Background: CHW-led community malaria case management (CCMm) extends services to rural, hard-to-reach communities in Kailahun District, Sierra Leone, where the malaria burden is heaviest; yet the same standardised intervention produces different outcomes across chiefdoms. This paper asks how contextual conditions enable or block the mechanisms through which CHWs produce outcomes. Methods: A qualitative realist evaluation using the Context–Mechanism–Outcome framework drew on six key informant interviews, three CHW contextual interviews, and six focus group discussions (58 caregivers) and analyzed them thematically with realist-informed coding and text-network analysis. Results: Contextual influences spanned nine domains: geographic, health-system, socio-cultural, gender, economic, governance, programmatic, historical, and market. Traditional authority engagement and geographic accessibility were decisive across every tier, and the same conditions acted as facilitators when present and barriers when absent. Conclusion: Context is constitutive, not background; policy should stabilise a small set of conditions—above all supply continuity and traditional authority engagement—that determine whether its mechanisms fire. Read more

Malaria remains a critical public health concern globally because it is linked to human practices and their living conditions. Malaria is a threat to more than 40% of the world's population. The role of household residents and communities cannot be overemphasized. Hence, the study examined the knowledge and practice of malaria prevention measures among selected peri-urban communities in Abuja. This study adopted cross-sectional survey research using quantitative methods of data collection. A multi-staged sampling technique was used to select 414 households in Abaji and Kuje peri-urban communities in Abuja, of which 385 household residents participated in the study. Research questions were formulated, and data were analysed using SPSS version 27 to compute descriptive statistics. The majority of respondents (47.5%) are above the age of 36years with the mean age of 47.1± 19.8. Findings revealed that knowledge of malaria prevention among the participants was moderate, with participants having correct responses ranging from 59.2%-79.3% across important items for knowledge, like preventive measures, awareness of environmental risk factors, and barriers to malaria prevention and control. Also, practices of malaria prevention were generally high, since many participants reported using malaria prevention and treatment actions such as indoor spraying (32.6%), house cleaning (29.2%), and use of mosquito repellent devices (21.5%). However, the use of insecticide-treated nets was reportedly low (5.6%), and treatment practices such as antimalarial monotherapy and antimalarial combination therapy were varied across the study population. In conclusion, while malaria prevention practices were considerably high, specific gaps in knowledge still exist. The researchers recommend that health education and community-based intervention be strengthened to improve knowledge and sustain the malaria prevention practices in peri-urban communities in Abuja. Read more

Cross-sectional study was conducted among 120 women of reproductive age in Okigwe LGA. of Imo State to investigate efficacy of phytotherapy using local plant-based remedies, for managing mixed infections of malaria and Reproductive tract infections (RTIs). Participants were screened for malaria using rapid diagnostic tests (RDTs) and for RTIs through microbiological analysis of vaginal swabs. Identified pathogens were cultured and analyzed for antimicrobial sensitivity. Phytotherapeutic treatments, including Artemisia annua, Moringa oleifera, and Allium sativum, were administered to a subgroup of women diagnosed with mixed infections. Efficacy was evaluated based on symptoms resolution, microbiological clearance, and malaria parasite count before and after treatment. Results revealed that all the women tested positive for varying degrees of malaria, with 35% of those also showing evidence of RTIs. The most common pathogens identified included Candida albicans, Escherichia coli, and Gardnerella vaginalis. After a 14-day treatment regimen, 70% of the women showed a reduction in pathogen load and symptomatic relief, Phytotherapy with Artemisia annua showed a significant reduction in malaria parasitemia, while Moringa oleifera and Allium sativum exhibited antimicrobial effects against common reproductive tract pathogens. Phytotherapy using local plants, such as Artemisia annua, Moringa oleifera, and Allium sativum, showed promising alternative to conventional treatments. Read more

The study shows a comparative analysis between Malthusian growth model and simple linear regression approach in predicting the outcome of malaria infection. These two models was applied in predicting the number of persons infected with malaria in Nigeria in the nearest future (2023 to 2030) using data from 2019 to 2022. The outcome revealed that at the end of 2030 the population of persons that will be infected with malaria using the regression model was One hundred and five million (105, 000, 000) while that of Malthusian model was Ninety one million, five hundred and thirty (91, 530, 000). Furthermore, results gotten from Malthusian model proved to be more reliable than the results gotten from the regression model because the coefficient of correlation and Residual sum of squares for Malthusian model was 0.999 and 1801670629370.527 with the data showing a level of statistical significance compared to the simple linear regression model approach which was 1.00 and 0.00 respectively. This research will assist government organizations; non-government organizations, private and health organization to apply a proactive measure and plan in dealing with the issue of malaria infection in the nation Read more

