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Global malaria control is entering a period of profound uncertainty, with earlier gains now stalling or reversing amid a rapidly deepening shortfall in programme and research funding. At the same time, parasite and vector resistance, changing transmission patterns driven by climate and urbanisation, and growing conflict and displacement are reshaping malaria epidemiology and undermining the effectiveness of core tools. In this context, there is an urgent need to reconsider how malaria research is prioritised, funded and conducted. Drawing on a diverse group of stakeholders, this Perspective argues that malaria research must adopt a dual mandate: protecting lives now while preparing programmes for the next generation of biological and systemic threats. We highlight three interlinked priorities. First, pragmatic, equity‑focused implementation and health‑systems research should be prioritised to optimise the effectiveness, efficiency and coverage of existing interventions, including through integrated delivery models and closer collaboration with affected communities and implementers. Second, sustained investment in innovation—such as next‑generation chemoprevention strategies, vaccines and monoclonal antibodies, novel vector control approaches, and digital or AI‑enabled surveillance—is essential, accompanied by operational research that addresses feasibility, cost and pathways to scale in real‑world conditions. Third, we highlight a critical research stream on sustainable and diversified financing, and on how data, economic evidence and political economy analysis can more effectively inform national and global decision‑making. By re‑orienting towards an impact‑driven, context‑sensitive and value‑for‑money research agenda, the malaria community can help stabilise fragile programmes, reduce the risk of resurgence and preserve momentum towards long-term malaria elimination in an era of constraint.

► Biological factors that affect the magnitude and quality of immune responses to vaccines. ► Socioeconomic factors that limit vaccine accessibility and evaluation. ► Strategies for circumventing these limitations in developing vaccines and evaluation of their immune responses. Human newborns are vulnerable to infectious diseases that account for majority of the morbidity and mortality, particularly in first year of life. Vaccines have become the most effective public health intervention strategy to curtail the prevalence of these infectious diseases. Although vaccines against a number of diseases exist, there are no vaccines against many other diseases that commonly affect children. The adequate assessment of immune responses to vaccines is an important step in the development of vaccines. However, a number of biological and “non-medical” socio-economic and ethical factors could influence either the administration and/or evaluation of vaccines in infants. Recognition and understanding of these determinants are crucial in planning interventions and for logical interpretations of results.

Chemical, physico-chemical and sensory properties of yoghurt and yoghurt simulates produced from blends of cow milk and coconut milk were investigated to produce a value-added product from the blends. Cow milk and coconut milk were blended in ratios 100:0; 80:20; 60:40; 50;50; 40:60; 20:80 and 0:100. Colour, pH, titratable acidity (TTA), proximate and mineral composition of the yoghurt samples were determined using standard methods. A 30–member panel assessed the yoghurt samples for sensory attributes, using a 5-point Hedonic scale. The L* value showed that 100% cow milk was the lightest with a value of 101.78. The pH and TTA values ranged from 3.78-3.81 and 0.21-0.51% respectively. The moisture contents ranged from 77.28–84.92%, protein: 2.20 – 4.69%, ash: 0.44 – 1.02%, fat: 0.07 – 0.31%, carbohydrate: 11.06 – 16.52%., phosphorus: 26.55 – 84.7 mg/100g, potassium: 62.27 – 161.62 mg/100g, zinc: 0.15 – 0.73 mg/100g, iron: 39.38 – 91.59 mg/100g, magnesium: 6.34 – 20.69 mg/100g, calcium: 61.58 – 217.23 mg/100g and manganese: 7.07 – 220 mg/100g. The yoghurt blend with 40% coconut was the most preferred among the blends and next to the sample with 100% milk in terms of general acceptability. Coconut yoghurt could serve as substitute for yoghurt from cow milk.

Health conscious consumers are investing in food products containing functional ingredients. The study investigates the effect of addition of selected plant extracts on phytochemical, antioxidant activity, physicochemical and consumer acceptability of yoghurt. Yoghurts were produced from 70% raw cow milk and 30% skimmed milk powder with 10% (v/v) of Cymbopogon citratus leaf, Carica papaya leaf, Sorghum bicolour stalk or Ocimum gratisimum infusion added before the fermentation stage. The yoghurt sample without the infusion served as the control. The yoghurt samples were analysed 1 day after production for phytochemical and antioxidant properties and after 1, 7, 14 and 21 days of refrigeration at 4°C for titratable acidity, pH, syneresis, colour and sensorial quality using standard methods. Total polyphenol content ranged from 0.04 to 0.12 mg GAE/100mL and alkaloid content ranged from 1.25% to 3.36% with the least value reported in the control sample, respectively. Similarly, antioxidant activity ranged from 13.88% to 45.74% with the highest value in yoghurt with the pawpaw leaf extract. The addition of various plant extracts resulted in lower pH, increased syneresis but no effect on the titratable acidity during storage period. The colour attributes (L*, a*, b*) showed significant differences (p≤0.05) among the samples over the storage period. Considering overall consumer acceptability, the control sample was most preferred. Functional milk product has potential to expand the application of endangered species of plant food material in the dairy industry.

