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Journal articles on the topic 'Malaria morbidity'

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Published: 4 June 2021
Last updated: 5 February 2022

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1

Ghanghoriya, Pawan, Rahul Borkar, Monica Lazarus, and Manish Ajmariya. "Study of malaria and associated co-morbidity in children admitted with fever manifestation in a tertiary care centre." International Journal of Contemporary Pediatrics 7, no. 8 (July 22, 2020): 1705. http://dx.doi.org/10.18203/2349-3291.ijcp20203161.

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Background: Children under five year of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with anti-malarial medications. Authors set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in tertiary care center NSCB Medical college Jabalpur, India.Methods: This prospective and analytic study focused on children admitted with fever in pediatric unit of N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India. If any co-morbidity present with malaria their manifestation was noted. Association of co-morbidity with malaria was done, and effect of co-morbidity on severity of malaria and outcome of patients was noted.Results: A total number of 1950 of children suspected to have malaria who were tested by RDT and microscopy (PSMP), out of them 100 children were positive. Mean age calculated was 7.3±4.3 years. Maximum number of severe malaria cases (40.6%) were found in 6 months to <5 years age group. Most common co-morbidity associated with malaria was anemia (53%) followed by pneumonia (36%) hepatitis (26%), diarrhea (24%), enteric fever (15%), septicemia and meningoencephalitis (10%) each, UTI (4%), and AKI (6%), while dengue (3%) and severe acute malnutrition (2%). Out of 69 cases of severe malaria 46.3% cases had two and 34.7% cases had more than two co-morbidities while in 31 cases of uncomplicated malaria 38.7% cases had two co-morbidity and only 3% had more than two co-morbidity.Conclusions: All RDT positive cases have associated co-morbidity with malaria in our study, more is the co-morbidity is longer were the duration of stay and higher the complications and even mortality.
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2

Snow, R. W., A. Menon, and B. M. Greenwood. "Measuring morbidity from malaria." Annals of Tropical Medicine & Parasitology 83, no. 3 (January 1989): 321–23. http://dx.doi.org/10.1080/00034983.1989.11812350.

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3

Marsh, K. "Malaria-a neglected disease?" Parasitology 104, S1 (June 1992): S53—S69. http://dx.doi.org/10.1017/s0031182000075247.

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SUMMARYIn situations where malaria eradication is not an option in the foreseeable future the emphasis must be on the control of morbidity and mortality due to malaria. Under such circumstances drawing a distinction between malarial parasitization and malarial disease may be important for workers in both field and laboratory. This concept is explored from the points of view of the epidemiological picture of malaria in endemic populations, the factors which may influence progression to disease and the processes which mediate disease.
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4

Soma-Pillay, P., and A. P. Macdonald. "Malaria in pregnancy." Obstetric Medicine 5, no. 1 (January 5, 2012): 2–5. http://dx.doi.org/10.1258/om.2011.110063.

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Malaria is a complex parasitic disease affecting about 32 million pregnancies each year in sub-Saharan Africa. Pregnant women are especially susceptible to malarial infection and have the risk of developing severe disease and birth complications. The target of Millennium Development Goal 6 is to end malaria deaths by 2015. Maternal and perinatal morbidity and mortality due to malaria may be reduced by implementing preventive measures, early diagnosis of suspected cases, effective antimalarial therapy and treatment of complications.
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5

Orish, Verner N., Joseph Y. Ansong, Isaac B. Anagi, Onyekachi S. Onyeabor, Adekunle O. Sanyaolu, and Nnaemeka C. Iriemenam. "Malaria and associated co-morbidity in children admitted with fever manifestation in Western Ghana: A retrospective study." Journal of Infection in Developing Countries 9, no. 11 (November 30, 2015): 1257–63. http://dx.doi.org/10.3855/jidc.6316.

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Introduction: Children under five years of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with effective anti-malarial medications. We set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in Sekondi-Takoradi, Ghana. Methodology: This retrospective study focused on children admitted with fever over a three-year period at the pediatric unit of Effia-Nkwanta Regional Hospital. The children were identified, and the medical records of those who were successfully treated and discharged were searched, retrieved, and reviewed. Results: A total of 1,193 children were identified and selected for analysis. The mean duration of admission increased from 2.17 days in 2010 to 3.36 in 2012. Conversely, the mean age decreased from 3.85 years in 2010 to 2.74 in 2012. Overall, laboratory-confirmed malaria prevalence decreased; however, this decrease was only observed among children five years of age or younger, while malaria prevalence increased among children one year of age or younger. The proportion of children with severe malarial anemia significantly increased, while the proportion of those with mild malaria decreased significantly. Conclusions: Despite the general decrease in malaria morbidity seen in this study, children younger than one year of age remain at increased risk of malaria morbidity. With an increase in malaria prevalence among children younger than one year of age over the three years of study, integrated and targeted control measures are highly needed for this age group.
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6

Hafsari, Tria Anggita, Yulinda Nurul Aini, and Fuat Edi Kurniawan. "Malaria Morbidity Prediction Scenario in Indonesia." Journal of Indonesian Social Sciences and Humanities 9, no. 1 (June 28, 2019): 57–70. http://dx.doi.org/10.14203/jissh.v9i1.97.

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Governments commitment in eradicating malaria has been realized in Malaria elimination program. The program aims to reduce Malaria case to zero in 2030. Starting from 2011, Indonesia suffered a drop in APIs value from 1,75 to 0,84. Despite the numerous drop in Malaria cases, some regions are still suffering from large major outbreaks especially in eastern Indonesia. WHO declares that Indonesia is a country at risk of malaria, because of the high rates of malaria morbidity. The aims of this paper is to predict the trend of malaria morbidity with the API variable value of each province in Indonesia. The method used in this research is probabilistic method using extrapolation trends and ARIMA (Autoregressive Integrated Moving Average) using variation percentage of training and testing data to obtain the best prediction method. Result of this article is API value scenario in Indonesia up to 2030. Based on the analysis result, the best method to predict the value of API is exponential growth method because it has the smallest MAPE value, which is 38.48 using 80% training data and 20% testing data. The prediction results show that from year 2018 to 2030, the value of API will decrease from 0.45 to 0.016.
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7

Miller, Max J. "Malaria morbidity in West Africa." Transactions of the Royal Society of Tropical Medicine and Hygiene 80, no. 2 (January 1986): 347–48. http://dx.doi.org/10.1016/0035-9203(86)90056-8.

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8

Greenwood, B. M., P. H. David, L. N. Otoo-Forbes, S. J. Allen, P. L. Alonso, J. R. Armstrong Schellenberg, P. Byass, M. Hurwitz, A. Menon, and R. W. Snow. "Mortality and morbidity from malaria after stopping malaria chemoprophylaxis." Transactions of the Royal Society of Tropical Medicine and Hygiene 89, no. 6 (November 1995): 629–33. http://dx.doi.org/10.1016/0035-9203(95)90419-0.

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9

Marsh, Kevin, and Robert W. Snow. "Host—parasite interaction and morbidity in malaria endemic areas." Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 352, no. 1359 (September 29, 1997): 1385–94. http://dx.doi.org/10.1098/rstb.1997.0124.

