A study in MalariaWorld last week found a link between malaria and nutrition. ‘The gut microbiome in early life predicts malaria susceptibility’ by Dutton et al of the University of Florida studied infants from birth in malaria-endemic eastern Democratic Republic of Congo. Infant faecal samples were collected at six weeks, and at three, six and 12 months of age, as well as at passive malaria sick and post-treatment visits, and were subjected to full length 16S rRNA sequencing.

The study found significant differences in relative abundance of a number of bacterial species between those infants who never had a malaria visit from those who did, and malaria episodes resulted in gut dysbiosis. Healthy gut-associated Bifidobacterium breve and its metabolic partner Cutibacterium avidum, along with Megasphaera micronuciformis were associated with malaria resistance, whereas bacteria previously associated with pathogenic processes, including Streptococcus salivarius, Klebsiella pneumoniae, and Rothia mucilaginosa, associated with malaria susceptibility.

The faecal samples collected were tested using digital polymerase chain reaction (PCR) techniques to identify bacteria. These data were correlated with detailed survey information of both mothers and infants and malaria status. There are no other clear signals from the data collected. But clearly, the infants microbiome is linked to the quality of nutrition they receive. We reported another study linking gut microbiome to malaria in April 2026.

There is opportunity to investigate microbiome-targeted strategies to support resistance to malaria in early life. It would be useful to identify the foods eaten by breast feeding mothers and by growing infants that encourage development of malaria resistant guts.

Surprisingly, we can agreed with the headline of a blog post published in MalariaWorld this week, but for a different reason. The post with the same name was written by Fredros Okumu for Devex. Devex is described thus by Editor in chief Raj Kumar – ‘Devex is the platform for insider journalism on global development — independent, trusted, essential’. It is funded by globalist organisations including Gates Foundation, World Bank, UN, European Commission and WEF.

In earlier posts we have discussed this issue including Burkina Faso’s ending of gene-drive mosquito trials, possible releases of GM mosquitos in Nairobi by Gates Foundation, and a general dismissal of possible dangers of the effectiveness of this bizarre idea.

Unsurprisingly, Okumu is making the case that the dangers of ‘Frankenstein’ mosquitos are insignificant compared to the 610,000 annual worldwide deaths from malaria. He says conversations start with the technology and that they should start with the disease. Again, we agree. And the first question he should answer is how does he know for sure that malaria is spread by mosquitos, or is it a disease of malnutrition?

He states if gene drives work as intended, engineered mosquitos could spread genetic traits that selectively suppress populations of the most dangerous malaria mosquitos or make them unable to transmit the parasite. This argument runs counter to basic Darwinian evolution theory. There is no way that Gates’ freak mosquitos will outcompete well evolved natural mosquitos. If natural mosquitos can survive insecticides they can survive these freaks.

He says another thing we agree with ‘But what succeeds in a laboratory does not automatically succeed in the world’. He uses this as an argument for field trials rather than as a cue to forget about the idea.

Comically he states ‘When COVID-19 arrived, the world understood speed as a moral obligation. In the U.S., Operation Warp Speed accelerated the development, testing, and manufacturing of multiple vaccine candidates without abandoning safety. It meant that delay itself was recognized as a risk. Malaria deserves the same seriousness’. Clearly, he does not understand that COVID19 vaccines caused immeasurably more harm than the supposed virus, a fact we know too well because of the premature demise of a close relative.

On the plus side the gene drive mosquitos are at worst a costly folly, unlike the real dangers caused to babies by vaccines including those for malaria tested against vaccines for rabies.

An article in MalariaWorld this week again reinforces the suspicion that malaria is a generic illness that can be found if sought. It reminds one of the testing for COVID19 that happened in much of the world in 2020-2022. ‘Non-linear age dynamics of malaria infection and fine-scale environmental exposure in rural Uganda’ by Lang et al examined data for 4308 participants aged 5 to 90 years from 52 villages across three lakeside districts of Mayuge, Buliisa, and Pakwach, with enrollment between January 2022 to February 2024. The primary outcome was malaria infection status by rapid diagnostic test (RDT) and secondary outcomes included microscopy-confirmed infection with parasite density quantification and self-reported fever within the past month.

