation: Farta District, Ethiopia, Malaria J, 2026 Sep 3, https://doi.org/10.1186/s12936-026-06124-3, a “key component of this strategy is the adoption of the ‘1–3–7’ surveillance and response approach, which emphasizes timely case detection and intervention. The approach involves three key steps: reporting confirmed malaria cases within one day, investigating cases and their contacts within three days, and initiating appropriate responses to prevent further transmission within seven days.” The authors studied the reporting for 9 months and interviewed 22 health workers as part of their study. The vast majority of cases were reported and investigated within the time periods required, but “only 31.8% of key players [demonstrated] adequate knowledge.”
Mbabazi M & al. “integrated epidemiologic surveillance with parasite genomics to characterize imported malaria episodes at three health facilities in southwestern Uganda. Between January 2023 and June 2024, [the authors] enrolled microscopy-confirmed malaria cases at three health facilities, Maziba and Muko (very low transmission) and Kamwezi (low-to-moderate transmission), administered travel history questionnaires, and collected dried blood spots” from 348 P. falciparum infections for genotyping. The results, reported in Imported Malaria Predominates in Near-Elimination Settings in Southwestern Uganda, PLOS Glob Public Health. 2026 Aug 12; 6(8):e0005951, https://doi.org/10.1371/journal.pgph.0005951, documented that whereas the cases from the very low transmission areas were imported from high-transmission areas in Uganda, the cases in Kamwezi were mostly clustered with similar genotypes and were therefore accounted for as locally acquired.
Despite its title, Yahoue G & al., Two Decades of Malaria in Burkina Faso (2004–2024): National and Regional Trends and Coverage of Preventive Interventions in Children Under Five and Pregnant Women, Malaria J, 2026 Sep 21, https://doi.org/10.1186/s12936-026-06142-1 is a retrospective analysis of “routine malaria surveillance data from the national health information system at both the national level and across the 13 administrative regions of Burkina Faso.” The data cited indicated that the “proportion of severe malaria cases among children under 5 years of age increased in all 12 regions studied between 2016–2018 and 2022–2024, despite a concurrent decline in incidence and mortality in this population. National malaria incidence increased from 140.9 cases per 1000 population in 2004 to a peak of 607.0 cases per 1000 population in 2017, before declining to 458.0 cases per 1000 population in 2024. This trend was primarily driven by uncomplicated malaria cases. The case fatality rate (deaths per 100 severe cases) increased from 1.07% … in 2004 to a peak of 2.32% (… in 2009–2010, before declining to 0.63% … in 2024. Marked regional disparities persisted…”
Spatiotemporal studies
Koenig V & al., Resurgence of Malaria in Northern Ethiopia (Tigray), 2018-2024: Evidence from Routine Surveillance Data, Trop Med Health. 2026 Jul 28; 54:168, https://doi.org/10.1186/s41182-026-01039-w
Ekuban AA & Baiden F, A 5-Year Retrospective Morbidity Profile of School-Aged Children at Ho Polyclinic, Volta Region, Ghana: Skin Conditions, Malaria, and Respiratory Illnesses as Leading Causes (2018-2022), Public Health Chall. 2026 Aug 14; 5(3):e70347, https://doi.org/10.1002/puh2.70347. {It is unclear whether this journal subjects articles to pre-publication peer review.}
Amsalu H & Girma A, Five-Year Trend Analysis of Malaria Prevalence at Pawe General Hospital, Northwest Ethiopia, from 2020 to 2024: A Cross-Sectional Retrospective Study (STROBE Compliant), Medicine (Baltimore). 2026 Aug 21; 105(34):e50360, https://doi.org/10.1097/md.0000000000050360
Negesse A & al., Prevalence of Malaria and Its Determinants Among Urban Residents in Central Ethiopia: Health Center- and Household-Based Study, Malaria J, 2026 Sep 9, https://doi.org/10.1186/s12936-026-06129-y
Geleto DL & al., Mapping Malaria Risk Zones Using GIS-Based Multi-Criteria Evaluation in Ilu Aba Bora Zone, Western Ethiopia, Malaria J, 2026 Sep 17, https://doi.org/10.1186/s12936-026-06131-4
Ayele H & al., Umbrella Review and Meta-Analysis on Malaria Infection and Associated Factors Among Pregnant Women in Africa, 2026, Malaria J, 2026 Sep 17, https://doi.org/10.1186/s12936-026-06157-8
Mbanze J & al., Determinants of Malaria Infection in Mopeia District, Mozambique: A Population-Based Cross-Sectional Study, Malaria J, 2026 Sep 21, https://doi.org/10.1186/s12936-026-06141-2
Jawneh SS & al., Epidemiological Assessment of Malaria in Children Under Five in Kanifing General Hospital, The Gambia: Analysing Seasonality, Spatial Distribution, and Predictors of Fatality (2021–2024), Malaria J, 2026 Sep 22, https://doi.org/10.1186/s12936-026-06145-y