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Severe morbidity due to Plasmodium falciparum is a major health problem in African children. The patterns of morbidity in endemic areas are modified by the immune response, and vary markedly with transmission intensity. Severe disease falls into three overlapping syndromes: coma, respiratory distress, and severe anaemia. Recently, it has become clear that metabolic acidosis plays a major role in the pathogenesis of severe disease and is particularly important in the overlap between the different clinical syndromes. We propose that the different manifestations of severe malarial morbidity arise from the interaction of a limited number of pathogenic processes: red cell destruction, toxin–mediated activation of cytokine cascades, and infected cell sequestration in tissue microvascular beds. The pattern of severe morbidity varies with age within any one endemic area, with severe anaemia predominating in the youngest children and coma having its highest incidence in older children. Between endemic areas there is a marked variation in mean age of children with severe malaria, and therefore in the importance of different clinical syndromes. The shift in mean age is due to a combination of increased challenge and more rapid development of immunity at higher levels of transmission. Recent comparative studies indicate that at higher levels of transmission the net effect of these shifts may be a paradoxical reduction in total severe malarial morbidity.
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10

Hati, Jagannath, Gouri Oram, and Purna Chandra Karua. "Influence of ABO Blood Group Homozygous and Heterozygous Alpha Thalassemia on the Severity of Falciparum Malaria in India." Journal of Evidence Based Medicine and Healthcare 7, no. 52 (December 28, 2020): 3131–36. http://dx.doi.org/10.18410/jebmh/2020/638.

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BACKGROUND Malaria is a global health burden. About 300 - 500 million people suffer from the disease every year, out of whom, about 1 million succumb.1 This study was undertaken, as there has been no such study regarding the possible effect of - thalassemia and ABO blood group in Indian population on falciparum malarial infection. METHODS This is an observational study carried on in all malarial patients admitted in the Department of General Medicine, VSS Medical College & Hospital, Burla, between October 2008 - September 2010. Inclusion criteria: (i) Fever with positive asexual forms of falciparum malarial parasites [thick smear, thin smear, positive quantitative buffy coat (QBC), ICT test]. (ii) WHO criteria for severe falciparum malaria2 . “Controls”: Healthy persons of about same age, sex, ethnicity and locality. Exclusion Criteria: Blood transfusion within 3 months, cases of DM, CKD, hepatitis, SCD, tuberculosis, HIV, chronic liver disease, and COPD. RESULTS 128 cases of malaria, between 15 - 75 years, both sexes, pregnant / non-pregnant were included in the study. For control, the gene frequencies were  /  29 (45.3 %),  3.7 /  27 (42.2 %) and 3.7 / 3.7 8 (12.5 %). For cases, it was found 33 (51.56 %), 25 (39.1 %) and 6 (9.4 %) respectively. In HPLC, HbA0 values of 3.7 / 3.7 (81.83  10) were >  /  (77.11  21.6) >  3.7 / , (64.8 ± 32.42), HbA2 values of  /  (2.1  1.4) >  3.7 /  (1.8 ± 0.8) > 3.7 / 3.7 (1.43  0.27). In HbF, there were nearly same number of cases in all three variants and were negligible in HbS. Anaemia, jaundice, oliguria were the predominant causes of morbidity in alpha thalassaemic patients with severe falciparum malaria. Blood group A patients had significantly higher morbidity than blood group B, AB and O. CONCLUSIONS The percentage of anaemia, coma, convulsion and death was significantly less in homozygous alpha thalassemia cases in comparison to normal alpha thalassemia and heterozygous alpha thalassemia. Above features were also found to be significantly less in blood group O patients, and significantly high in blood group A patients, when compared to other blood groups. Prevalence of heterozygous and homozygous -thalassemia was lower in cases in comparison to controls. MCV was significantly lower in homozygous alpha thalassemia patients in comparison to other genotypes of alpha thalassemia. Anaemia, jaundice, coma, shock, oliguria, being the major co-morbidity conditions, should be detected and treated early. KEYWORDS Severe falciparum Malaria, ABO Blood Group, Homozygous & Heterozygous, -Thalassemia
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11

McClean, Karen L., and A. Senthilselvan. "Mosquito Bed Nets: Implementation in Rural Villages in Zambia and the Effect on Subclinical Parasitaemia and Haemoglobin." Tropical Doctor 32, no. 3 (July 2002): 139–42. http://dx.doi.org/10.1177/004947550203200306.

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Malaria continues to be an increasing health concern in many endemic areas where it remains a major contributor to childhood morbidity and mortality. Chemoprophylaxis and treatment are increasingly compromised by drug resistance. Vaccination for malaria is not yet available outside clinical trials. In clinical trials bed nets have been shown to be effective in reducing malarial morbidity and mortality. Their efficacy outside of the clinical trial setting has been less well documented. We describe our experience with the introduction of bed nets in a remote rural Zambian village and document the effect on malarial parasitaemia, spleen rates and haemoglobin. Children were evaluated at the end of the rainy seasons in April 1998 and April 1999. Insecticide impregnated nets were made available for purchase to the village in July 1998. Rates of parasitaemia and anaemia were significantly reduced.
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12

Lamikanra, Abigail A., Douglas Brown, Alexandre Potocnik, Climent Casals-Pascual, Jean Langhorne, and David J. Roberts. "Malarial anemia: of mice and men." Blood 110, no. 1 (July 1, 2007): 18–28. http://dx.doi.org/10.1182/blood-2006-09-018069.

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Severe malaria is manifest by a variety of clinical syndromes dependent on properties of both the host and the parasite. In young infants, severe malarial anemia (SMA) is the most common syndrome of severe disease and contributes substantially to the considerable mortality and morbidity from malaria. There is now growing evidence, from both human and mouse studies of malaria, to show that anemia is due not only to increased hemolysis of infected and clearance of uninfected red blood cells (RBCs) but also to an inability of the infected host to produce an adequate erythroid response. In this review, we will summarize the recent clinical and experimental studies of malaria to highlight similarities and differences in human and mouse pathology that result in anemia and so inform the use of mouse models in the study of severe malarial anemia in humans.
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13

Wigaty, Lirih, Samsul Bakri, Trio Santoso, and Dyah Wulan S. R. Wardani. "Pengaruh Perubahan Penggunaan Lahan Terhadap Angka Kesakitan Malaria : Studi Di Provinsi Lampung." Jurnal Sylva Lestari 4, no. 3 (June 8, 2016): 1. http://dx.doi.org/10.23960/jsl341-10.

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Ecological disruption as a result of changes in the area of forest cover to other land uses can affect the microclimate and impact toward malaria morbidity. Malaria is an infectious disease caused by protozoa a genus of Plasmodium that transmitted by female Anopheles sp. mosquito vectors. The environmental factors that play a role in the risk to transmission of malaria related to vector breeding places. The purpose of this research is establish the impact of land use changes toward malaria morbidity. This study was conducted from March to September 2015. Dynamics of land use changes in regency/city be identified through interpretation of landsat imagery in 2002, 2009, and 2014 with supervised classification and resulted in percentage of land use, the influence of impact toward malaria morbidity processed using multiple linear regression models. Parameter optimization using statistic software. The result showed that the impact of positive variable that significant toward malaria morbidity are mangrove forest and total population, while impact of negative variable that significant are extensive swamp and health personnel. Variable which not impact that significant toward malaria morbidity are forests, community forests, undeveloped land, dry land, other land uses, population density, precipitation, unhealthyhousing, urban, and physiographic. Keywords : land use, malaria morbidity
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14

Kodeih, Hanna, James Maher, and Natalia Schlabritz-Lutsevich. "The management of a pregnant patient with malaria in West Texas." Southwest Respiratory and Critical Care Chronicles 7, no. 28 (April 19, 2019): 47–52. http://dx.doi.org/10.12746/swrccc.v7i28.545.