There is a dearth of information on the Impact of malarial intervention measures on vectorial infection rates in the study area. This study therefore investigated the Impact of malaria intervention measures on prevalence and vectorial infection rates in two Local Government Areas of Imo State, Nigeria. The study employed a cross sectional design involving 735 participants aged 5 years to >60 years, division of study subjects into four groups and was conducted between July 2023 and May 2024. Participants blood were collected and processed using Rapid Diagnostic Tests (RDTs). Indoor resting malaria vectors collected by pyrethrum knock down (PKD) were assessed for parasitological/entomological indices with standard methods. Malarial intervention compliance was monitored and impact assessed by comparing results from different intervention measures/cohorts. Overall, pre-intervention malaria prevalence (26.12%) were five times significantly higher than intervention prevalence result 9.05% (P<0.05). All intervention measures Insecticide treated bednet (ITNs), Indoor residual spray (IRS) and Prophalytic drugs (Drugs) reduced malaria prevalence significantly (P0.05). Species from NICs; Anopheles gambiae (44.81%) and An. funestus (32.05%) were higher than those from ICs Anopheles gambiae (14.84%) and An. funestus (3.44%). NICs had more parous mosquitoes, ICs had comparable sporozoite rates (1.36% vs 2.06%), Entomological Inoculation Rate (0.099 vs 0.0331) and infectivity rates (1.05% vs 0.59%). In conclusion, this study suggests that malaria management efforts should involve integrated strategy that revolves on proper environmental sanitation and human behavioural patterns. Read more

Malaria remains hyperendemic in Kenya’s Lake Victoria basin despite scalable interventions. It is a pressing public health challenge in Migori county that reported 27% mortality rate in 2020 in children aged 6-59 months, far exceeding national levels. Reports indicate different contributing factors to malaria dynamics in Migori county, including marginal insecticide-treated net (ITN) use, ITN access, effective anti-malaria treatment, and prevalence of malaria infection. The present study seeks to elucidate the temporal interaction between malaria incidence and mortality by employing a range of time series analyses, incorporating exogenous influences, by applying classical vector autoregressive (VAR) model to capture lagged dependencies. Further, the study invoked a Bayesian VAR (BVAR) after incorporating exogenous variables for parameter estimating, utilizing Monte Carlo simulations and Gibbs sampling. For model adequacy and forecast accuracy, the analysis made use of Ljung-Box test, partial autocorrelation function, autocorrelation function (ACF), and normality tests among other diagnostic tests. The hierarchical Bayesian vector autoregressive model (BVARX) incorporates monthly incidence and mortality rates (2014-2024, n=120) as the endogenous variables. The exogenous variables comprised ITN access and use, treatment efficacy, and infection prevalence. Ward-level heterogeneity summed the spatial random effects. Hamilton Monte Carlo model estimation with convergence assessed using R ̂<1.01 Counterfactual simulations quantified intervention impacts. ITN use reduced incidence (β = −1.43, 95% CrI: −2.21, −0.65) but access increased mortality (β = 1.81, CrI: 0.32, 3.30), suggesting behavioral misuse. VARX outperformed VAR (WAIC: 412 vs. 587), yet residual spatial autocorrelation (Moran’s I = 0.34, *p* = 0.01) indicated unobserved confounders. BVARX forecasts predicted 22% (CrI: 18–27%) higher incidence by 2025 under current interventions. The regression analysis identified that higher ITN use is significantly associated with reductions in both malaria mortality and incidence. While ITNs and treatments show efficacy, their benefits are eroded by suboptimal utilization and ecological feedbacks. The study recommended the use of ward-level VARX outputs for geospatial targeting of ITN campaign as well as integrated resistance monitoring through adaptive Bayesian frameworks. Read more

Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is an important zoonosis with medical and veterinary significance worldwide. The disease is primarily contracted by ingesting undercooked or raw meat containing viable tissue cysts, or by ingesting food or water contaminated with oocysts. Malaria, on the other hand, is caused by protozoan parasites of the genus Plasmodium, with the most serious and sometimes fatal type being caused by Plasmodium falciparum. Malaria stands as the most significant infectious disease in tropical and subtropical regions, continuing to pose a major global health challenge. A rapid and accurate diagnosis is crucial for controlling these diseases, especially among vulnerable groups such as pregnant women. However, several diagnostic methods are hindered by shortcomings such as false negatives, false positives, and accuracy issues. Hence, this study aims to assess the utility of Polymerase Chain Reaction (PCR) in diagnosing these parasitic diseases in pregnant women at the Garoua Regional Hospital during antenatal care. A cross-sectional analytical study was conducted, recruiting 105 participants who responded to a questionnaire and were diagnosed with malaria and toxoplasmosis using rapid diagnostic tests and microscopy. Dried blood spots were prepared from finger-prick blood samples of each participant for molecular analysis. Of the 105 participants, 70.87% originated from the North region and 21.36% from the Far North region. The women had an average age of 26 years, with the majority being married (98.06%) and housewives (79.05%), while 24.76% had never attended school. Among the 105 participants, 17/105 (16.19%) and 30/105 (28.57%) were diagnosed positive for malaria and toxoplasmosis using rapid diagnostic tests and microscopy, respectively. Meanwhile, 18/105 (17.14%) and 75/105 (71.5%) tested positive for malaria and toxoplasmosis, respectively, using PCR. Read more

In this research work, a dynamically consistent non-standard finite difference (NSFD) scheme is developed to solve a continuous-time model of malaria transmission with herbal medicine as control strategy. We compared results from NSFD scheme with the standard finite difference methods (4th order Runge-kutta and forward Euler methods). The numerical investigation showed that the proposed NSFD method remains consistent, preserves the positivity of solutions and converges to true equilibrium points of the continuous model independent of the step size h. Read more

Malaria is a major health problem affecting people in the tropics and sub-tropical regions of the world. This cross-sectional hospital-based study was carried out to determine the prevalence of malaria infection among pregnant women attending a tertiary hospital in Nnewi, Anambra State, Nigeria. A total of 100 venous blood samples were collected from pregnant women into EDTA tubes and examined using field stained thick and thin films for identification of malaria parasites. Demographic information such as age, trimester and insecticide treated nets usage was obtained using a structured questionnaire. Data was analyzed using Statistical Package for the Social Sciences version 22. Chi-square test was used to determine the difference among the variables studied and P≤ 0.05 were considered significant. Out of the 100 blood samples examined, 27 were infected and had an overall prevalence of 27%. Women within the age bracket of 31-35 years had the highest prevalence rate 11(36.7%) while no infection was recorded in the 41-45 years age group 0(0.0%). Pregnant women in their first trimester had the highest infection prevalence of 13(35.1%) while those in their third trimester had the least prevalence 5(17.9%). In relation to ITNs usage, pregnant women who don’t normally sleep under ITNs had the highest infection prevalence 23(31.5%) while those that usually sleep under ITNS had the least prevalence rate 4(14.8%). It is pertinent to periodically check the malaria infection status of pregnant women attending antenatal services. Prophylactic treatment should be routinely administered to avoid pregnancy complications due to malaria infection. Read more

This study sheds light on the prevalence of malaria and typhoid in children below the age of five in a hospital in Nigeria. This study aimed to determine the presence of malaria, typhoid and malaria-typhoid co-infection in children less than five years of age. In this community-based descriptive, quantitative and cross-sectional hospital-based survey, the blood samples of 125 children between 0 to less than 5 years (68 males and 57 females) were examined for the presence of malaria parasites and typhoid infection. Blood samples were collected using venepuncture. The malaria parasitaemia was detected using malaria microscopy on a thick blood film. Typhoid fever infection was detected using the Widal Agglutination Test. The chi-square test was used to compare the prevalence of malaria, typhoid fever and malaria/typhoid co-infections between male and female infected and uninfected participants and between children below 1 year and those 1 year and above. P-values less than 0.05 were considered significant. A prevalence of 47.2%, 32% and 16% were recorded for malaria, typhoid and malaria/typhoid co-infection respectively. A mean malaria parasite intensity of 56.8475 (±3.30177) was recorded. There was no significant difference between the prevalence of malaria, typhoid and malaria/typhoid co-infection between the genders and age groups. Also, there was no significant difference between the mean PCV of the infected (33.1610 (±0.80748) and uninfected (34.6667 (0.48441) (P> 0.05). These results underscore the importance of continued efforts to combat these diseases and improve the health and well-being of children in the region. Read more