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.

We examine MalariaWorld and other sources each week looking for interesting studies, especially those that look at the effect of poverty, nutrition, water quality and sanitation on the occurrence and severity of malaria. So  we were drawn to ‘Socioeconomic and household water management determinants of malaria and other vector-borne disease prevention in Urban Gujarat, India’ by Batheja et al in this week’s MalariaWorld.

However the abstract reveals that nothing useful was found in the study, a socioeconomic and health survey in the cities of Ahmedabad and Surat, India, between September and November 2023. Data were collected from 4,074 households, comprising 15,484 individuals, and associations were examined between socioeconomic indicators, water availability, storage practices, and mosquito-borne disease incidence and prevention behaviours. Logistic regressions were used to identify significant predictors.

They found that self-reported disease prevalence was low, with 77 cases of malaria, dengue, and chikungunya, equivalent to 18.90 cases per 1,000 households. Socioeconomic factors such as wealth, caste, and family size were significantly associated with disease reporting and prevention practices. Households in the richest wealth quintile were more likely to adopt prevention measures, but less likely to perceive mosquito-related risks. Water management practices, particularly storage in clean large containers, were associated with increased disease symptoms and prevention measures, highlighting the complexity of vector control. Households with impermeable storage containers reported reduced use of active prevention measures.

They concluded that socioeconomic disparities and water management practices significantly influence malaria incidence and prevention behaviours. Targeted interventions prioritizing disadvantaged households, improved water storage practices, and enhanced investments in preventive care are essential to reduce vector-borne disease vulnerability and accelerate India’s malaria elimination goals.

What a huge nothing burger! Malaria was reported for just 0.40% of study participants. This is very low compared to incidence of 61% in Bas-Uele province of DRC reported last week. Obviously, with such a low incidence it is impossible to draw any statistically significant conclusions from the data. The results reported relate more so to behaviours to prevent these supposedly mosquito transmitted ailments.

If this is the most relevant study the researchers could conduct, can we deduce that in common with much of the rest of Asia, malaria is ceasing to be a major health problem in India?

Two studies in MalariaWorld this week, in Congo and Ghana, clearly suggest that poverty is the key factor linked to the occurrence of malaria in children < 5 years. And Klu et al in the Ghana study interestingly found that children who did not sleep under ITNs had lower odds of malaria (aOR = 0.52) compared to those who did. And drinking untreated water (aOR = 0.47) was associated with lower malaria risk.

‘Prevalence and factors associated with malaria among children aged 6–59 months in the Democratic Republic of the Congo: a nationwide cross-sectional survey’ by Adam et al in Malaria Journal studied a weighted sample of 10,013 children aged 6–59 months who underwent a malaria rapid diagnostic test, drawn from the 2023/24 DRC Demographic and Health Survey. It found an overall prevalence of malaria among children aged 6–59 months in the DRC was 33%, varying significantly between provinces, from 5% in Kinshasa to 61% in Bas-Uele province. Factors associated with malaria in this age group included children of mothers with no education (APR = 1.15) and those with primary education (APR = 1.13), children from the poor wealth quintile (APR = 1.52) and the middle wealth quintile (APR = 1.42), children who never slept under an insecticide-treated net (ITN) (APR = 1.18), children from households without a television (APR = 1.73), and those living in houses with unimproved floor material (APR = 1.54) or unimproved roof material (APR = 1.27).

These factors clearly show the influence of poverty. Capital residents are wealthier, as are those with more education and those who can afford televisions and improved floor and roof materials. The authors make a big deal of the ITN results, but the 1.18 improvement is much less than 1.73 for televisions. I expect if malaria researchers could link televisions to mosquito elimination, they would be proposing TVs as a solution!

And this result is contradicted in ‘Household characteristics, water, sanitation and hygiene (WASH) and malaria prevalence among children aged 6–59 months in Ghana: an analysis of the 2022 Ghana Demographic and Health Survey’ by Klu et al also published in Malaria Journal. The study analyzed data from the 2022 Ghana Demographic and Health Survey (GDHS), using a weighted sample of 3,255 households with children aged 6–59 months. Malaria testing was performed with rapid diagnostic tests (RDTs).