The most notable aspect of the study was the high prevalence of malaria especially as detected using RTDs (41.2% – lower by microscopy, the ‘gold standard’ – 32.3%). However, this did not directly relate to fever with just 11.2% of positive adults with fever. For children (5 to 10) it was 30.8%. What is also interesting is that many of RDT negative adults (5.8%) and children (16.3%) had fever. Positive tests are associated with higher levels of illness but not completely. And the significant number of asymptomatic plasmodium positive individuals casts doubt on the validity of such tests for diagnosing illness.

Plasmodia are likely organisms that consume dead blood cells. They are more likely in unwell than well people but and not exactly correlated with illness. This study confirms that many well people test positive and unwell people test negative. Unwell people are more likely to be tested which is what make studies like this, that also include tests of well people so interesting.

However, the belief in malaria and its cures is strong. A friend in Kenya was ill this week and went to hospital. A malaria test was positive and malaria drugs were prescribed. They didn’t cure the illness. But her belief in the medical establishment is strong and she complies. It will be difficult to end malaria in Africa when the belief in it is so culturally entrenched.  

In MalariaWorld this week there is a study investigating the people’s opinion about malaria and its treatment in Ethiopia. In ‘The social experience of malaria treatment-seeking: pathways, gender, and inequality in Jimma Zone, Ethiopia’, Gerba et al interviewed people and conducted focus group studies on malaria and its treatment. While it is clear that the researchers are strong believers in the mosquito transmission hypothesis, the interviewees consider other causes to be more important. And they rely on traditional remedies as a first response.

Local terms for malaria, busa (seasonal fever), sekera (killer disease) and buda (evil eye), are related to how symptoms were recognized and interpreted.

Busa was widely used to refer to recurrent seasonal fevers, particularly those occurring during the rainy period. Many participants associated busa with environmental and seasonal changes rather than with mosquito bites. One woman explained: “Every year when the rains come, busa also comes. The children fall sick one after the other”. In western countries such an illness would be considered a cold or flu (on in 2020-2022 COVID19). Many households initially adopted a ‘wait-and-see’ approach before seeking biomedical care with this illness.

Sekera is a severe or life-threatening forms of illness, characterized by high fever, intense chills, weakness, and loss of speech. For many, the experience of sekera was not just a biological state but a state of total social paralysis; one participant noted that the illness: “Finishes a person”, and is associated with sudden deterioration and a high risk of death. Illness episodes labeled as sekera are treated with greater urgency and fear, often prompting families to seek stronger forms of intervention.

Buda was linked to spiritual harm, envy, and the evil eye. Some participants believed that malaria-like symptoms could result from social tension or spiritual attack rather than physical causes alone. An elderly woman explained “Malaria is not only about mosquitos. It is like buda; it comes when someone envies you, when your body is not protected. If it catches you, it can finish you”. In such cases, illness was understood not merely as a physical condition but as a reflection of social vulnerability.

Treatment usually begins with hot beverages and OTC medications. If symptoms worsen traditional herbal remedies would be used. Spiritual practices such as the use of holy water and prayer are used. If symptoms get very bad medical care at a clinic would be sought.

The authors reference similar observations in other African studies. In Ghana, Tanzania, Kenya, Burkina Faso, Uganda, and Malawi communities frequently use locally meaningful fever terms that do not neatly correspond to biomedical classifications. However, in the medical establishment the belief in the mosquito tall tale continues irregardless.

Picture. Spiritual healer or Sangoma from South Africa (Source—Ancient Origins).