Africa holds 15 % of world’s population with an across sector infrastructure investments average returns of 15 to 20%. The diverse location of people living within the continent makes intercity, interstate, or inter-country transactions difficult and where it does happens, comes with huge transaction cost. This creates a wide gap in Africa’s regional economy, resulting in wide spread of poverty, intra and inter regional conflicts within the continent. E-commerce provides a viable platform for bridging the gap in African economies. However, its adaptability and sustainability becomes a major concern. The level of development of e-commerce and its impact on the economy are analysed. Results show that e-commerce has made positive impact on the African economies but lack of trust on transactions within and from the continent is major challenge. Therefore, investment in e-commerce infrastructure in Africa (with more emphasis on Nigeria) will lead to rapid economic development within the continent.

A vaccine to decrease transmission of human immunodeficiency virus type 1 (HIV-1) during breast-feeding would complement efforts to eliminate infant HIV-1 infection by antiretroviral therapy. Relative to adults, infants have distinct immune development, potentially high-risk of transmission when exposed to HIV-1 and rapid progression to AIDS when infected. To date, there have been only three published HIV-1 vaccine trials in infants. We conducted a randomized phase I clinical trial PedVacc 001 assessing the feasibility, safety and immunogenicity of a single dose of candidate vaccine MVA.HIVA administered intramuscularly to 20-week-old infants born to HIV-1-negative mothers in The Gambia. Infants were followed to 9 months of age with assessment of safety, immunogenicity and interference with Expanded Program on Immunization (EPI) vaccines. The trial is the first stage of developing more complex prime-boost vaccination strategies against breast milk transmission of HIV-1. From March to October 2010, 48 infants (24 vaccine and 24 no-treatment) were enrolled with 100% retention. The MVA.HIVA vaccine was safe with no difference in adverse events between vaccinees and untreated infants. Two vaccine recipients (9%) and no controls had positive ex vivo interferon-γ ELISPOT assay responses. Antibody levels elicited to the EPI vaccines, which included diphtheria, tetanus, whole-cell pertussis, hepatitis B virus, Haemophilus influenzae type b and oral poliovirus, reached protective levels for the vast majority and were similar between the two arms. A single low-dose of MVA.HIVA administered to 20-week-old infants in The Gambia was found to be safe and without interference with the induction of protective antibody levels by EPI vaccines, but did not alone induce sufficient HIV-1-specific responses. These data support the use of MVA carrying other transgenes as a boosting vector within more complex prime-boost vaccine strategies against transmission of HIV-1 and/or other infections in this age group. ClinicalTrials.gov NCT00982579. The Pan African Clinical Trials Registry PACTR2008120000904116.

Background: Chronic kidney disease (CKD) is a global public health problem, with a greater burden and prohibitive cost of care particularly in developing countries. This study determined the prevalence of chronic kidney disease and identified its associated risk factors in patients attending the Family Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria. Method: Consecutive newly-registered patients who attended the Family Practice Clinic of Wesley Guild Hospital, Ilesa from August 2005 to January 2006 were recruited and studied. Relevant data were collected by using an interviewer-administered questionnaire, and determining the spot urinary ACR (albumin-creatinine ratio) of the subjects by using Microalbustix™ reagent strips and using their serum creatinine concentration. The glomerular filtration rate (GFR) of each subject was estimated using the Modification of Diet in Renal Disease (MDRD) formula. A repeat urine test was done three months after the initial screening to identify subjects with persistent microalbuminuria.Results: The age of the study subjects ranged from 20 to 74 years, with a mean age of 50.52 + 13.03 years. There were 68 males and 182 females in the sample population, showing a male to female ratio of 1:2.7. One hundred and thirteen of the 250 subjects (45.2%) were found to have pathologic albuminuria at the initial screening, while 31 (12.4%) had persistent albuminuria three months later. Also, 51 subjects (20.4%) had estimated low GFR at the initial screening and 26 (10.4%) had persistent low GFR three months later. Significant risk factors for CKD in the study subjects were increasing age, elevated blood pressure, history of diabetes mellitus (DM), habitual intake of analgesics and herbs, and an abnormal waist to hip ratio (p < 0.05). The association between persistent abnormal ACR and low GFR did not reach statistical significance (p = 0.053). Habitual analgesic intake (p = 0.002) and age group (p = 0.0027) were true predictors of CKD among the study subjects.Conclusions: The prevalence of CKD in the study population was high and its association with modifiable risk factors was demonstrated. Family physicians have a unique opportunity to identify and address these factors in their patients. Routine screening for CKD in family practice clinics is indicated to reduce the burden of renal disease in the population.

