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. 2022 Oct 11;107(4_Suppl):40-48.
doi: 10.4269/ajtmh.21-1263. Print 2022 Oct 11.

Understanding the Intransigence of Malaria in Malawi

Lauren M Cohee  1 , Jessy Goupeyou-Youmsi  2 , Karl B Seydel  3 , Charles Mangani  4 , Peter Ntenda  2 , Alick Sixpence  2 , Rex B Mbewe  5   6 , Alfred Matengeni  2 , Shannon Takala-Harrison  1 , Edward D Walker  6 , Mark L Wilson  7 , Themba Mzilahowa  2 , Miriam K Laufer  1 , Clarissa Valim  8 , Terrie E Taylor  3 , Don P Mathanga  2   4
Affiliations

Understanding the Intransigence of Malaria in Malawi

Lauren M Cohee et al. Am J Trop Med Hyg. .

Abstract

Despite the scale-up of interventions against malaria over the past decade, this disease remains a leading threat to health in Malawi. To evaluate the epidemiology of both Plasmodium falciparum infection and malaria disease, the Malawi International Center of Excellence for Malaria Research (ICEMR) has developed and implemented diverse and robust surveillance and research projects. Descriptive studies in ICEMR Phase 1 increased our understanding of the declining effectiveness of long-lasting insecticidal nets (LLINs), the role of school-age children in malaria parasite transmission, and the complexity of host-parasite interactions leading to disease. These findings informed the design of ICEMR Phase 2 to test hypotheses about LLIN use and effectiveness, vector resistance to insecticides, demographic targets of malaria control, patterns and causes of asymptomatic to life-threatening disease, and the impacts of RTS,S vaccination plus piperonyl butoxide-treated LLINs on infection and disease in young children. These investigations are helping us to understand mosquito-to-human and human-to-mosquito transmission in the context of Malawi's intransigent malaria problem.

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Figures

Figure 1.
Figure 1.
Infection prevalence and net use by age group. Vertical line indicates timing of national net distribution campaign. Previously published in Walldorf et al.
Figure 2.
Figure 2.
Distribution of gametocyte containing infections by age group: prevalence in the total population and proportion of infections. Previously published in Coalson et al.
Figure 3.
Figure 3.
Age group contribution to mosquito infections in the rainy season using simulation models considering different estimates of vector-human interactions. Previously published in Coalson et al.
Figure 4.
Figure 4.
Monthly malaria cases in relation to intervention type and timing.
See this image and copyright information in PMC

References

    1. World Health Organization , 2020. World Malaria Report 2020: 20 Years of Global Progress and Challenges. Available at: https://www.wipo.int/amc/en/. Accessed December 30, 2020.
    1. Malawi Health Management Information Systems Available at: https://dhis2.health.gov.mw/dhis-web-commons/security/login.action#/. Accessed November 16, 2021.
    1. Malawi Population and Housing Census Report—2018 , 2019. Malawi Population and Housing Main Report. Available at: http://www.nsomalawi.mw/images/stories/data_on_line/demography/census_20....
    1. Mangani C et al. 2022. Malawi ICEMR malaria research: interactions and results influencing health policies and practices. Am J Trop Med Hyg 107 (Suppl 4): 49–54. - PMC - PubMed
    1. Walldorf JA et al. 2015. School-age children are a reservoir of malaria infection in Malawi. PLoS One 10: e0134061. - PMC - PubMed

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