One thing we can agree with establishment malaria researchers is that mosquito bites are not desirable. We don’t believe that disease is transmitted but mosquito bites are uncomfortable and itchy. Before travelling to Botswana a few years ago I prepared my own homemade natural mosquito repellent by dissolving 1% peppermint oil in coconut oil!

And today in MalariaWorld there is an interesting paper comparing natural and synthetic mosquito repellents. In ‘Do natural or synthetic excito-repellents work better? A study on coastal malaria vector Anopheles epiroticus in Ko Chang, Thailand’, Sukkanon et al compared the effectiveness of four synthetic and two natural mosquito repellents with field and laboratory strains of Anopheles epiroticus.

An insecticide-susceptible laboratory strain of An. Epiroticus and field strain of An. epiroticus derived from fed females collected using an entomological mount aspirator around the buffalo pen were used in the trial. Four synthetic and two natural repellent agents were used in the study. Three pyrethroids (deltamethrin, permethrin, alpha-cypermethrin) and DEET (N,N-diethyl-meta-toluamide) were the synthetics. Vetiver oil (extracted from the roots of the Vetiveria zizanioides plant) and citronella oil (extracted from lemongrass) were the natural repellents. They were dissolved in alcohol and soaked in paper in the studies.

Mosquitos were exposed to treated paper in contact studies, where mosquitos could contact the paper, and non-contact studies (paper behind a net). The chamber had an escape to another chamber and effectiveness of the repellent was measured by the number that escaped.

For the laboratory strain, 5% citronella oil was the most effective repellent for in both the non-contact (59.26%) and contact (52.73%) studies. Vetiver oil 5% achieved 40.38% in contact study. The best synthetic was deltamethrin at 42.11% in contact study. For the contact study with the field strain the synthetics were more effective – DEET 5%, 64.15% and deltamethrin 5%, 60.00%. The natural material were also effective at 5% in contact study – vetiver oil 48.14% and citronella oil 40.74%. High mortality rates were also observed for the mosquitos that did not escape in non-contact citronella oil study.

The authors concluded that pyrethroids, particularly deltamethrin and permethrin, along with DEET, showed enhanced efficacy against field populations as contact irritants, while natural repellents like citronella oil were more effective against laboratory strains as non-contact repellents.

In MalariaWorld this week there is reference to a paper that links malaria with a deficiency of micronutrients. ‘Burden and co-occurrence of anemia, micronutrient deficiencies, inflammation, and malaria among women, adolescents, and children in Madagascar: a national cross-sectional survey’ by Rohner et al is published in The Journal of Nutrition. Unfortunately, the full article is behind a paywall but interesting details are presented in the available summary.

Venous blood and urine were analysed for malaria, anaemia, inflammation, iron, zinc, iodine, fluoride, vitamins A, D, and B12, folate, riboflavin, and thiamine biomarkers. Malaria was detected in 4% to 14% of participants, and inflammation in 21% to 46% of participants. Anaemia affected 42% of PSC (preschool children) and about one-third of the older groups. Iron deficiency was most common in PSC (26%) and less frequent in adolescents and women (6%–16%). Zinc deficiency affected one-third of all groups. Riboflavin deficiency was highly prevalent, affecting 75% of PSC and nearly 90% of older groups. Vitamin A deficiency prevalence was 12% among PSC but rare in older groups, while folate deficiency affected 12% of adolescent girls and 21% of non-pregnant women. Other deficiencies were uncommon (iodine, vitamins B12 and D, and thiamine).

Micronutrient (MN) supplementation was considered in the article. Clearly many in Madagascar and elsewhere in Sub-Saharan Africa have a diet insufficient in nutrients and the level of anaemia is a notable marker. Madagascar faces very high rates of stunting and wasting, which are believed to be compounded by widespread deficiencies in zinc, iron, vitamin A, iodine, and other MNs. The authors consider malaria and inflammation as contributors to anaemia in Madagascar rather than as symptoms of malnutrition, with recent national surveys reporting persistent malaria transmission.