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Travel associated infectious disease, such as malaria, should be considered in returningtravelers from an endemic area presenting with fever. Malaria in pregnancy has a high maternaland fetal morbidity and mortality burden. Early diagnosis is essential to improve maternal andfetal outcomes by providing maternal supportive measures and anti-malarial medication.We present a patient with severe acute febrile illness with mental status changes at 32 weeksgestation. She became acutely symptomatic including high grade fever while visiting WestTexas from Nigeria. Despite initial diagnostic uncertainty, a multidisciplinary team successfullydiagnosed and treated her severe malaria. She delivered at term with no long lasting maternal orfetal sequelae from her malarial infection. In an age of globalization, travel associated infectiousdiseases should be considered in the differential of acute febrile illness in pregnant women.
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15

Cserti-Gazdewich, Christine, Charles Musoke, Aggrey Dhabangi, Deborah Nakiboneka-Ssenabulya, Henry Ddungu, Nicolette Nabukeera-Barungi, Arthur Mpimbaza, Isaac Ssewanyana, and Walter H. Dzik. "ABO In Morbidity and Mortality of Plasmodium Falciparum malaria." Blood 116, no. 21 (November 19, 2010): 666. http://dx.doi.org/10.1182/blood.v116.21.666.666.

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Abstract Abstract 666 Background: Plasmodium falciparum malaria has been called the greatest force in human evolution as a result of its disproportionate lethality among children and its longstanding presence in human history. Malaria's complex pathogenesis is based in part on cytoadhesion, which is mediated by a parasite-derived surface protein (PfEMP1) expressed on infected erythrocytes. PfEMP1 binds with ligands on red cells, platelets, and endothelium, and through the lectin-like DBL1α domain, binds preferentially to blood Group A. This contributes to the obstruction of microvascular perfusion and to cerebral malaria, lactic acidosis, and death. Initial studies demonstrated increased cytoadhesion to Group A RBC in vitro, suggesting that Group A hosts may be at risk of greater morbidity with P falciparum. Subsequently, retrospective clinical studies demonstrated a higher proportion of Group A individuals among those with severe disease. Recently, attention has focused on malaria pathogenesis and von Willebrand factor, which is elevated in Group A individuals. While the cumulative evidence suggests a central role for ABO in malaria, proof for a driving effect on the evolutionary distribution of ABO blood groups has awaited definitive study of the relationship between ABO and P falciparum malaria mortality. We report here initial findings from the Cytoadherence in Pediatric Malaria (CPM) Study (clinicaltrials.gov, NCT 00707200) which was designed to examine associations between malaria outcomes and host blood groups implicated in erythrocyte cytoadhesion. Methods: We performed a 2 year prospective observational study of children with acute malaria (age 6 mo – 12 yr) presenting for care at Mulago Hospital, Uganda. HIV positive patients were excluded from analysis. We enrolled children who met pre-study WHO criteria for either Uncomplicated Malaria (UM) or Severe Malaria (SM). Patients were followed from the time of presentation to discharge or death. ABO blood groups were determined by standard hemagglutination. The study was approved by the Uganda National Council on Science and Technology and all participating institutions. Results: At the study's conclusion (October 2009), 2092 children were enrolled. Children with HIV (n=45), those whose blood smears lacked species-confirmed P falciparum parasitemia on review by an external, blinded reference parasitology laboratory (n=35), and one child outside of the pre-defined study age range were excluded, leaving 2011 for analysis. Of these, 1078 had UM and 855 had SM, with 48 of the SM (5.6%) being fatal cases. Among those with SM, 850 had either cerebral malaria (CM, n=174), severe malaria anemia (SMA, hemoglobin < 5g/dL, n=558), or lactic acidosis (LA, lactate >5mM, n=482) in an overlapping distribution. The proportion of individuals with Group A or AB increased with categories of increasing disease severity (UM = 28%, SM = 37.1%; fatal = 47.9%). Group O correspondingly decreased (UM = 49.9%, SM = 40.6%, fatal = 37.5%). There was a highly statistically significant difference in the distribution of A, B, AB and O between UM and SM, χ2 =29.57, p=0.000002. Importantly, we observed a significant difference between UM and fatal cases for the distribution of all four ABO groups (χ2 = 4.624, p=0.0315) which was especially significant for Group A or AB versus O (χ2 = 5.946, p=0.0147). A significant difference in ABO distribution was also observed for specific severe malaria syndromes, with Group O enriched for UM and Group A or AB enriched among those with CM (χ2= 12.18, p=0.006791) and SMA (χ2 = 34.24, p<10−5). Conclusions: This is the largest prospective study on the relationship between ABO blood groups and P falciparum malaria and the first report sufficiently powered to demonstrate the effect of ABO on survival in P falciparum malaria. We report a statistically significant and clinically important advantage among group O hosts and a corresponding disadvantage for group A or AB hosts. Our results confirm clinically the findings of in vitro studies on ABO and cytoadhesion as well as prior retrospective studies on ABO and disease severity. Because our study was conducted in children, the results have direct bearing on the effect of malaria on genetic selection. The results have implications for the pathogenesis of P falciparum malaria, for new treatment strategies aimed at interrupting cytoadhesion, and for our understanding of the worldwide distribution of ABO blood groups. Disclosures: No relevant conflicts of interest to declare.
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Lusingu, John, Daniel Minja, and Thor Theander. "PO 8575 EVOLUTION OF MALARIA MORBIDITY IN TWO VILLAGES IN KOROGWE, TANZANIA." BMJ Global Health 4, Suppl 3 (April 2019): A56.3—A57. http://dx.doi.org/10.1136/bmjgh-2019-edc.149.

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BackgroundThe malaria burden has decreased significantly in recent years in sub-Saharan Africa due to targeted interventions aimed at parasites and vectors. However, studies have shown that a limited number of infective bites makes individuals in malaria-endemic regions more susceptible to subsequent malaria infection as they grow older due to waning or lost immunity. This study investigated the evolution of malaria morbidity for 14 years in Korogwe, Tanzania since 2003.MethodsA longitudinal study was carried out in Korogwe over 14 years, from January 2003 to December 2017 whereby community health workers (CHWs) passively monitored malaria episodes at a village health post. They evaluated febrile episodes and collected blood smears from all residents of the community who presented with fever. The blood smears were processed and read at the Korogwe field station by two independent microscopists. Artemisinin combination therapy (ACT) and malaria rapid diagnostic tests were introduced in the community in 2007. Uncomplicated malaria cases were treated with sulphadoxine-pyrimethamine (SP) from 2003 to 2006, then with artemether-lumefantrine (ALu) from 2007.ResultsA total of 20,841 attendances were documented by CHWs between 2003 and 2017. Malaria parasitaemia was documented in 5043 consultations [24.1% (95% confidence interval (CI): 23.6% to 24.8%)]. Interestingly, malaria episodes declined markedly from 38.12% to 10.42% between 2003 and 2017. The highest reduction was documented in 2010 (at 3.1%) but thereafter, there was an increase in malaria in 2015 to 32.2% which decreased to 10.42% in 2017. Use of long-lasting insecticide-treated nets (LLINs) was associated with reduction of malaria episodes by 34% (95% CI: 26% to 42%).ConclusionPrompt diagnosis at village level, use of ACT and LLINs has contributed to the reduced number of malaria episodes in Korogwe. However, the malaria resurgences raised concerns about malaria elimination in these communities.
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17

Awoyemi, A. O. "Malaria morbidity amongst hospital workers in Ilorin." African Journal of Clinical and Experimental Microbiology 4, no. 1 (January 1, 2003): 18. http://dx.doi.org/10.4314/ajcem.v4i1.7319.

