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.

MalariaWorld this week carried details an announcement by WHO (World Health Organization) on April 24 last week, the eve of World Malaria Day. The highlight of the article was the new prequalification of an artemether-lumefantrine treatment, that is the first antimalarial formulation designed specifically for the youngest malaria patients (<6 months).

The treatment, produced by Novartis and sold as Coartem Baby or Riamet Baby was approved by Swissmedic last year and reviewed in this column on July 11, 2025 ‘New Wonderdrug for Babies Tested without Control’. Its performance in terms of efficacy and side-effects was hardly a game changer.

WHO also, on April 14, 2026, prequalified three new rapid diagnostic tests (RDTs) designed to address emerging diagnostic challenges for malaria. These tests detect even more ‘cases’ of malaria than current tests many of which the WHO consider that there is a problem with false negatives, a failure to detect plasmodia parasite protein. This is curious since current RTDs already detect more malaria ‘cases’ than the gold standard microscopy method. Of course, the WHO would never consider false positives, which seem like the more likely outcome of the more sensitive tests to be an issue.

They also promote vaccines and bed nets in the announcement, whose ineffectiveness has been covered here over the last few weeks.

On the eve of World Malaria Day (April 25) there is a reference to a Nature editorial in MalariaWorld. ‘Malaria deaths should be falling — not rising’ has the subheading ‘The tools exist to end this killer disease. It is the money and the will that are lacking’. This is an interesting complaint considering just three weeks ago here it was reported here that vaccines are cost ineffective. The malaria expenditure costs with immunisation are over 20 times the cost without!

The Nature editorial starts by saying ‘There will be little to celebrate on World Malaria Day on 25 April. Global malaria cases, which stood at 238 million in 2018, had climbed to 282 million by 2024, the latest year for which figures are available. Deaths from the disease rose from 575,000 to 610,000 over the same period’. It goes on to say ‘Deplorably, this is happening despite the advent of vaccines. In October, it will be five years since the World Health Organization (WHO) recommended the world’s first malaria vaccine, RTS,S. This was hailed at the time as a tool that would “change the course of public health history” by WHO director-general Tedros Adhanom Ghebreyesus. A second vaccine, R21, was recommended two years later.’

Followers of this column are well aware that clinical trials of these vaccines were carried out without a placebo control, but instead with Rabies vaccines that would be expected to worsen the health of recipients. Under conventional medical treatment a course of malaria vaccinations does not begin unless there has been a bite by a suspect rabid animal because of the side-effects. We will not address broader questions concerning rabies here.

Malaria vaccines were tested in trials with Rabies vaccines used as controls instead of harmless placebos (Rabipur manufactured by GSK, Marburg, Germany and owned by Bavarian Nordic, Hellerup, Denmark was used as the control in RTS,S study). Abhayrab, manufactured by Indian Immunologicals Limited, was used as control in trial of R21.

There is a widespread belief that vaccines helped reduce the incidence of many diseases in the developed world, but careful analysis of data found that most of the decrease of incidence of these illnesses occurred before vaccines were introduced (see ‘Dissolving Illusions’ by Bystrianyk and Humphries). The Nature editorial even refers to the recent elimination of malaria in Egypt and Cabo Verde that was achieved without vaccines.

The real problem for the malaria business is addressed in the sub-heading, money. The article despairs that Robert F. Kennedy Jr has said that the United States will no longer contribute to Gavi, The Bill and Melinda Gates business that promotes vaccines in many countries. And we know that vaccines are cost ineffective and cannot be paid for with the scant resources of many of the affected countries.

As an aside, why is April 25 World Malaria Day? It was Africa Malaria Day from 2001 but we cannot find an explanation of the significance of this date. Please let us know in comments if you know.

An interesting article referenced in MalariaWorld this week found that household net use showed no significant association with malaria of children under five (CU5) after controlling for wealth index. ‘Risk factors for malaria among children under five living in net-owning households in Mozambique from the 2022–3 Demographic and Health Survey’ by Mooney et al examined household-level mosquito net use in Mozambique using 2022–3 national survey data.

