Key takeaways from China's success in eliminating malaria: leveraging existing evidence for a malaria-free world

Cabo Verde's malaria-free certification: A blueprint for eradicating malaria in Africa

The World Health Organisation (WHO) officially certified Cabo Verde as a malaria-free country in January 2024, marking a key milestone in world health and demonstrating the efficacy of comprehensive malaria control programs. Cabo Verde is only the third country in the WHO African region to have achieved this designation, highlighting the potential for other nations to successfully eradicate malaria. Despite encountering hurdles like drug-resistant strains and COVID-19 disruptions, Cabo Verde's success after years of strategic planning and multisectoral collaboration highlights the value of long-term public health initiatives. To emulate this achievement, African countries must take a holistic approach that includes strong leadership, effective monitoring systems, and community engagement. Leveraging current resources and embracing breakthroughs, such as the recent introduction of malaria vaccinations, will be critical to achieving a malaria-free Africa. Countries that integrate socioeconomic development into malaria eradication efforts might reduce the burden of malaria on vulnerable communities while also driving progress towards larger development goals. Cabo Verde's success serves as an example of the continent's malaria fight, emphasizing the significance of long-term vigilance, adaptability, and collaborative action in realizing a common goal of a malaria-free future.

How Real-Time Case-Based Malaria Surveillance Helps Zanzibar Get a Step Closer to Malaria Elimination: Description of Operational Platform and Resources

Testing and treating asymptomatic populations have the potential to reduce the population's parasite reservoir and reduce malaria transmission. Zanzibar's malaria case notification (MCN) platform collects detailed sociodemographic and epidemiological data from all confirmed malaria cases to inform programmatic decision-making. We describe the design and operationalization process of the platform and other malaria surveillance resources that are enabling Zanzibar's progress toward malaria elimination.The MCN platform consists of an interactive short message service (SMS) system for case notification, a software application for Android mobile devices, a visual question set and workflow manager, a back-end database server, and a web browser-based application for data analytics, configuration, and management. Malaria case data were collected from August 2012 to December 2021 and reported via SMS from all public and private health facilities to a central database and then to district malaria surveillance officers' mobile devices. Data included patient names, shehia (administrative area), and date of diagnosis, enabling officers to track patients, ideally within 24 hours of reporting. Patients' household members were tested for malaria using conventional rapid diagnostic tests (RDTs). Treatment using artemisinin-based combination therapy was provided for persons testing positive.Between 2012 and 2021, a total of 48,899 index malaria cases were confirmed at health facilities, 22,152 (45.3%) within 24 hours of reporting; 41,886 (85.7%) cases were fully investigated and followed up to the household level. A total of 111,811 additional household members were tested with RDTs, of whom 10,602 (9.5%) were malaria positive.The MCN platform reports malaria case data in near real time, enabling prompt follow-up of index cases and prompt testing and treatment of members in index case households. Along with routine testing and treatment and other preventive interventions, the MCN platform is foundational to the programmatic efforts in further reducing malaria and ultimately eliminating autochthonous malaria transmission in Zanzibar.

Public health engagement: new opportunities and challenges in 60 years of China's health aid to Africa

Along with China's active engagement in global affairs over the past decade, China's public health engagement (CPHE) has become an essential element of China's 60th anniversary of health aid and cooperation with Africa. Through analysis, we found that CPHE in Africa reflects a new shift in the content and form of China's foreign health aid. Compared with China's medical teams which only involve bilateral cooperation, CPHE has a number of substantive characteristics, mainly including the construction of public health infrastructure, malaria control, participation in public health emergencies and the provision of global public goods. This complexity necessitates that CPHE be implemented in a different form from China's medical teams, by adopting inclusive multiparty cooperation involving African and international partners. However, CPHE in Africa still faces a number of challenges in its practices. In particular, these challenges arise from the cross-cultural practice process, the African sociocultural context, the experience of public health and its participants. While the reasons for these challenges are diverse, this study argues that the main reason is the lack of multidisciplinary engagement in the Africanisation of the Chinese experience that corresponds to cross-cultural practice. On the Chinese side, a systematic strategy is needed to critically refine these challenges.

Virtual screening and molecular dynamic simulations of the antimalarial derivatives of 2-anilino 4-amino substituted quinazolines docked against a Pf-DHODH protein target

Background

The processes of drug development and validation are too expensive to be subjected to experimental trial and errors. Hence, the use of the insilico approach becomes imperative. To this effect, the drug-likeness and pharmacokinetic properties of the ten (10) previously designed derivatives of 2-anilino 4-amino substituted quinazolines were carried out. Their predicted ligand binding interactions were also carried out by docking them against the Plasmodium falciparum dihydroorotate dehydrogenase (Pf-DHODH) protein target, and the stability of the complex was determined through dynamic simulations. The drug-likeness and pharmacokinetic characteristics were estimated using the online SwissADME software, while the Molegro Virtual Docker (MVD) software was used for molecular docking. And the dynamic simulation was performed for the duration of 100 ns to verify the stability of the docked complex, with the aid of a Schrödinger program, Desmond.

Results

The designed derivatives were all found to pass the Lipinski test of drug likeness, while the pharmacokinetic studies result that the skin permeability and molar refractivity values of the derivatives are both within the limits. In addition, except for derivative C-01, most of the derivatives have strong gastrointestinal absorptions and lack Pgp substrate. Furthermore, no derivative inhibited CYP1A2, CYP2C9, or CYP2C19. The docking studies show the better binding affinities between the ligands and Pf-DHODH than those between the atovaquone or chloroquine standards. The derivative C-02, {5-((6,7-dimethoxy-4-((3-nitrobenzyl)amino)quinazolin-2-yl)amino)-2-fluorobenzaldehyde} was found to be the most stable derivative, with a re-rank docking score of - 173.528 kcal/mol and interaction energy of - 225.112 kcal/mol. The dynamic simulation analysis shows that the derivative C-02 forms a stable complex with the protein target over the simulation time.

Conclusions

The ability of these ligands to form hydrogen bonds, as well as various other interactions, was cited as a factor responsible for their better binding affinity. These findings could aid further the development of enhanced antimalarial drugs.