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18

Shankar, Anuraj H. "Nutritional Modulation of Malaria Morbidity and Mortality." Journal of Infectious Diseases 182, s1 (September 2000): S37—S53. http://dx.doi.org/10.1086/315906.

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19

Pathak, Vrushali A., and Kanjaksha Ghosh. "Erythropoiesis in Malaria Infections and Factors Modifying the Erythropoietic Response." Anemia 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/9310905.

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Anemia is the primary clinical manifestation of malarial infections and is responsible for the substantial rate of morbidity. The pathophysiology discussed till now catalogued several causes for malarial anemia among which ineffective erythropoiesis being remarkable one occurs silently in the bone marrow. A systematic literature search was performed and summarized information on erythropoietic response upon malaria infection and the factors responsible for the same. This review summarizes the clinical and experimental studies on patients, mouse models, and in vitro cell cultures reporting erythropoietic changes upon malaria infection as well as factors accountable for the same. Inadequate erythropoietic response during malaria infection may be the collective effect of various mediators generated by host immune response as well as parasite metabolites. The interplay between various modulators causing the pathophysiology needs to be explored further. Globin gene expression profiling upon malaria infection should also be looked into as abnormal production of globin chains could be a possible contributor to ineffective erythropoiesis.
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Mockenhaupt, Frank P., Klaus Reither, Philipp Zanger, Felix Roepcke, Ina Danquah, Eiman Saad, Peter Ziniel, et al. "Intermittent Preventive Treatment in Infants as a Means of Malaria Control: a Randomized, Double-Blind, Placebo-Controlled Trial in Northern Ghana." Antimicrobial Agents and Chemotherapy 51, no. 9 (July 16, 2007): 3273–81. http://dx.doi.org/10.1128/aac.00513-07.

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ABSTRACT Morbidity and mortality from malaria remain unacceptably high among young children in sub-Saharan Africa. Intermittent preventive treatment in infancy (IPTi) involves the administration of antimalarials alongside routine vaccinations and might be an option in malaria control. In an area of intense, perennial malaria transmission in northern Ghana, 1,200 children received IPTi with sulfadoxine-pyrimethamine or placebo at approximately 3, 9, and 15 months of age. Children were followed up until 24 months of age to assess morbidity and adverse events. During the intervention period (3 to 18 months of age), IPTi reduced the incidences of malaria and severe anemia by 22.5% (95% confidence interval, 12 to 32%) and 23.6% (95% confidence interval, 4 to 39%), respectively, and reduced hospitalizations and episodes of asymptomatic parasitemia by one-third. Protection was pronounced in the first year of life and not discernible in the second. The malaria-protective effect was largely confined to a period of 1 month after sulfadoxine-pyrimethamine treatments. Following the intervention, protection against asymptomatic parasitemia persisted. In contrast, a significant rebound of severe malaria, predominantly severe malarial anemia, occurred among children having received IPTi. Although the treatment was generally well tolerated, one case of moderately severe skin reaction followed sulfadoxine-pyrimethamine treatment. IPTi reduces malaria and anemia in infants in northern Ghana. Extension of IPTi into the second year of life by administering a dose at 15 months of age provided no substantial benefit beyond a 1-month prophylactic effect. Although this simple intervention offers one of the few available malaria-preventive measures for regions where malaria is endemic, the observed rebound of severe malaria advises caution and requires further investigation.
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Pradhan, Subal Ku, Pawan Mutalik, Tirumal Subudhi, Arakhita Swain, and Niranjan Mohanty. "Outcomes of paediatric malarial hepatopathy: a study from Eastern India." Paediatrica Indonesiana 54, no. 5 (October 30, 2014): 256. http://dx.doi.org/10.14238/pi54.5.2014.256-9.

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Background Severe malaria causes multi-organ involvement ,including hepatic dysfunction.Jaundice in severe malaria is foundmore commonly in adults than in children. It is important toassess the factors associated with malarial hepatopathy, the variedclinical presentations, as well as the complications in order toinitiate early interventional measures. There are a limited numberof studies in the pediatric population on malarial hepatopathy.Objective To assess the factors associated with malarialhepatopathy, the varied clinical presentations, as well as itscomplications.Methods This prospective study was conducted in the Departmentof Paediatrics, Sardar Vallabh Bhai Patel Post Graduate Institute ofPaediatrics (SVPPGIP), Cuttack, Odisha, India from January 20 10to June 2013, and included 70 children with malaria and jaundice,aged 6 months to 14 years. Malaria was confirmed by microscopicexamination of blood smears. Detailed clinical evaluations andinvestigation s were carried out to find multi-organ afflictions,with a special emphasis on hepatic involvement.Results Of218 children with malaria admitted during this period,70 (32%) children had fever and jaundice on presentation. Allchildren who had both Plasmodium faldparum and vivax infectionhad malarial hepatopathy. Complications, including acutekidney injury (AKI), disseminated intravascular coagulation(DIC), cerebral malaria, and mortality, were significantlyhigher among children with malarial hepatopathy compared tochildren without hepatopathy. Howevei; there was no significantdifference of hypoglycemia, respiratory distress syndrome (RDS),convulsions or severe anemia, between children with and withouthepatopathy.Conclusion Hepatopathy is more common with mixed malariainfections. The incidence of AKI, DIC, cerebral malaria, andmortality are significantly higher in patients with hepatopathy.Malarial hepatopathy should be considered in patients presentingwith acute febrile illness and jaundice so that specific treatmentcan be initiated early to prevent increased morbidity and mortality.
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SRINIVASA RAO, M., U. SURYANARYANA MURTY, K. MADHUSUDHAN RAO, N. KARTIK, G. PREEYANTEE, and N. BALAKRISHNA. "Assessment of malaria incidence using the Richards model in Arunachal Pradesh, India." Epidemiology and Infection 142, no. 10 (January 7, 2014): 2227–36. http://dx.doi.org/10.1017/s095026881300335x.

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SUMMARYMonitoring of malaria intensity in terrain regions of Arunachal Pradesh, India is very difficult as the dynamics of mosquito populations varies to a large extent due to altitude and frequent changes in climatic conditions. There is a scarcity of information on the influence of climatic factors on malaria morbidity in Arunachal Pradesh. Hence, a pilot study was conducted from 2006 to 2010 to understand malaria transmission dynamics, seasonal distribution and disease morbidity. Plasmodium vivax and P. falciparum are the two major parasites for malaria transmission in Arunachal Pradesh. Out of 142 558 malaria cases analysed from 2006 to 2010, P. vivax infection contributed 72·1% followed by P. falciparum (27·9%). However, the overall morbidity of malaria declined from 37/1000 in 2006 to 18/1000 population in 2010. From this study it was observed that the temporal distribution of malaria cases varied between districts and high morbidity rates were reported mostly during the wet season. To understand malaria transmission dynamics in the study area, the Richards model was used to predict malaria cases. The output of the results from this model predicted a higher number of malaria cases (K) during 2006 and a gradual decline in subsequent years. Similarly, the growth rate r, and exponential deviation α, were almost identical for all the years, which shows that the Richards model is the most suitable model for the prediction of malaria cases.
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Ouédraogo, Alphonse, Alfred B. Tiono, Amidou Diarra, Souleymane Sanon, Jean Baptiste Yaro, Esperance Ouedraogo, Edith C. Bougouma, et al. "Malaria Morbidity in High and Seasonal Malaria Transmission Area of Burkina Faso." PLoS ONE 8, no. 1 (January 8, 2013): e50036. http://dx.doi.org/10.1371/journal.pone.0050036.