The prevalence of malaria among children aged 6–59 months was much lower (3.7%). Insecticide-treated net (ITN) ownership was high (78.9%), but only 51.5% of children slept under ITNs. Approximately 41.5% of children were anaemic. In multivariate analysis, children in households headed by persons aged 40–59 years had lower odds of malaria compared to those in households headed by persons aged 70+. Children from wealthier households had significantly lower odds of malaria (aOR = 0.15). Unexpectedly, children who did not sleep under ITNs had lower odds of malaria (aOR = 0.52) compared to those who did. Anaemic children had more than twice the odds of malaria (aOR = 2.03) showing important of nutrition. Drinking untreated water (aOR = 0.47) and improved sanitation (aOR = 0.59) were associated with lower malaria risk, whereas having toilets located outside (aOR = 16.64) the dwelling was associated with higher odds of malaria.

Sanitation, nutrition and wealth are clearly important and the authors emphasise the need for targeted interventions in households with lower wealth and inadequate sanitation. They also, curiously, promote ITN distributions despite their finding.

(picture from ubongo.org)

This week our attention was drawn to a tweet by Kenyan lawyer and politician Paul Muite (@Paul_Muite) accusing the Gates Foundation of releasing genetically modified mosquitos in Nairobi. The claim was debunked by Gates foundation supposedly stating “We do not release mosquitoes, operate laboratories that do so, or run vector-control activities in Nairobi or anywhere else.” However, the referenced press release is not available on their website.

Despite this the controversy rumbles on. On February 12 an article in The Standard reports that advocates want to know the truth about GMO mosquitos in Nairobi. They want to see all documents related to Muite’s claim. This indicates that many Kenyans are uncomfortable with novel research malaria carried out by international organisations.

However, the Kenya government, along with many other African governments are supportive of new technology efforts. Another article today ‘Prof Faith Osier: The Kenyan scientist bringing vaccine manufacturing closer home’  promotes the malaria vaccines whose underwhelming nature we frequently discuss. They plan to start manufacturing in Kenya, although the article does not specify which vaccine. Dr Osier discusses mRNA vaccines whose use is very controversial as a result of the side-effects of the COVID ‘vaccines’.

Kenyan publication Daily Nation reported on August 20, 2025 about Gates’ plans to release genetically modified mosquitos in Tanzania in 2029, ‘Gene drive mosquitoes’ set for 2029 release to fight malaria in East Africa. This was addressed in this column in December 2025,  Innovative Bug Hunting in Tanzania. We have addressed gene drive mosquitos, especially in Burkina Faso here on August16, 2025, August 29, 2025 and August 18, 2024.

Daily Nation reported On February 11 about the suspected increase in mosquito numbers in Nairobi  ‘The buzzing crisis: Why mosquito numbers are rising’. Dr Eric Ochomo, an entomologist at KEMRI (Kenya Medical Research Institute) says they have noticed an increase in mosquito numbers but they are Aedes and Culex species, not Anopheles, the supposed malaria vector. He blamed the increase on increasing temperatures.

The gene drive mosquito controversy suggests that Africans are becoming more suspicious of technological solutions western organisations are introducing to the continent.

MalariaWorld this week reports a study ‘Determinants of malaria infection across different districts of Khyber Pakhtunkhwa, Pakistan: a cross-sectional study’ by Haq et al.  The study highlights the multifactorial nature of malaria transmission in KP, Pakistan, with strong associations found between malaria infection and various determinants. Key risk factors identified include younger age, male gender, low educational attainment, low household income, large family size, distance from health facilities, poor housing construction, and lack of modern sanitation.

The study did find that preventive measures such as bed net use showed significance in bivariate analysis, but their independent effect was not retained in the final model. This is because it is often confounded with other factors related to poverty. The authors recommend comprehensive interventions beyond individual behaviour change. Policymakers and public health authorities should use these findings to inform district-level malaria control strategies, focusing on education, improved housing, access to healthcare, and sanitation.

Missing is any reference to nutrition despite the fact that the main author is in Department of Clinical Nutrition at the College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia. And throughout there are several references to how the factors might be related to more or fewer mosquito bite opportunities.

However, the clear message of this study is that factors related to poverty – income, housing quality, quality of sanitation, and level of education are linked to greater occurrence of malaria.

This weekly column will also be promulgated on Facebook from now on in addition to usmalaria website, X and LinkedIn. Understanding Malaria has been established as a non-profit organization to raise money to fund research on malaria with emphasis on how the occurrence and severity of malaria can be reduced by improvements in nutrition and drinking water quality. Its main goal is to expand knowledge to reduce the burden of the disease particularly in Africa. I invite you all to assist.