The American Journal of Tropical Medicine and Hygiene

Malaria programs rely upon a variety of diagnostic assays, including rapid diagnostic tests (RDTs), microscopy, polymerase chain reaction (PCR), and bead-based immunoassays (BBA), to monitor malaria prevalence and support control and elimination efforts. Data comparing these assays are limited, especially from high-burden countries like the Democratic Republic of the Congo (DRC). Using cross-sectional and routine data, we compared diagnostic performance and Plasmodium falciparum prevalence estim...

BackgroundPlasmodium vivax presents a significant obstacle to malaria elimination due to its capacity to form dormant liver-stage hypnozoites that can cause relapses. Universal radical cure, which administers hypnozoite-targeting treatment to patients with P. falciparum malaria living in co-endemic areas, has potential to reduce P. vivax relapses. However, its implementation is hindered by the lack of a diagnostic tool for detecting hypnozoite carriage. MethodsThis study evaluated the performan...

The Philippines confirmed local transmission of COVID-19 on 7 March 2020. We described the characteristics and epidemiological time-to-event distributions for laboratory-confirmed cases in the Philippines. The median age of 8,212 cases was 46 years (IQR: 32-61), with 46.2% being female and 68.8% living in the National Capital Region. Health care workers represented 24.7% of all detected infections. Mean length of hospitalization for those who were discharged or died were 16.00 days (95% CI: 15.4...

BackgroundThe spread of antibiotic-resistant bacteria may be driven by human-animal-environment interactions, especially in regions with limited restrictions on antibiotic use, widespread food animal production, and free-roaming domestic animals. In this study, we aimed to identify risk factors related to domestic animals, backyard food animals, and commercial food animal production in Ecuadorian communities. Methods & FindingsWe conducted a repeated-measures study from 2018-2021 in 7 semi-rura...

BackgroundRodent-borne viruses, including hantaviruses, arenaviruses, and rodent hepatitis virus (HEV-C), pose significant health threats to humans, causing severe diseases such as hepatitis, respiratory illness, and hemorrhagic fevers. In Cambodia, data on these viruses remain limited, and their burdens on human health are unknown. This study investigated the presences of these viruses in rodents and assessed potential human exposure across diverse environmental and socio-economic contexts in C...

BackgroundPapua New Guinea (PNG) has the highest malaria transmission outside of Africa and long-lasting insecticidal nets (LLINs) are the only vector-control tool distributed country-wide. LLINs were introduced into PNG in about 2006 and have been attributed to have had a huge impact on malaria transmission, with reductions in observed average malaria prevalence from 15.7% (2008) to 1% (2014). However, since 2015 malaria indicators in PNG have risen significantly. Similar trends have been obser...

The amounts of parasite DNA in soil samples from different playgrounds and other public areas can help identify areas of possible microbe transmission as well as giving indications of possible occurrence of parasite infection in nearby communities. We collected 207 soil samples from parks located on Paiute indigenous tribal areas in southwest Utah and from higher income city of St. George, Utah, and tested them for the presence of 11 parasites that can cause human disease. Molecular tests reveal...

IntroductionReactive case detection (RACD), or testing and treatment of close contacts of recent malaria cases, is widely used in settings nearing malaria elimination, but often results in very low yield and uncertain impact. In areas where the primary vector exposure occurs outside the home, adapting RACD to target high-risk populations with specific exposure profiles may increase yield, surveillance value, and impact on treatment rates and transmission. MethodsWe evaluated the feasibility and...

BackgroundDespite the implementation of different control interventions, infections in the communities (among asymptomatic and symptomatic individuals) still play a crucial role in sustaining malaria transmission. This study evaluated the performance of rapid diagnostic tests (RDTs), microscopy, and quantitative PCR (qPCR) in detecting malaria parasites among community members in five villages of Kyerwa district, Kagera region, an area where artemisinin partial resistance (ART-R) has been recent...

Abstract/SummaryIn a study published in Nature Communications in August 2020, we demonstrated an abrupt decrease in the bioefficacy of long-lasting insecticidal nets (LLINs) for malaria prevention delivered to Papua New Guinea (PNG) between 2012 and 2013. This coincided with a rise in malaria cases in the country. At the time of publication of the original article, we were unable to pinpoint the exact reasons for the observed shift towards inferior product performance and stated that further st...

