Is malaria immunity a possible protection against severe symptoms and outcomes of COVID-19?

Outcomes of childhood severe malaria: a comparative of study pre-COVID-19 and COVID-19 periods

BACKGROUND

The collateral damages from measures adopted to mitigate the coronavirus disease 2019 (COVID-19) pandemic have been projected to negatively impact malaria in sub-Saharan Africa. Herein, we compare the prevalence and outcomes of childhood severe malaria during the pre-COVID-19 and COVID-19 periods at a tertiary health facility in Nigeria.

METHODS

This was a retrospective review of cases of severe malaria admitted from 1st January to 31st December 2019 (pre-COVID-19 period) and 1st January to 31st December 2020 (COVID-19 period). We extracted relevant information, including demographics, the duration of symptoms before presentation, forms of severe malaria, and outcomes of hospitalization (discharged or death).

RESULTS

In the pre-COVID-19 period, there were a total of 2312 admissions to the EPU and 1685 in the COVID-19 period, representing a decline of 27%. In contrast, there were 263 and 292 severe malaria admissions in the pre-COVID-19 and COVID-19 periods, respectively, representing an 11% increase in the absolute number of cases. The prevalence rates were 11.4% in the pre-COVID-19 period and 17.3% in the COVID-19 period, representing an increase of 52% in the percentage differences. The mortality rate in the COVID-19 period was higher than the pre-COVID-19 period ([10.3%; 30/292 vs. 2.3%; 6/263], p 0.001). The death rate increased by 350% during the COVID-19 period. The odds ratio (OR) of a child dying from severe malaria in the COVID-19 era was 4.9 [95% confidence interval (CI): 2.008 to 11.982]. In the COVID-19 era, presentation at a health facility was also delayed (p = 0.029), as were the odds of multiple features of severe malaria manifestations (OR-1.9, 95% CI, 1.107 to 3.269; p = 0.020).

CONCLUSION

This study shows that the prevalence of severe childhood malaria increased by as much as 11.0%, with a disproportionate increase in mortality compared to the pre-pandemic level. Most children with severe malaria presented late with multiple features of severe malaria, probably contributing to the poor hospitalization outcomes (death) observed in this study.

Main modulators of COVID-19 epidemic in sub-Saharan Africa

Background

The coronavirus disease 2019 (COVID-19) pandemic is responsible for an important global death toll from which sub-Saharan Africa (SSA) seems mostly protected. The reasons explaining this situation are still poorly understood.

Methods

We analyzed the correlation between reported COVID-19 data between February 14, 2020 and May 18, 2021, and demographic, socioeconomic, climatic, diagnostic data, and comorbidities in 47 SSA countries. Different databases including the WHO data center, Our World in Data, and the World Bank were used.

Findings

As of May 17, 2021, SSA reported 2% of COVID-19 cases and 2.9% of deaths, with the southern region being the most affected with 56.4% of cases and 75.0% of deaths. COVID-19 mortality was positively correlated with medical variables (national obesity rate, diabetes prevalence, cancer incidence, and cardiovascular disease mortality rate), socioeconomic characteristics (international tourism, per capita health expenditure, human development index, HDI, and years of schooling), and health system variables (nurse density, number of COVID-19 tests per capita), but negatively correlated with the population under 15 years of age and the malaria index.

Interpretation

Our study suggests that higher economic status fits with high COVID-19 mortality in SSA. In this regard, it represents primarily a disease of modern and wealthy societies, and can therefore be considered as an exception among infectious diseases that historically affected more severely underserved populations living in low- and middle-income countries. However, it should be made clear that observed correlations do not imply inevitably causation and that additional studies are necessary to confirm our observations.

Evaluating the Performance of Deep Learning Frameworks for Malaria Parasite Detection Using Microscopic Images of Peripheral Blood Smears

Malaria is a significant health concern in many third-world countries, especially for pregnant women and young children. It accounted for about 229 million cases and 600,000 mortality globally in 2019. Hence, rapid and accurate detection is vital. This study is focused on achieving three goals. The first is to develop a deep learning framework capable of automating and accurately classifying malaria parasites using microscopic images of thin and thick peripheral blood smears. The second is to report which of the two peripheral blood smears is the most appropriate for use in accurately detecting malaria parasites in peripheral blood smears. Finally, we evaluate the performance of our proposed model with commonly used transfer learning models. We proposed a convolutional neural network capable of accurately predicting the presence of malaria parasites using microscopic images of thin and thick peripheral blood smears. Model evaluation was carried out using commonly used evaluation metrics, and the outcome proved satisfactory. The proposed model performed better when thick peripheral smears were used with accuracy, precision, and sensitivity of 96.97%, 97.00%, and 97.00%. Identifying the most appropriate peripheral blood smear is vital for improved accuracy, rapid smear preparation, and rapid diagnosis of patients, especially in regions where malaria is endemic.

Sociodemographic and Psychological Variables and Concerns Related to COVID-19 Vaccination among Polish Citizens

The aim of this study performed during the fourth wave of the pandemic was to analyse differences in sociodemographic and psychological variables between those who cite concerns regarding COVID-19 vaccination and those who do not, as well as the differences between those whose concerns stem from a negative evaluation of vaccines and those whose concerns are based on a positive evaluation of vaccines. The study included 417 participants aged 18 to 76 years (M = 34, SD = 13.9). Among the respondents, 89% were female. A survey questionnaire on sociodemographic variables and standardized research tools were used: mood (UMACL), emotions (PANAS), satisfaction with life (SWLS), optimism (LOT-R), and coping with stress (CISS). The results of the study indicate that the elderly and working people are concerned about inadequate vaccination of the population, whereas students are concerned about the pressure of compulsory vaccination. People who are concerned about inadequate vaccination of population are more likely to experience concerns about various stressors. Our results do not indicate a relationship between psychological variables and vaccination-related concerns. The results obtained may be the basis for the identification of target groups in order to adapt social campaigns promoting vaccination against COVID-19 in Poland.

Co-Infection with Plasmodium vivax and COVID-19 in Thailand

With the emergence of SARS-CoV-2, healthcare systems not only had to address the pressing clinical needs of the COVID-19 pandemic but anticipate the effect on and of other conditions and diseases. This was of particular concern in areas of the world endemic with malaria, a disease which takes hundreds of thousands of lives each year. This case report from Thailand describes a 25-year-old man diagnosed with Plasmodium vivax, who was then found to be co-infected with COVID-19. Both conditions can have overlapping acute febrile illness symptoms which may delay or complicate diagnoses. He had no prior history of malaria and had received two vaccinations against COVID-19. His clinical course was mild with no pulmonary complications or oxygen requirement, and he responded well to treatments for both conditions. Three months after cure, he again contracted COVID-19 but did not experience any P. vivax relapse. Review of the available literature produced less than 10 publications describing co-infections with P. vivax and COVID-19; nonetheless, in endemic areas, vigilance for both diseases should continue, as co-infections could significantly alter the course of clinical management and prognosis as well as affect the healthcare staff caring for these patients.