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K, Affan. "Cost of Illness of Malaria in Coastal Karnataka, India." Journal of Communicable Diseases 53, no. 02 (June 30, 2021): 28–34. http://dx.doi.org/10.24321/0019.5138.202122.

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Background: Malaria is one of the major health issues in developing and underdeveloped countries. It is considered to be one of the main reasons for morbidity and mortality. This study intends to estimate the cost of illness of malaria at the household level and health service utilisation pattern for malaria treatment in coastal Karnataka. Materials and Methods: It was a secondary data-based cross-sectional study comprising people suffering from malaria during the period from September to December 2016. Result: The median gross total cost of illness (a single episode of malaria) was 4,000 INR, the median direct medical cost was zero, and the median direct non-medical cost was 100 INR. The majority of individuals (92.2%) took treatment from public healthcare sectors. Conclusion: The effective implementation of anti-malarial interventions by the District Health Authority, District Vector Borne Disease Control Office, and treatment from public health sectors resulted in negligible direct medical cost which made a remarkable reduction in the cost of illness of malaria.
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Sun, Guang, Wun-Ling Chang, Jie Li, Seth Mark Berney, Donald Kimpel, and Henri C. van der Heyde. "Inhibition of Platelet Adherence to Brain Microvasculature Protects against Severe Plasmodium berghei Malaria." Infection and Immunity 71, no. 11 (November 2003): 6553–61. http://dx.doi.org/10.1128/iai.71.11.6553-6561.2003.

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ABSTRACT Some patients with Plasmodium falciparum infections develop cerebral malaria, acute respiratory distress, and shock and ultimately die even though drug therapy has eliminated the parasite from the blood, suggesting that a systemic inflammatory response contributes to malarial pathogenesis. Plasmodium berghei-infected mice are a well-recognized model of severe malaria (experimental severe malaria [ESM]), and infected mice exhibit a systemic inflammatory response. Because platelets are proposed to contribute to ESM and other systemic inflammatory responses, we determined whether platelet adherence contributes to experimental malarial pathogenesis. Indeed, a significant (P < 0.005) increase in the number of rolling and adherent platelets was observed by intravital microscopy in brain venules of P. berghei-infected mice compared with the number in uninfected controls. P-selectin- or ICAM-1-deficient mice exhibit increased survival after P. berghei infection. We observed a significant (P < 0.0001) reduction in the morbidity of mice injected with anti-CD41 (αIIb or gpIIb) monoclonal antibody on day 1 of P. berghei infection compared with the morbidity of infected controls injected with rat immunoglobulin G. Additionally, platelet rolling and adhesion in brain venules were reduced in P. berghei mice lacking either P-selectin or ICAM-1 or when the platelets were coated with anti-CD41 monoclonal antibody. Unlike other inflammatory conditions, we did not detect platelet-leukocyte interactions during P. berghei malaria. Because (i) leukocyte adhesion is not markedly altered in the absence of P-selectin or ICAM-1 and (ii) CD41 is not an adhesion molecule for parasitized erythrocytes, these findings support the hypothesis that inhibition of platelet adhesion to the brain microvasculature protects against development of malarial pathogenesis.
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Rathod, Shital N., Arvind Chavan, Shilpa Sharma, Tushar Rathod, Nihal Khan, and Koustubh Bavdhankar. "Changing clinical profile of malaria at a tertiary care hospital." International Journal of Advances in Medicine 5, no. 3 (May 22, 2018): 510. http://dx.doi.org/10.18203/2349-3933.ijam20181844.

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Background: There is a widespread range of diverse typical and atypical manifestations of malaria. The diagnosis of malaria may escape the attention of treating physician due to its unusual and vague presentations.The morbidity and mortality due to malaria is increased due to lack of early diagnosis and right treatment. The Aim of the present study was to examine the changing clinical pattern of malaria with special attention to atypical presentations.Methods: The present study comprised of 630 cases of definitively diagnosed malaria.Diagnostic methods used were conventional thick and thin peripheral smear stained with Leishman stain and rapid malarial antigen test.Results: This study revealed atypical symptoms like lack of taste (1.3%), throat discomfort (13.33%) and cough (24.0%) and vomiting (52.4%) as presenting complaints. These were significantly more in patients with P. vivax infestations.Conclusions: A high degree of suspicion is necessary for early detection and treatment of malaria, especially of unusual presentations.
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Adillida, Adillida, Yoyoh Yusroh, Munar Lubis, Bidasari Lubis, Tiangsa Sembiring, and Syahril Pasaribu. "The effect of vitamin A supplementation on morbidity due to Plasmodium falciparum." Paediatrica Indonesiana 44, no. 4 (October 10, 2016): 133. http://dx.doi.org/10.14238/pi44.4.2004.133-7.

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Objective To investigate the effect of vitamin A supplementationon malaria morbidity.Methods The study was a randomized double-blind placebo-con-trolled trial, conducted in Panyabungan, Mandailing Natal, NorthSumatera from April 2001 to April 2002. Children aged 6-60 monthssuffering from falciparum malaria were randomly assigned to highdose vitamin A or placebo every 4 months for a year. All childrenwere treated in accordance with health center policy. Malaria mor-bidity was assessed from health center visit due to fever, diarrhea,cough, or abdominal pain. Parents gave reports if their child re-ceived malaria treatment from other health centers.Results The number of febrile episodes (probable malaria illness)was lower in the treatment group than that of control, but not sig-nificant. The parasitemia was not different between both groups.There was a significant difference in spleen enlargement betweenthe treatment group and control (p=0.04). There was no differencein health center visit between the two groups.Conclusion The findings suggest that vitamin A supplementationhas only effect on spleen enlargement in malaria.
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Aribodor, Dennis N., Obioma C. Nwaorgu, Christine I. Eneanya, Ikechukwu Okoli, Reed Pukkila-Worley, and Harrison O. Etaga. "Association of low birth weight and placental malarial infection in Nigeria." Journal of Infection in Developing Countries 3, no. 08 (September 15, 2009): 620–23. http://dx.doi.org/10.3855/jidc.554.

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BACKGROUND: Malaria causes significant morbidity and mortality among pregnant women in Nigeria. However, the contribution of malaria infection to neonatal development is incompletely understood. Here we determined the prevalence of placental malarial infection in six communities in Anambra State, Nigeria, between 2005 and 2006, and compare these data to neonatal birth weight. METHODOLOGY: Blood samples were obtained from the placenta of 500 parturient mothers and examined for the presence of malaria parasites. Newborn birth weight was then compared with the malaria status of their mothers. RESULTS: Placental malarial infection was found in 322 of 500 mothers (64.4%). The prevalence of infection did not differ among the six different Nigerian communities (P = 0.978). Furthermore, there was no difference in infection rates between rural and urban areas (64.9% vs. 64.0%, respectively, P = 0.827). Interestingly, neonates born from mothers with placental malaria had lower birth weights than neonates born from uninfected mothers [2500 g (range 1900 g - 3200 g) vs. 3800 g (range 3200 g - 4700 g), P < 0.001]. Forty-five percent (145/322) of the newborns born from infected mothers were of low birth weight (defined as birth weight less than 2,500 g). CONCLUSION: Malaria infection during pregnancy is common in Nigeria and is likely associated with low newborn birth weight.
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Ihekwereme, Chibueze Peter, Charles Okechukwu Esimone, and Edward Chieke Nwanegbo. "Hemozoin Inhibition and Control of Clinical Malaria." Advances in Pharmacological Sciences 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/984150.