To induce a deployable level of efficacy, a successful malaria vaccine would likely benefit from both potent cellular and humoral immunity. These requirements are met by a heterologous prime-boost immunization strategy employing a chimpanzee adenovirus vector followed by modified vaccinia Ankara (MVA), both encoding the pre-erythrocytic malaria antigen ME-thrombospondin-related adhesive protein (TRAP), with high immunogenicity and significant efficacy in UK adults. We undertook two phase 1b open-label studies in adults in Kenya and The Gambia in areas of similar seasonal malaria transmission dynamics and have previously reported safety and basic immunogenicity data. We now report flow cytometry and additional interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) data characterizing pre-existing and induced cellular immunity as well as anti-TRAP IgG responses. T-cell responses induced by vaccination averaged 1,254 spot-forming cells (SFC) per million peripheral blood mononuclear cells (PBMC) across both trials and flow cytometry revealed cytokine production from both CD4+ and CD8+ T cells with the frequency of CD8+ IFN-γ-secreting monofunctional T cells (previously shown to associate with vaccine efficacy) particularly high in Kenyan adults. Immunization with ChAd63 and MVA ME-TRAP induced strong cellular and humoral immune responses in adults living in two malaria-endemic regions of Africa. This prime-boost approach targeting the pre-erythrocytic stage of the malaria life-cycle is now being assessed for efficacy in a target population.

Background Malaria remains a major health problem, especially in sub-Saharan Africa where more than 90% of the disease and where nearly all deaths occur in children. Adding to this high burden is the co-existence of intestinal and genito-urinary helminth infections. Existing control programmes for these helminths are operating sub-optimally. Conversely, a malaria prevention programme, called seasonal malaria chemoprevention (SMC), introduced in 2012 has achieved more than 75% treatment coverage and prevented 75–85% cases of uncomplicated and severe malaria in children. This encouraging development supports the need to explore strategies involving the integration of helminth control with successful platforms such as SMC. This would align worm and malaria control within the Sustainable Development Goals of ending the diseases of poverty and promoting health and well-being for those at risk. Methods This study will have quantitative and qualitative components. The quantitative component will be a three-arm, observer-blind, placebo-controlled, interventional study of co-administration of SMC and anthelminthic drugs to pre-school and school-age children in Saraya district, southeast Senegal. Six hundred children aged 1–14 years will be randomly assigned to receive either SMC drugs only, SMC drugs and praziquantel or SMC drugs and albendazole and praziquantel at a ratio of 1:1:1. The primary outcome will be solicited and unsolicited adverse reactions to the study medications. The secondary outcomes will be the prevalence and intensity of Plasmodium -helminth co-infection and the prevalence of anaemia and mean haemoglobin concentration. The qualitative component of the study will include the conduct of structured interviews to assess the acceptability, feasibility, enablers and barriers to the combined use of anthelminthic and SMC drugs among randomly selected parents/caregivers of children enrolled in the study and health care workers responsible for the delivery of the combined services. Discussion This study will provide evidence to boost the public health recommendations for combined malaria and helminth control. If successful, this project will reinforce the evidence that health care systems in developing countries can be comprehensive health management rather than focussed on vertical management of a single disease. Trial registration ClinicalTrials.gov NCT05354258. Registered on 28 April 2022. PACTR202204794105273. Registered on 25 April 2022

Acute type A aortic dissection (ATAAD) surgery is often complicated by postoperative acute refractory hypoxemia (ARH). Multiple risk factors contribute to ARH, and perioperative blood transfusion is a potential risk factor. This study investigates the association between perioperative blood product transfusion and ARH in ATAAD surgical patients. This retrospective cohort study included 282 patients who underwent surgical repair of ATAAD between 2015 and 2020. Perioperative blood product transfusion volumes, postoperative oxygenation indices, laboratory and radiological findings were analyzed. The primary outcome, ARH, was defined as moderate-to-severe hypoxemia (P/F ≤ 200 mmHg) within 72 hours postoperatively. Multivariate logistic regression was used to identify risk factors for ARH, confounders were adjusted for, and platelet transfusion association was further evaluated. Acute refractory hypoxemia occurred in 35.8% of the total patient cohort. At baseline, ARH patients had significantly higher BMI and a high prevalence of hypertension and coronary artery disease. Marfan syndrome was significantly more prevalent in the non-ARH group. Platelet transfusion was administered in 81.2% of patients, and a significantly higher frequency of ARH patients received platelet transfusion [p=0.013; Adjusted OR 95% CI; 3.43 (1.54-7.63)]. A synergistic effect was observed between high preoperative C-reactive protein (CRP) and platelet transfusion in the resulting ARH [ < 0.001; adjusted OR 95% CI: 16.06 (3.02-85.50)]. After multivariate logistic regression analysis, platelet transfusion, high CRP, brachiocephalic trunk involvement, and prolonged hypothermic circulatory arrest time were independent risk factors for postoperative ARH after ATAAD surgery. ARH patients required a significantly longer duration of mechanical ventilation. Platelet transfusion was independently associated with risk of postoperative ARH, supporting a potential TRALI-like mechanism. Findings suggest that in high-risk ATAAD surgery, the synergistic effect of preoperative systemic inflammation and platelet transfusion may contribute to lung injury compatible with the \"two-hit\" model. This potential pathway requires further investigation.