IntroductionMalaria presents a significant global public health burden, although substantial progress has been made, with vector control initiatives such as indoor residual surface spraying with insecticides and insecticide treated nets. There now exists many different approaches to apply residual insecticide to indoor and outdoor surfaces in malaria endemic settings. This review aims to synthesise the best available evidence regarding full or partial indoor or outdoor residual insecticide surfa...

BackgroundIn clinical trials of therapies for uncomplicated Plasmodium falciparum, there are usually some patients who fail treatment even in the absence of drug resistance. Treatment failures are categorised as clinical or parasitological failures, the latter indicating that recrudescence of the infection has occurred without inducing the return of symptoms. Asymptomatic treatment failure has public health implications for continued malaria transmission and may be important for the spread of ...

BackgroundTanzania adopted and has been implementing the World Health Organization (WHO) recommended interventions to control and eventually eliminate malaria. However, malaria is still a leading public health problem and the country experiences heterogeneous transmission; but the drivers of these patterns are not clearly known. This study assessed the prevalence and risk of malaria infections among asymptomatic individuals living in a hyperendemic area which has high prevalence of artemisinin p...

BackgroundWater insecurity, a global public health crisis, will be intensified by climate change. In coastal Peru, little is known about the health effects of water insecurity from a community perspective. Understanding first-hand experiences and perceptions of mothers and healthcare providers can inform strategies to mitigate the effects of water insecurity and climate change on health outcomes and health disparities. MethodsThis qualitative study took place in 2023 in Carabayllo, the Northern...

BackgroundIndonesia faces challenges in achieving its goal of eliminating malaria by 2030, with cases stagnating between 2015 and 2019 despite a decline in 2013. This study aims to analyse epidemiological trends and demographic changes in malaria cases regionally from 2010 to 2019, considering differences in surveillance across the country. MethodsWe used national and sub-national malaria routine surveillance data, applying statistical models to derive insights for future interventions. The ana...

Following substantial progress in malaria control in the Philippines, new surveillance approaches are needed to identify and target residual malaria transmission. This study evaluated an enhanced surveillance approach using rolling cross-sectional surveys of all health facility attendees augmented with molecular diagnostics and geolocation. Facility surveys were carried out in 3 sites representing different transmission intensities: Morong, Bataan (pre-elimination), Abra de Ilog, Occidental Mind...

What is already known on this topic - summarise the state of scientific knowledge on this subject before you did your study and why this study needed to be done. There is a significant body of research on drowning in low-middle-income countries with general knowledge of the demographic and behavioral risk factors and an emerging body of research on this topic specific to Uganda. This systematic review aims to gather the existing research for the Lake Victoria basin and highlight critical gaps i...

BackgroundMalaria in eastern Indonesia remains high despite significant reductions and local elimination in other parts of the country. Malaria control activities that have been implemented include early diagnosis and prompt treatment, provision of Long-lasting insecticide-treated nets (LLINs), and indoor residual spraying (IRS). To expedite malaria elimination in this region, a rapid entomological assessment combined with human behaviour observations (HBOs) were conducted in eight high malaria ...

Prompt diagnosis and effective treatment are key malaria interventions that rely on community knowledge and adherence to treatment. With the emergence of artemisinin resistance in Rwanda, ensuring optimal malaria treatment practices within communities is essential. This study examined malaria knowledge, attitudes, and practices (KAP) among febrile patients at government clinics to identify factors affecting influencing malaria treatment practices. A cross-sectional study was conducted in six hea...

The soil is the primary environmental reservoir for many parasites transmitted to humans through the fecal-oral route, causing disease. Our environmental study used a high-throughput multi-parallel real-time quantitative PCR (qPCR) assay to detect parasites DNA in soil collected from the outdoor built environments of 34 houses. The total parasite prevalence was Acanthamoeba spp. (53%), Blastocystis spp. (12%), Ascaris lumbricoides (12%), Toxocara canis (9%), Ancylostoma spp. (3%), Trichuris tric...