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Background Rapid diagnostic tests (RDTs) that rely on the detection of Plasmodium falciparum histidine-rich protein 2 ( Pf HRP2) have become key tools for diagnosing P. falciparum infection. The utility of RDTs can be limited by Pf HRP2 persistence, however it can be a potential benefit in low transmission settings where detection of persistent Pf HRP2 using newer ultra-sensitive Pf HRP2 based RDTs can serve as a surveillance tool to identify recent exposure. Better understanding of the dynamics of Pf HRP2 over the course of a malaria infection can inform optimal use of RDTs. Methods A previously published mathematical model was refined to mimic the production and decay of Pf HRP2 during a malaria infection. Data from 15 individuals from volunteer infection studies were used to update the original model and estimate key model parameters. The refined model was applied to a cohort of patients from Namibia who received treatment for clinical malaria infection for whom longitudinal Pf HRP2 concentrations were measured. Results The refinement of the Pf HRP2 dynamic model indicated that in malaria naïve hosts, P. falciparum parasites of the 3D7 strain produce 33.6 × 10 −15  g (95% CI 25.0–42.1 × 10 −15  g) of Pf HRP2 in vivo per parasite replication cycle, with an elimination half-life of 1.67 days (95% CI 1.11–3.40 days). The refined model included these updated parameters and incorporated individualized body fluid volume calculations, which improved predictive accuracy when compared to the original model. The performance of the model in predicting clearance of Pf HRP2 post treatment in clinical samples from six adults with P. falciparum infection in Namibia improved when using a longer elimination half-life of 4.5 days, with 14% to 67% of observations for each individual within the predicted range. Conclusions The updated mathematical model can predict the growth and clearance of Pf HRP2 during the production and decay of a mono-infection with P. falciparum , increasing the understanding of Pf HRP2 antigen dynamics. This model can guide the optimal use of Pf HRP2-based RDTs for reliable diagnosis of P. falciparum infection and re-infection in endemic settings, but also for malaria surveillance and elimination programmes in low transmission areas.

Background: Asymptomatic malaria is a major challenge to be addressed in the implementation of the malaria elimina­tion program. The main goal of the malaria surveillance system in the elimination phase is to identify reliably all the positive cases of malaria reliably (symptomatic and asymptomatic) in the shortest possible time. This study focused on the monitoring of asymptomatic malaria reservoirs in areas where local transmission had been previously established. Methods: It was a case-study approach that was conducted in the Anarestan area. A total of 246 residents and immi­grants living in the area at the age range of 4–60 years old were randomly selected to be tested for malaria by micro­scope, RDT, and nested-PCR techniques. The inclusion criterion for participants to be entered into the study was the absence of specific symptoms of malaria. Moreover, participants who have been taking antimalarials for the last month were excluded from the study. Results: The results indicated no positive cases of asymptomatic malaria among the participants tested by all methods. Conclusion: The results of this study have shown that, without concerns for asymptomatic parasitic patients, a malaria elimination program has been successfully implemented within the studies area. In addition, the findings emphasized the existence of a strong malaria surveillance system in this area.

Background: China was certified malaria-free by theWorld Health Organization on 30 June 2021. However, due to imported malaria, maintaining a malaria-free status in China is an ongoing challenge. There are critical gaps in the detection of imported malaria through the currently available tools, especially for non-'falciparum' malaria. In the study, a novel point-of-care Rapid Diagnostic Test designed for the detection of imported malaria infections was evaluated in the field. Methods: Suspected imported malaria cases reported from Guangxi and Anhui Provinces of China during 2018-2019 were enrolled to evaluate the novel RDTs. Diagnostic performance of the novel RDTs was evaluated based on its sensitivity, specificity, positive and negative predictive values, and Cohen's kappa coefficient, using polymerase chain reaction as the gold standard. The Additive and absolute Net Reclassification Index were calculated to compare the diagnostic performance between the novel RDTs and Wondfo RDTs (control group). Results: A total of 602 samples were tested using the novel RDTs. Compared to the results of PCR, the novel RDTs presented sensitivity, specificity, PPV, NPV, and diagnostic accuracy rates of 78.37%, 95.05%, 94.70%, 79.59%, and 86.21%, respectively. Among the positive samples, the novel RDTs found 87.01%, 71.31%, 81.82%, and 61.54% of 'P. falciparum', 'P. ovale', 'P. vivax', and 'P. malariae', respectively. The ability to detect non-falciparum malaria did not differ significantly between the novel andWondfo RDTs (control group). However,Wondfo RDTs can detect more 'P. falciparum' cases than the novel RDTs (96.10% vs. 87.01%, p < 0.001). After the introduction of the novel RDTs, the value of the additive and absolute Net Reclassification Index is 1.83% and 1.33%, respectively. Conclusions: The novel RDTs demonstrated the ability to distinguish 'P. ovale' and 'P. malariae' from 'P. vivax' which may help to improve the malaria post-elimination surveillance tools in China.