The bottom line is that the Plasmodia, considered the malaria parasites, and Anopheles mosquitos, considered their vector, remain present in countries without malaria. The main difference is that these countries do not have high incidence of malnutrition. Malaria disappeared when living standards improved. The same will happen when living standards improve in Madagascar and the rest of Sub-Saharan Africa where malaria remains a scourge.

In MalariaWorld today there is a reference to a draft manuscript looking at a cost-effectiveness analysis in Malaysia. ‘Cost-effectiveness of outdoor residual spraying, insecticide-treated nets, and their combination for zoonotic malaria control in Sabah, Malaysia: a comparative analysis’ by Firdaus et al compared the supposed reduction in the number of cases based on cost for different insecticide application programmes.

The paper stated that the cost of no intervention was MYR 3,913, of LLIN – MYR 18,089, of ORS – MYR 30,507 and of ORS + LLIN – MYR 39,765 (Exchange rate (2025): 1 MYR (Malaysian Ringgit) = US$0.23). The effectiveness was estimated by comparing the number of reported cases for the three interventions for January-December 2023 with the baseline which was the number of cases reported for the test areas for 2020-2021.

However, in our opinion the study is very flawed because of the variation of the number of baseline cases. For ORS area baseline was 15 cases with just two reported in test period and this was reported as a reduction of 13 cases as a cost of MYR 2,046 each. For ORS + LLIN there were seven at baseline and one in test so the six-case reduction cost MYR 5,975 per case. For LLIN baseline was five and zero in test so the five-case reduction cost MYR 2,835 per case.

Another major flaw in the study is that the effectiveness of no intervention was not measured and was assumed to be zero reduction of cases from the baseline period. Clearly there were far more cases reported in 2020-21 baseline period (27 in three areas) than in 2023 (three cases in the three areas). It would not be surprising if the reduction in a no intervention area for the study period would be similar to the test areas and therefore much more cost-effective. And their observed result that either ORS or LLIN is more effectives than the two together makes no sense if the interventions are effective. The fact that both together cost more is not a surprising result if they have no effect on the occurrence of malaria.

There is a trend in recent articles that malaria programmes whether insecticide as reported here or vaccines as reported in March are cost ineffective for reducing malaria cases. It makes us question how well malaria researchers actually understand the real causes and treatments for malaria.

In MalariaWorld this week there is a link to an article in The Conversation, ‘Illegal gold mining causes surges in malaria in the Amazon, and the association is far worse than we suspected’ by  de Angeli Dutra and Casagrande. Malaria cases reported have increased from around 5,000 to 20,000 annually in Yanomami indigenous territory since then president of Brazil, Jair Bolsonaro, deregulated gold mining in indigenous territories of Brazil in 2019.

Since that time the number of illegal gold miners in Yanomami territory, the largest Indigenous territory in the Amazon, had surged to 20,000, roughly two-thirds the number of the local Yanomami population. The picture from the article is of a man with a phrase in Portuguese painted on his back that translates to “Mining Kills,” from a protest against the increase of mining activities that are encroaching on his land, in front of the Ministry of Mines and Energy in Brasilia, Brazil, in 2022.

Three explanations are given for the surge in malaria cases. The first two are a hat tip to the unproven mosquito-plasmodium hypothesis. The miners’ activities create pools for mosquito breeding (as if there were not already enough water pools for mosquito breeding in the Amazon basin), and miners travel potentially bringing the illness from hotspots for malaria transmission across South America (it is not clear where these hotspots are).

The third explanation and, in the opinion of Understanding Malaria, the most likely reason is that small-scale gold miners often use mercury to cheaply and easily extract gold particles. This mercury is dumped into waterways across the region, poisoning the people who rely on the rivers for water and for fish, weakening their immune systems and making them more susceptible to malaria. The most likely cause of malaria is malnutrition – both absence of nutrients and poisoning, and there are few poisons more toxic to mammals than mercury.