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Malaria has a negative impact on health and social and economic life of residents of endemic countries. The ultimate goals of designing new treatment for malaria are to prevent clinical infection, reduce morbidity, and decrease mortality. There are great advances in the understanding of the parasite-host interaction through studies by various scientists. In some of these studies, attempts were made to evaluate the roles of malaria pigment or toxins in the pathogenesis of malaria. Hemozoin is a key metabolite associated with severe malaria anemia (SMA), immunosuppression, and cytokine dysfunction. Targeting of this pigment may be necessary in the design of new therapeutic products against malaria. In this review, the roles of hemozoin in the morbidity and mortality of malaria are highlighted as an essential target in the quest for effective control of clinical malaria.
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Al-Awadhi, Mohammad, Suhail Ahmad, and Jamshaid Iqbal. "Current Status and the Epidemiology of Malaria in the Middle East Region and Beyond." Microorganisms 9, no. 2 (February 9, 2021): 338. http://dx.doi.org/10.3390/microorganisms9020338.

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Vector-borne parasitic infectious diseases are important causes of morbidity and mortality globally. Malaria is one of the most common vector-borne parasitic infection and is caused by five Plasmodium species, namely P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi. Epidemiologically, differences in the patterns of malaria cases, causative agent, disease severity, antimicrobial resistance, and mortality exist across diverse geographical regions. The world witnessed 229 million malaria cases which resulted in 409,000 deaths in 2019 alone. Although malaria cases are reported from 87 countries globally, Africa bears the brunt of these infections and deaths as nearly 94% of total malaria cases and deaths occur in this continent, particularly in sub-Saharan Africa. Most of the Middle East Region countries are malaria-free as no indigenous cases of infection have been described in recent years. However, imported cases of malaria continue to occur as some of these countries. Indeed, the six Gulf Cooperation Council (GCC) countries have large expatriate population originating from malaria endemic countries. In this review, the current status and epidemiology of malaria in the Middle East Region countries and other malaria-endemic countries that are home to a large migrant workforce being employed in Middle East Region countries are discussed.
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Benn, Christine Stabell, and Peter Aaby. "Does IPTi decrease malaria morbidity but not mortality?" Lancet 380, no. 9846 (September 2012): 958–60. http://dx.doi.org/10.1016/s0140-6736(12)61184-2.

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Keating, Joseph, and Thomas P. Eisele. "Epidemiology of malaria morbidity after control scale-up." Lancet Infectious Diseases 11, no. 12 (December 2011): 891–92. http://dx.doi.org/10.1016/s1473-3099(11)70212-2.

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33

Bradley, A. K., A. M. Greenwood, P. Byass, B. M. Greenwood, K. Marsh, S. Tulloch, and R. Hayes. "BED-NETS (MOSQUITO-NETS) AND MORBIDITY FROM MALARIA." Lancet 328, no. 8500 (July 1986): 204–7. http://dx.doi.org/10.1016/s0140-6736(86)92500-6.

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Briand, V., C. Badaut, and M. Cot. "Placental malaria, maternal HIV infection and infant morbidity." Annals of Tropical Paediatrics 29, no. 2 (June 2009): 71–83. http://dx.doi.org/10.1179/146532809x440699.

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Genton, Blaise, Fadwa Al-Yaman, and MichaelP Alpers. "Assessment of malaria morbidity in vaccine efficacy trials." Lancet 345, no. 8952 (March 1995): 804. http://dx.doi.org/10.1016/s0140-6736(95)90688-6.

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Dev, V., C. R. Hira, and M. K. Rajkhowa. "Malaria-attributable morbidity in Assam, north–eastern India." Annals of Tropical Medicine And Parasitology 95, no. 8 (December 1, 2001): 789–96. http://dx.doi.org/10.1080/00034980120111136.

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Dev, V., C. R. Hira, and M. K. Rajkhowa. "Malaria-attributable morbidity in Assam, north-eastern India." Annals of Tropical Medicine & Parasitology 95, no. 8 (December 2001): 789–96. http://dx.doi.org/10.1080/00034983.2001.11813698.

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Beck, Hans-Peter. "A traffic jam to reduce morbidity in malaria." Blood 124, no. 23 (November 27, 2014): 3342–43. http://dx.doi.org/10.1182/blood-2014-09-597740.

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Trape, J.-F., and C. Rogier. "Combating malaria morbidity and mortality by reducing transmission." Parasitology Today 12, no. 6 (June 1996): 236–40. http://dx.doi.org/10.1016/0169-4758(96)10015-6.

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Amadi, Chijioke Patrick, Grace Michael Ikon, and Udoinyang Clement Inyang. "Current prevalence of falciparum malarial infection among HIV patients on highly active antiretroviral therapy in university of Uyo teaching hospital, Uyo Nigeria." International Journal of Research in Medical Sciences 6, no. 9 (August 25, 2018): 2916. http://dx.doi.org/10.18203/2320-6012.ijrms20183627.

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Background: Malaria and HIV remain two leading causes of morbidity and mortality to patients in developing African countries. Both infectious diseases have been documented to account for an enormous morbidity and mortality in Sub-Saharan Africa. The geographical overlap in sub-Saharan Africa and South America has led to similarities in co-infection with Plasmodium and HIV, this has resulted in the quick progression and severity of both diseases particularly among the poor, and contributes to the poverty of sub-Saharan African nations by taking a toll on young people who contribute greatly to the workforce of the economy. The present study was conducted to determine the prevalence of malarial infection in HIV patients receiving high active antiretroviral therapy in university Uyo teaching hospital, Uyo Nigeria.Methods: A predesigned structured questionnaire was administered to collect bio data and socio-demographic characteristics from the participants consisting 35 HIV infected adult patients and 32 non HIV infected adults as controls. All HIV patients were receiving HAART during this study. The HAART regimens used by HIV infected patients consist of zidovudine, lamivudine, efavirenze, and nevirapine.Results: About 5 (14.2%) HIV patients on HAART had falciparum malaria. No falciparum malaria was detected in HIV negative participants. Of the five positive malaria cases detected in HIV patients, 8.5% were females and 5.7% were males.Conclusions: There was no significant difference of malaria parasite infection by gender (P = 0.88), age group (P = 0.17), and CD4+ count (O.R:1.0, P = 0.81).
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Hurrell, Richard. "Iron and Malaria: Absorption, Efficacy and Safety." International Journal for Vitamin and Nutrition Research 80, no. 45 (October 1, 2010): 279–92. http://dx.doi.org/10.1024/0300-9831/a000035.