The World Malaria Report 2018 published by the World Health Organization highlights that no significant progress in reducing global malaria cases was achieved for the period 2015-2017. India carries 4% of the global malaria burden and contributes 87% of the total malaria cases in South-East Asia. India is in malaria elimination mode, and set targets for malaria-free status by 2030. Diagnosis and treatment of asymptomatic falciparum malaria cases continues to be a challenge for health care providers. To overcome these hurdles innovative solutions along with the existing tools and strategies involving vector control, mass drug administration, disease surveillance hold the key to solve this gigantic health problem.

This study aimed to assess the current progress of dog-mediated rabies control and the level of political commitment among 88 rabies-endemic countries and to provide further recommendations for the elimination of dog-mediated rabies by 2030. A correlational study was conducted using data and relevant regulations from the websites of international organizations and NGOs. In general, rabies was yet to be considered a priority disease and only one out of five countries and territories has prepared a national strategic plan for rabies control and prevention. Likewise, scores of dog-mediated rabies control indicators such as dog vaccination rate and the number of post-exposure prophylaxis per 1000 people remained minimal. There were also regional differences in preparation for dog-mediated rabies control and progress towards elimination. In particular, more efforts are needed for Pan-African Rabies Control Network (PARACON) member countries. In order to meet the goal of global dog-mediated zero rabies by 2030, both dog-mediated rabies control activities such as dog vaccination and strong political commitment should be strengthened and promoted in all rabies-endemic regions of the world.

Large-scale control and progressive elimination of a wide variety of parasitic diseases is moving to the fore. Indeed, there is good pace and broad political commitment. Yet, there are some worrying signs ahead, particularly the anticipated declines in funding and coverage of key interventions, and the paucity of novel tools and strategies. Further and intensified research and development is thus urgently required. We discuss advances in epidemiological sampling, diagnostic tools and geospatial methodologies. We emphasise the need for integrating sound epidemiological designs (e.g. cluster-randomised sampling) with innovative diagnostic tools and strategies (e.g. Mini-FLOTAC for detection of parasitic elements and pooling of biological samples) and high-resolution geospatial tools. Recognising these challenges, standardisation of quality procedures, and innovating, validating and applying new tools and strategies will foster and sustain long-term control and eventual elimination of human and veterinary public health issues.

To validate a crowdsourced, image-based morbidity hotspot method for surveillance of neglected tropical diseases. We conducted our crowdsourced surveillance pilot implementation study between November 2022 and October 2024 in 45 communities across three Nigerian states, covering a population of 477 138 people. Three additional states, where the project was not implemented but surveillance data obtained, served as control. Residents self-reported suspected symptoms by using smartphones to capture and transmit images of skin and eye manifestations via digital communication platforms. An expert panel then examined the images to confirm signs of neglected tropical diseases. We used frequency and percentages to present data; we also compared incidence data from both pilot and control locations. In total, 512 subjects submitted images, either themselves or via a community focal point. Their mean age was 53  years (standard deviation: 20.7). Forty-six percent (234/512) were women and 55% (281/512) were farmers. Notably, 43% (218/512) had experienced symptoms of neglected tropical diseases for 1-5 years before our study and 85% (437/512) had not received any intervention. Of all photos submitted, 75% (386/512) showed signs of neglected tropical diseases. In Ondo state crowdsourced surveillance led to an average of 54.3 monthly reports, versus traditional surveillance which averaged 6.8 (  < 0.01). Cost analysis showed that crowdsourced surveillance cost 72.4 United States dollars per case detected. Our surveillance method outperformed traditional surveillance, showing its promise for enhancing neglected tropical disease surveillance. The method's ability to detect emerging conditions and support post-elimination surveillance reinforces its value.