The study published in Transactions of The Royal Society of Tropical Medicine and Hygiene, has results clearly stated in the abstract. Household net use showed no significant association with CU5 malaria after controlling for wealth index. Wealth index indicated a dose-response, where middle-resource households were 43% less likely (adjusted OR [aOR] = 0.57; 95% CI 0.38 to 0.84; P < .0048) and highest-resource households were 84% less likely (aOR = 0.16; 95% CI 0.09 to 0.27; P < .0001) compared with lowest-resource households.

Many studies continue to be published that claim a benefit from net use including in MalariaWorld this week. ‘Prevalence and factors associated with malaria amongst under-five children in Senga Hill District, Northern Province, Zambia, a community-based cross-sectional study’ by Arthur et al found that correct hanging of an ITN reduced the odds of being positive for malaria by 88%. And having two insecticide treated nests (ITNs) and indoor residual spraying (IRS) done in the last spraying season reduced odds of being malaria positive by 86%. These are similar percentage reductions to those seen in the Mooney study for the highest resource households.

However, the Arthur study did not analyse family wealth. To repeat the well know experimental axiom, correlation does not imply causation. The Mooney paper also states Causation cannot be inferred from a cross-sectional survey. They state that the findings are consistent with prior studies suggesting that wealthier households may benefit from improved housing conditions, access to healthcare and malaria- prevention resources.

In general wealthier families are more likely to buy mosquito nets and pay for insecticide spraying. Wealthier families are less likely to have children under five with malaria. But that does not imply that nets or insecticide spraying reduce the incidence of malaria. The cause of the decreased malaria could be the result of some other factor related to wealth. Wealthier families can afford better food, cleaner water, better built houses, and better sanitation. Could one or all of these factors be the reason for reduced malaria?

Despite the unconvincing evidence of their effectiveness nets continue to be promoted. A YouTube video reported in MalariaWorld this week by CGTN describes a government supported net distribution scheme in Uganda.

Originally posted April 17. Revised April 20.

https://usmalaria.com/nets-ineffective-at-preventing-malaria-but-are-promoted-anyway/

A study in MalariaWorld this week found a strong link between malaria and acute kidney injury (AKI) in paediatric patients in Nigeria. ‘A study using point of care creatinine testing in a Nigerian primary health care centre: Malaria as the leading cause of Acute Kidney Injury particularly in children’ by Ugwem-Ikuru et al published in Nephron was conducted at Ozuoba Model Comprehensive Primary Health Care Centre in Nigeria.

The study found that while just 0.6% of adult patients had AKI found by testing creatinine, AKI was found in 56.9% of children and malaria in 69.9%. The majority of AKI cases had malaria and it was more prevalent in younger patients. There is a high prevalence of both malaria, detected using lateral flow immunochromatography (STANDARD Q Malaria P.f/Pan Ag Test) to detect Plasmodium antigens in a finger-prick sample of blood, and AKI measured using POC Cr technology StatSensor Xpress Creatinine test.

High levels of creatinine suggest poor kidney function. The occurrence may be due to use of non-steroidal anti-inflammatory drugs commonly used as to reduce fever (paracetamol, ibuprofen etc). The authors point out that the vulnerability of the paediatric population may be due to an immature immune system. The linkage of the two conditions suggests a common cause and general poor health of children in the region. Severe AKI is a common feature of severe malaria occurring in up to 45% of adult patients as well.

It is possible that two conditions have common causes.

A study reported in MalariaWorld this week found a connection between gastrointestinal (GI) microbiome and protection against malaria. ‘Distinct gastrointestinal microbial signatures predict parasite levels in controlled Plasmodium infections in both rhesus macaques and humans’ by Gustin et al found that Rhesus macaques fed with a high protein diet were less susceptible to Plasmodium infections than macaques fed a high fibre diet.

In the experiments the animals were infected with Plasmodium fragile, which is similar to Plasmodium falciparum.  To examine the effect of diet and microbiome on susceptibility to infection two different populations were kept in different houses and fed a diet either high in fibre or high in protein. Those fed the high protein diet experienced lower parasitemia.

The researchers also looked at 35 human subjects who were supposedly inoculated by infected mosquito bites but the study found no statistically significant results. The subjects were treated with Malarone and/or KAF156, a novel imidazolopiperazine class of antimalarial drugs, which was the main subject of the study.