I visited an artisanal gold mine in Kenya and the final purification step was mixing a slurry of the final densest dust with mercury to form an amalgam. The mercury was later burned off to leave the gold metal. The people who do this with no protection will be poisoned and mercury poisoning symptoms are similar to malaria symptoms.

The authors were shocked by the results. The relationship was far stronger than they had suspected. Every 0.03% increase in mining led to a 20-46% increase in malaria one to two years later, resulting in a 300% increase in malaria in the Yanomami territory between 2016-2023.

This is no surprise to Understanding Malaria. We covered the link between mining and malaria previously in August 2024. Mining operations expose people to many toxic materials they would not otherwise be exposed to.

In MalariaWorld this week there is a reference to a blog published by the United Nations Development Programme. ‘Why it is time to rewrite Africa’s malaria story’ by Aissata De of UNDP and Dr Michael Adekunle Charles, CEO of the RBM Partnership to End Malaria, makes the point that the lack of development fuels malaria.

The article opens with the point that if you woke up with severe fever, would you stay home from work? What if the choice meant losing a week’s wages, or deciding if you could afford the trip to a doctor at all? Clearly malaria, what ever its causes, has a more serious effect on people with the least. Malaria causes up to half a billion lost workdays each year and slows GDP growth by up to 1.3 percent. It accounts for half of preventable school absences, undermining learning and opportunity.

Recent analysis in Uganda found that districts with low development indicators are five times more likely to experience a high number of malaria cases. In Kapelebyong district in Uganda, malaria treatment can cost households a significant 120,000 shillings a year, often requiring long journeys to clinics facing staff and medicine shortages.

These establishment figures do promote the current activities that are not working, such as vaccines tested without placebo controls, and mosquito control. But it is promising that they are recognising that poverty, weak infrastructure, limited services, and environmental risk do not just coexist with malaria; they actively sustain it.

They call for a rethink of how malaria is tackled. I wonder would they go so far as to examine the mosquito transmission tall tale created by Ross, Grassi and others 125 years ago, and the related medical and mosquito control programmes that make so much money for Western and Chinese manufacturers and their African agents?

In MalariaWorld this week there is an interesting article. ‘Malaria incidence rose following the introduction of neonicotinoid-based IRS in selected districts in northern Ghana: An observational analysis’ by Coleman et al described how there was a significant increase in the occurrence of malaria (26%) when nicotinamide insecticides replaced organophosphates in IRS programmes in Ghana from 2015-2022.

A decrease had been seen earlier when pyrethroids were replaced with organophosphates and in one district the incidence decreased again when organophosphates were reintroduced instead of neonicotinoids. The reason given for the changes to the insecticide used was  Ghana’s insecticide resistance management plan, which promotes the rotation of insecticides with different modes of action to slow the development of resistance.

The paper contains no data on the effect on mosquito populations as a result of these changes. Clearly, the assumption based on the hypothesis that mosquitos spread malaria is that the increase when the neonicotinoid were introduced was due to reduced effectiveness at eliminating mosquitos. However, at the time of introduction to IRS programme neonicotinoids were already in widespread use for agriculture so they must be effective. The authors opine that the widespread use has caused resistance in Anopheles mosquitos. However, they also report that testing in 2017 found that Anopheles mosquitos were susceptible to Clothianidin, one of the commonly used neonicotinoids, in high usage cotton producing areas.

Clearly, there are health risks as a result of spraying potent toxins indoors. And a study ‘Effects of Neonicotinoid Pesticide Exposure on Human Health: A Systematic Review’ by Cimino et al found chronic neonic exposure and adverse developmental or neurological outcomes, including tetralogy of Fallot, anencephaly, autism spectrum disorder, and a symptom cluster including memory loss and finger tremor.

Perhaps instead malaria is an illness of poverty exacerbated by exposure to toxins. Perhaps what this study shows is that neonicotinoids are more harmful to human health than the other insecticide used.