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Febrile malaria and asymptomatic malaria parasitemia substantially decrease iron absorption in single-meal, stable isotope studies in women and children, but to date there is no evidence of decreased efficacy of iron-fortified foods in malaria-endemic regions. Without inadequate malarial surveillance or health care, giving iron supplements to children in areas of high transmission could increase morbidity and mortality. The most likely explanation is the appearance of non-transferrin-bound iron (NTBI) in the plasma. NTBI forms when the rate of iron influx into the plasma exceeds the rate of iron binding to transferrin. Two studies in women have reported substantially increased NTBI with the ingestion of iron supplements. Our studies confirm this, but found no significant increase in NTBI on consumption of iron-fortified food. It seems likely that the malarial parasite in hepatocytes can utilize NTBI, but it cannot do so in infected erythrocytes. NTBI however may increase the sequestration of parasite-infected erythrocytes in capillaries. Bacteremia is common in children with severe malaria and sequestration in villi capillaries could lead to a breaching of the intestinal barrier, allowing the passage of pathogenic bacteria into the systemic circulation. This is especially important as frequent high iron doses increase the number of pathogens in the intestine at the expense of the barrier bacteria.
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Frank, Ahimbisibwe B., Matagi Leon, Senkumba Mohamed, and Atuhaire Privah. "Personal Orientation: The Silent Player in Efforts to Improve Treatment Seeking-Behavior Regarding Malaria in Uganda." International Journal of Innovative Science and Research Technology 5, no. 5 (May 16, 2020): 61–66. http://dx.doi.org/10.38124/ijisrt20may021.

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Uganda government and development partners have engaged in various communication activities and programs with a view to change people’s behaviors regarding malaria, mobilize communities and create an enabling environment for sound health practices. However, malaria has remained one of the leading causes of mortality and morbidity in Uganda. All players in the communications effort against malaria had a goal of reducing malaria-related mortality and morbidity by 70% by 2015. It was not clear whether this was achieved since another strategic objective proposed in 2015 was that at least 85% of the population should undertake correct practices in malaria prevention and treatment by 2017.
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Nanyunja, Miriam, Juliet Nabyonga Orem, Frederick Kato, Mugagga Kaggwa, Charles Katureebe, and Joaquim Saweka. "Malaria Treatment Policy Change and Implementation: The Case of Uganda." Malaria Research and Treatment 2011 (September 19, 2011): 1–14. http://dx.doi.org/10.4061/2011/683167.

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Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.
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Kaur, Prabhjot, Arun Bhatia, Kanav Midha, and Mampi Debnath. "Malaria: A Cause of Anemia and Its Effect on Pregnancy." World Journal of Anemia 1, no. 2 (2017): 51–62. http://dx.doi.org/10.5005/jp-journals-10065-0012.

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ABSTRACT Malaria is one of the major health problems in the world. It remains an important cause of very high human morbidity and mortality, especially, among children and pregnant women. It results from the infection of parasites belonging to the genus Plasmodium. Plasmodium falciparum and Plasmodium vivax are the major pathogens responsible for causing human malaria. Approximately 75% of cases are caused by P. falciparum and associated with the mortality rate of approximately 0.5 to 1.0%. Both P. falciparum and P. vivax induce anemia during their erythrocytic stages of infection. Most of the malarial infections are related to some degree of anemia, the severity of which depends upon patient-specific characteristics (e.g., age, innate and acquired resistance, comorbid features, etc.) as well as parasite-specific characteristics (e.g., species, adhesive, and drug-resistant phenotype, etc.). Malarial anemia encompasses reduced production of erythrocytes as well as increased removal of circulating erythrocytes in the bone marrow. Susceptibility to severe malarial anemia is associated with the polymorphisms of the cytokines, which are likely to function by perturbing erythropoiesis. This article reviews the epidemiology, pathophysiology, clinical features, treatment, and various complications occurring due to malarial anemia. The second part of this article also focuses on the effect of malaria during pregnancy. Some significant effects of malaria during pregnancy include spontaneous abortion, preterm delivery, low birthweight, stillbirth, congenital infection, and maternal death. How to cite this article Saxena R, Bhatia A, Midha K, Debnath M, Kaur P. Malaria: A Cause of Anemia and Its Effect on Pregnancy. World J Anemia. 2017;1(2):51-62.
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O’Meara, Wendy Prudhomme, Ryan Simmons, Paige Bullins, Betsy Freedman, Lucy Abel, Judith Mangeni, Steve M. Taylor, and Andrew A. Obala. "Mosquito Exposure and Malaria Morbidity: A Microlevel Analysis of Household Mosquito Populations and Malaria in a Population-Based Longitudinal Cohort in Western Kenya." Journal of Infectious Diseases 221, no. 7 (October 30, 2019): 1176–84. http://dx.doi.org/10.1093/infdis/jiz561.

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Abstract Background Malaria morbidity is highly overdispersed in the population. Fine-scale differences in mosquito exposure may partially explain this heterogeneity in individual malaria outcomes. Methods In 38 households we explored the effect of household-level mosquito exposure and individual insecticide-treated net (ITN) use on relative risk (RR) of confirmed malaria. We conducted monthly active surveillance (n = 254; 2624 person-months) and weekly mosquito collection (2092 household-days of collection), and used molecular techniques to confirm human blood feeding and exposure to infectious mosquitoes. Results Of 1494 female Anopheles (89.8% Anopheles gambiae sensu lato), 88.3% were fed, 51.9% had a human blood meal, and 9.2% were sporozoite infected. In total, 168 laboratory-confirmed malaria episodes were reported (incidence rate 0.064 episodes per person-month at risk; 95% confidence interval [CI], .055–.074). Malaria risk was directly associated with exposure to sporozoite-infected mosquitoes (RR, 1.24; 95% CI, 1.11–1.38). No direct effect was measured between ITN use and malaria morbidity; however, ITN use did moderate the effect of mosquito exposure on morbidity. Conclusions Malaria risk increases linearly with vector density and feeding success for persons with low ITN use. In contrast, malaria risk among high ITN users is consistently low and insensitive to variation in mosquito exposure.
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Nimpaye, Hermann, Desiré Nisubire, and Joseph Nyandwi. "Plasmodium falciparum and P. malariae: infection rates in the population of Northern Imbo Plain, Burundi." East African Health Research Journal 4, no. 2 (November 26, 2020): 189–93. http://dx.doi.org/10.24248/eahrj.v4i2.643.

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Background: Burundi is cited among countries where malaria remains endemic. Notably, malaria is highly endemic in Imbo region, a lowland lying astride Lake Tanganyika. Among key malaria riposte interventions includes the promotion of Long-Lasting Insecticidal Nets (LLINs), but its incidence rate has not reduced. In this paper, we present the distribution of malaria species in 2 settings within Imbo region by accounting for the seasonal variations and the mostly infected populations. Methods: The study was conducted from 2 Health Care Centres of Murambi and Rugombo in Cibitoke District, Northern Burundi. Blood samples were collected on blood slides and the samples were used to confirm the presence of malaria parasites by microscopy. Results: The study observed an average malaria parasite prevalence of 32.5% across the selected site. Majority of patients 459(95.2%) were infected by P. falciparum while 8(1.7%) patients were infected by P. malariae. Patients from Murambi were more infected than those from Rugombo. P. falciparum was the most highly prevalent specie in the 2 localities. High prevalence was observed in children aged between 2 and 5 years. Among older participants P. falciparum still predominated and mixed infections were rather the least prevalent. Conclusion: This study showed that P. falciparum and P. malariae are the most parasites involved in malaria morbidity in North Imbo region. The transmission of P. falciparum was observed year-round. Patients in Murambi are most exposed to malaria infections than those in Rugombo. Further research at large scale including entomological studies is required to better understand the relationship between Entomological Inoculation Rates (EIR) and malaria transmission levels in this setting.
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de Souza, J. Brian, Manohursingh Runglall, Patrick H. Corran, Lucy C. Okell, Sanjeev Kumar, D. Channe Gowda, Kevin N. Couper, and Eleanor M. Riley. "Neutralization of Malaria Glycosylphosphatidylinositol In Vitro by Serum IgG from Malaria-Exposed Individuals." Infection and Immunity 78, no. 9 (June 21, 2010): 3920–29. http://dx.doi.org/10.1128/iai.00359-10.