This study is clearly based on belief in the hypothesis that malaria is a parasitic illness caused by Plasmodia spread by mosquitos. Nevertheless, it is interesting to note gut microbiome has a major effect with a high protein diet providing protection. The role of nutrition on susceptibility to malaria is evident.

In MalariaWorld this week there is a study that found that implementing the malaria vaccine would lead to significant increase in Uganda’s immunization budget and the overall health sector budgets. In ‘The Cost and Budget Impact of Malaria Vaccine Introduction in Uganda’ Ochanda et al examined the cost impact of the addition of doses of the RTS,S (Mosquirix from GSK) to Uganda’s immunisation programme. The five-year net cost would be US$141m. The five-year estimate of malaria treatment costs without immunization would be US$6m. The malaria expenditure costs with immunisation are over 20 times the cost without!

We have discussed malaria vaccines many times before especially highlighting the very poor clinical trials and  underwhelming performance in manufacturer sponsored trials. Malaria vaccines were tested in trials with Rabies vaccines used as controls instead of harmless placebos (Rabipur manufactured by GSK, Marburg, Germany and owned by Bavarian Nordic, Hellerup, Denmark was used as the control in RTS,S study). So the benefit presented in this paper reduction of five-year malaria treatment costs from $6m to $1.5m is based on dubious information. And this cost of treatment is dwarfed by the vaccine cost of $147m based on a cost of $5 per dose.

It is extremely unclear why the leaders of Uganda and other African countries are cooperating with foreign drug countries in trials of these materials that are useless, costly and probably harmful. Thankfully, as reported by NTV Uganda in December, the people are not fooled ‘Low Uptake of R21 Vaccine in Uganda’.

After St Patrick’s Day mass in Nairobi I learned about a trial in Uganda in 2012 in which the water treatment agent, chlorine dioxide (sodium chlorite and acid activator) was found to cure malaria. And this effective solution was covered up. I found a video describing the trial and have uploaded it to Rumble ‘LEAKED Proof the Red Cross Cured 154 Malaria Cases with Chlorine Dioxide’.

The video was provided by Jim Humble who developed the chlorine dioxide treatment used that is called MMS. More information on the product is available on his website. There is a conclusion in the video from his colleague, Leo Koehof. The trial was carried out in December 2012 by Klass Proesmans of Water Reference Centre with the Red Cross at Iganga, Uganda. Patients were tested for malaria parasites using Rapid Diagnostic Tests and positives rechecked by microscope. Positive patients were given the MMS treated water (see picture). All tested negative when retested then next day or day after. Over the course of the test 154 patients were cured with no apparent side effects.

However, the cover-up began immediately. Klaas Proesmans of Water Reference Centre, the narrator of the video, and the Red Cross denied that the study occurred. Leo Koehof included a link for his YouTube video but the link is no longer active. The cover-up continues. My first upload of the video to YouTube was removed nearly instantly as ‘medical misinformation’.  ‘Content that poses a serious risk of egregious harm by spreading medical misinformation that contradicts information from health authorities isn’t allowed on YouTube.’ Now after the lies of the COVID scamdemic the social media moguls and medical establishment are not fooling us.

I have more questions. The study, while interesting was relatively uncontrolled. Would the patients who tested negative the next day have tested negative anyway without the treatment? Or if given water treated with other water treatments such as chlorine or hydrogen peroxide? I do not believe that the plasmodia are a parasite that cause illness, but a symptom of poor health. This marker of malaria discovered by Lavaran in 1880 needs to be better understood.

I investigated chlorine dioxide in my previous role as Product Development Manger at Aquatabs, a water treatment tablet manufacturer. However, while gaseous chlorine dioxide is a marvellous water treatment chemical, tablet and solution products don’t just add chlorine dioxide to water, but also the chemicals that are required to generate it – sodium chlorite and an acid and whatever stabilisers are needed for the product. I thought it less appropriate for daily use than the chlorine-based water treatment products already made by Aquatabs.

However, for curing malaria, a product already used as a water treatment seems much less likely to have side-effects than the course or artesunate injections typically prescribed in Kenya and elsewhere for patients who test positive in a malaria test RTD.