Background Surveillance is a core component of an effective system to support malaria elimination. Poor surveillance data will prevent countries from monitoring progress towards elimination and targeting interventions to the last remaining at-risk places. An evaluation of the performance of surveillance systems in 16 countries was conducted to identify key gaps which could be addressed to build effective systems for malaria elimination. Methods A standardized surveillance system landscaping was conducted between 2015 and 2017 in collaboration with governmental malaria programmes. Malaria surveillance guidelines from the World Health Organization and other technical bodies were used to identify the characteristics of an optimal surveillance system, against which systems of study countries were compared. Data collection was conducted through review of existing material and datasets, and interviews with key stakeholders, and the outcomes were summarized descriptively. Additionally, the cumulative fraction of incident infections reported through surveillance systems was estimated using surveillance data, government records, survey data, and other scientific sources. Results The landscaping identified common gaps across countries related to the lack of surveillance coverage in remote communities or in the private sector, the lack of adequate health information architecture to capture high quality case-based data, poor integration of data from other sources such as intervention information, poor visualization of generated information, and its lack of availability for making programmatic decisions. The median percentage of symptomatic cases captured by the surveillance systems in the 16 countries was estimated to be 37%, mostly driven by the lack of treatment-seeking in the public health sector (64%) or, in countries with large private sectors, the lack of integration of this sector within the surveillance system. Conclusions The landscaping analysis undertaken provides a clear framework through which to identify multiple gaps in current malaria surveillance systems. While perfect systems are not required to eliminate malaria, closing the gaps identified will allow countries to deploy resources more efficiently, track progress, and accelerate towards malaria elimination. Since the landscaping undertaken here, several countries have addressed some of the identified gaps by improving coverage of surveillance, integrating case data with other information, and strengthening visualization and use of data.

There has been a significant reduction in malaria morbidity and mortality worldwide from 2000 to 2019. However, the incidence and mortality increased again in 2020 due to the disruption to services during the COVID-19 pandemic. Surveillance to reduce the burden of malaria, eliminate the disease and prevent its retransmission is, therefore, crucial. The 1-3-7 approach proposed by China has played an important role in eliminating malaria, which has been internationally popularized and adopted in some countries to help eliminate malaria. This review summarizes the experience and lessons of 1-3-7 approach in China and its application in other malaria-endemic countries, so as to provide references for its role in eliminating malaria and preventing retransmission. This approach needs to be tailored and adapted according to the region condition, considering the completion, timeliness and limitation of case-based reactive surveillance and response. It is very important to popularize malaria knowledge, train staff, improve the capacity of health centres and monitor high-risk groups to improve the performance in eliminating settings. After all, remaining vigilance in detecting malaria cases and optimizing surveillance and response systems are critical to achieving and sustaining malaria elimination.

Background In response to the recent increase in measles cases and reported outbreaks across Europe, Czech surveillance data were analysed. The aim was also to evaluate the effect of vaccination on measles complications and hospitalisation. Methods The measles cases reported to the Czech national surveillance system between 2018-2024, based on the EU case definition (2018), were analysed using logistic regression with an odds ratio (OR) supplemented with the 95% confidence interval (95% CI) to measure the association between vaccination status and the occurrence of complications or hospitalisation. Results A total of 837 measles cases were reported, of which 94% were laboratory confirmed and 437 (52%) were male. The majority of cases (590; 71%) occurred in 2019. An epidemiological link was found in 407 cases. The median age of cases was 34 years (range: 0-75). In total, 111 (13%) measles cases were imported (62 from Ukraine, 5 from Vietnam and smaller numbers from 25 other countries; 59 of the imported cases were unvaccinated). Hospitalisation was required in 561 cases (67%). In total, 41% of all cases were known to have been vaccinated, of which 62% with two doses and 23% with one dose. Measles complications occurred in 11% of cases, most frequently pneumonia (3%). The highest proportion of complications occurred in infants (<1 year; 28%; cases who were too young to be vaccinated) and in adults aged 55-64 years (27%). Two doses of vaccine significantly reduced the risk of any complications compared to unvaccinated cases: OR 0.39 (95% CI: 0.21-0.72, p = 0.002) and the likelihood of hospitalisation: OR 0.50 (95% CI: 0.34-0.73, p < 0.001). Conclusions A protective effect of two-dose vaccination against measles complications and hospitalisation for measles was demonstrated. To prevent further cases, increased awareness and promotion of measles vaccination is recommended for all individuals, including travellers, as a substantial proportion of cases were unvaccinated. Key messages • Two-dose vaccination has a protective effect against measles complications and hospitalisation; increasing public awareness about the importance of measles vaccination and vaccine uptake is essential. • We recommend continuing routine childhood vaccination against measles and maintaining high vaccination coverage in order to prevent further cases and retaining measles elimination status in Czechia.