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ABSTRACT Parasite-derived glycosylphosphatidylinositol (GPI) is believed to be a major inducer of the pathways leading to pathology and morbidity during Plasmodium falciparum infection and has been termed a malaria “toxin.” The generation of neutralizing anti-GPI (“antitoxic”) antibodies has therefore been hypothesized to be an important step in the acquisition of antidisease immunity to malaria; however, to date the GPI-neutralizing capacity of antibodies induced during natural Plasmodium falciparum infection has not been evaluated. Here we describe the development of an in vitro macrophage-based assay to assess the neutralizing capacity of malarial GPI-specific IgG. We demonstrate that IgG from Plasmodium falciparum-exposed individuals can significantly inhibit the GPI-induced activation of macrophages in vitro, as shown by reduced levels of tumor necrosis factor production and attenuation of CD40 expression. The GPI-neutralizing capacity of individual IgG samples was directly correlated with the anti-GPI antibody titer. IgG from malaria-exposed individuals also neutralized the macrophage-activating effects of P. falciparum schizont extract (PfSE), but there was only a poor correlation between PfSE-neutralizing activity and the anti-GPI antibody titer, suggesting that PfSE contains other macrophage-activating moieties, in addition to GPI. In conclusion, we have established an in vitro assay to test the toxin-neutralizing activities of antimalarial antibodies and have shown that anti-GPI antibodies from malaria-immune individuals are able to neutralize GPI-induced macrophage activation; however, the clinical relevance of anti-GPI antibodies remains to be proven, given that malarial schizonts contain other proinflammatory moieties, in addition to GPI.
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Brown, Graham, and Stephen Rogerson. "Malaria: global challenges for malaria eradication." Microbiology Australia 37, no. 1 (2016): 34. http://dx.doi.org/10.1071/ma16013.

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The enormous decline in the annual morbidity and mortality from malaria is the spectacular global public health success of the past decade. This achievement results largely from increased finance for investment in measures known to prevent malaria: bednets treated with long-lasting insecticides, chemoprophylaxis, and rapid access to effective treatment. Such has been the success of these measures that plans are being put in place to achieve the vision of a malaria-free world within the next three decades. Large financial and political commitments and ongoing research will be required to maintain the gains, overcome known and unknown challenges such as drug and insecticide resistance, and to achieve those goals. Effective vaccines or methods for reducing mosquito vectorial capacity would add enormously to the chance of achieving this goal. The aim of this article is to summarise the current status of malaria control, the recent research successes, the challenges being addressed, and the plan for progress to elimination of malaria in the longer term.
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Macnab, Andrew John, Ronald Mukisa, Sharif Mutabazi, and Rachel Steed. "Engaging schools in diagnosis and treatment of malaria: Evidence of sustained impact on morbidity and behavior." GHMJ (Global Health Management Journal) 1, no. 2 (October 31, 2017): 43. http://dx.doi.org/10.35898/ghmj-1292.

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Background: In low and middle income countries (LMICs) teachers send home children found sick in class devolving subsequent care to parents; where malaria is endemic, morbidity is high as the most parents fail to access WHO-endorsed rapid diagnostic testing (RDT and prompt treatment with artemisinin combination therapy (ACT). Consequently malaria is the principal reason a child misses school; so, we trained teachers to use RDT to evaluate all sick pupils and give ACT promptly to those positive.Aims: Pre, intra and post intervention evaluation of impact of using the WHO Health Promoting School (HPS) model to empower teachers to provide RDT and ACT and engage and inform pupils about malaria in 4 schools in rural Uganda.Methods: Documenting duration of absence from school as a surrogate measure for morbidity and change in children’s knowledge and reported behaviors regarding malaria. Pre-intervention (year 1) baseline evaluation of days of absence and children’s malaria knowledge/behavior; Intervention (year 2) trained teachers administered RDT in all sick children and treated those positive with ADT; Post-intervention (end of year 3) after schools independently continued RDT/ACT and education on malaria.Results: Pre-intervention <1:5 pupils had basic knowledge about malaria (caused by mosquitos; can be prevented; requires rapid diagnosis and prompt medication). In year 1: 953 of 1764 pupils were sent home due to illness. Mean duration of absence was 6.5 (SD 3.17) school days. In year 2: 1066 of 1774 pupils were sick, all had RDT, 765/1066 (68%) tested positive and received ACT; their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001). By year 2 all children knew the signs and symptoms of malaria and had essential epidemiological knowledge. Twelve months post intervention the universality of this knowledge had been sustained and the whole-school focus on malaria continued. Children reported better health, more consistent attendance and improved academic achievement, and had become proactive in prevention strategies; 6% fewer tested positive for malaria; and key health knowledge was being passed to new pupils.Conclusion: Teacher administered RDT/ACT reduced child morbidity from malaria significantly; essential knowledge was generated and new health practices acquired that changed behaviors. Our WHO HPS model is applicable to other LMICs where malaria is endemic and morbidity high.
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Ndoreraho, Adolphe, Muhammed Shakir, Celestine Ameh, Chukwuma Umeokonkwo, Olusola Aruna, Juma Ndereye, and Ayo Adebowale. "Trends in Malaria Cases and Deaths: Assessing National Prevention and Control Progress in Burundi." East African Health Research Journal 4, no. 2 (November 26, 2020): 182–88. http://dx.doi.org/10.24248/eahrj.v4i2.642.

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Abstract:
Background: Malaria is associated with high morbidity and mortality especially in World’s tropical regions. In 2016, an estimated 216 million and 445,000 cases of malaria and deaths associated with malaria respectively were reported globally. Malaria is the first leading cause of outpatient visits, hospitalization and death in Burundi. We therefore examined the trend in malaria cases and deaths in Burundi. Methods: We extracted data from Burundi National Health Information System (BNHIS) and assessed trends in malaria cases and deaths from January 2015 to December 2017. A suspected case of malaria was defined as any person treated by anti-malarial drugs without testing while a confirmed case as any person with a positive microscopy or rapid diagnostic test for malaria parasite. We described malaria cases and deaths, and calculated malaria case incidence rate. Results: A total of22,225,699 malaria cases with 8,660 deaths (CFR 0.04%) was documented during the study period. Out of 22,225,699 cases, 45,291 cases (0.2%) were suspected malaria cases. The observed peak season of malaria infection in any of the studied year was in the raining season (March-June). All provinces of the country were affected. Kirundo and Cankuzo provinces the incidence of malaria cases increased from 10.1 cases per 1,000 persons in 2015 to 13.2 cases per 1,000 persons in 2017. The case fatality rate decreased from 0.06% in 2015 to 0.01% in 2017. Conclusions: An increasing trend in malaria prevalence was observed in Burundi but Kirundo and Cankuzo provinces were the most affected. However, the case fatality decreased within the studied period. Malaria intervention should be intensified/scaled up in the raining season and the most affected provinces.
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