Further research such as this on water and nutrition to prevent and treat malaria are the objectives of Understanding Malaria CLG.

In MalariaWorld this week my eye was drawn to the strangely titled ‘Musings from a Vectosaur: Malaria in 2026’ by Manuel F. Lluberas. Vectosaur seems to be a word invented by Lluberas from the physics term vector meaning a quantity that has both magnitude and direction (that is often applied to insects that supposedly spread infectious disease) and from the Latinized Greek, Saurus, meaning lizard. So, are we to assume that Lluberas considers himself a lizard with direction?

Underlying, the paper is a belief that malaria is spread by mosquitos, and he states ‘Modern malaria programmes rely overwhelmingly on two tools: Long-lasting insecticidal nets and indoor residual spraying’. I expect the proponents of various vaccine and drug dispensing programmes might argue with this, but Lluberas is a bug hunter, following the traditions started by Ross and Grassi.

Even if malaria were spread by mosquitos, he states the problem with the ‘insectecutor’ approach ‘Under sustained pressure, mosquito populations are responding exactly as evolutionary biology predicts: Through increasing insecticide resistance and shifts in feeding and resting behaviour that circumvent indoor interventions’.

And he despairs that even the WHO cannot be sure of how effective programmes are. WHO explained that in a large share of the countries reporting, places carrying most of the malaria burden, it was “not actually possible to reliably assess trends” because “surveillance systems were weak and unreliable.”

He says the two strategies, ‘long-lasting insecticidal nets (LLINs) and, to a lesser extent, indoor residual spraying (IRS) have their place. Both have saved lives. But they were never meant to carry the entire burden of malaria control alone.’ However, many studies I reported including one from a few weeks ago found nets to be ineffective.

He states that ‘Field entomologists tend to view the matter differently. Mosquitoes are not policy documents. They are adaptable biological systems that respond to pressure. Apply a single intervention across vast areas year after year and the vector will respond in the only way evolution allows: adapting’.

He ends his essay with ‘Perhaps the growing recognition that we are “off-course” will provide the necessary push. Until then, some of us old vectosaurs will keep asking the inconvenient question: Are we doing the right thing? Are we doing things right?’

I wonder would he go so far as to question the linkage of malaria (and other illnesses) to mosquitos which is based on the dubious work of Ross and Grassi? I doubt it. If health authorities realised that mosquitos don’t spread malaria, there would be much less research funding for entomologists.

A study in MalariaWorld this week reported there was an increased risk of malaria infection in undernourished children compared to children with an adequate nutritional status. ‘Malaria and malnutrition in children under the Seasonal Malaria Chemoprevention (SMC) coverage in the health district of Nanoro, Burkina Faso’ by Compaore et al found that malnourished children were 1.41 times more likely to have an episode of clinical malaria than children with adequate nutritional status (ANS).

The authors state that only children of the control (no intervention) arms of two projects SMC-NUT and SMC-RST which started in July 2020 and up to July 2022 were considered for the investigation. Full details of these studies, which look at a combination of SMC (with Amodiaquine-Sulfadoxine-Pyrimethamine) and nutritional supplements will presumably be reported later.  

At enrolment and during the monthly home visits or at any attendance at health facilities, weight, height and mid-upper arm circumference were measured and these data were used to determine nutritional status on a monthly basis over the study period using the WHO Anthro survey online tool with the input parameters (Age, sex, weight, and height). Participants were classified as stunting, wasting, and underweight. Undernutrition status was defined as participants having at least one of these indicators (stunting, wasting, and underweight), while adequate nutrition participants were those without any of these signs. To ensure the stability of the nutritional status classification, only children who had at least three consecutive visits and maintained the same nutritional status across those visits were included in the analysis.

Of the 425 included in the study a majority (61%) were considered malnourished. And there were 209 incidents of malaria in the 260 malnourished subjects (80%) compared to 90 of 165 (55%) of the supposedly adequately nourished children detected using rapid diagnostic tests. Malaria is clearly more common in children who the researchers considered malnourished. However, the incidence even in those considered adequately nourished is 55%. This is very high suggesting a high degree of poverty in the study areas. This causes one to question if even the minority who are considered adequately nourished are also malnourished, but less so. They are not yet stunting, wasting, or underweight.