Malaria

The term malaria originates from Medieval , 'bad air', a part of miasma theory; the disease was formerly called ague, paludism or marsh fever due to its association with swamps and marshland. The term appeared in English at least as early as 1768. The scientific study of malaria is called malariology. ==Signs and symptoms==

, gastroenteritis, flu and other viral diseases. Severe malaria occurs when the Plasmodium infection causes damage to vital organs such as the kidney, liver, lungs or brain. Symptoms include severe anemia, jaundice, convulsions, confusion, coma, kidney failure and eventually death. Complications A unique feature of P falciparum is its ability to generate adhesive proteins on the surface of infected red blood cells (RBC). Infected RBCs obstruct capillaries (causing hypoxia) and accumulate in vital organs, interfering with their function. P falciparum infection underlies most severe complications of malaria. Individuals with cerebral malaria exhibit neurological symptoms, such as confusion, seizures, or coma. Malaria can lead to acute respiratory distress syndrome in up to 25% of cases. It is caused by damage to the capillary endothelium, in turn damaging the alveoli of the lung. Symptoms are extreme shortness of breath and a bluish tinge to the lips (cyanosis) indicating lack of oxygen. Coinfection of HIV with malaria increases mortality. Other complications include an enlarged spleen, enlarged liver or both of these. So-called blackwater fever occurs when haemoglobin from lysed red blood cells leaks into and discolours the urine; this often precedes kidney failure. Malaria during pregnancy can cause stillbirths, infant mortality, miscarriage, and low birth weight, particularly in P. falciparum infection, but also with P. vivax. ==Cause==

Malaria is caused by infection with parasites in the genus Plasmodium, which are transmitted between the human hosts by mosquitoes in the genus Anopheles. Life cycle The plasmodium parasite has a complex life cycle involving human and mosquito hosts, taking a different form at each stage of the cycle. • Within the human host, the sporozoites enter the bloodstream and travel to the liver, where they invade liver cells (hepatocytes). • They grow and divide in the liver, with each infected hepatocyte eventually harboring up to 40,000 parasites. Symptoms develop once there are more than around 100,000 parasites per milliliter of blood. Malaria parasites can also be transmitted by blood transfusions, although this is rare. in liver cells. Reinfection means that parasites were eliminated from the entire body but a new infection has established. Recurrence of infection within two weeks of treatment ending is typically attributed to treatment failure. ==Pathophysiology==

Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter the bloodstream and migrate to the liver where they infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days. This release of merozoites into the bloodstream, together with their waste products and fragments of erythrocyte, triggers fever and other symptoms which can be periodic and intense. Immune system evasion Immune evasion is a key feature of Plasmodium, underlying its success and persistence as a parasite. Approximately 10% of the Plasmodium genome is dedicated to mechanisms which avoid or subvert the immune system. Liver Specialised macrophages called Kupffer cells defend the liver; they identify alien material in the bloodstream and destroy it. Sporozoites attack Kupffer cells and neutralise them. They transit through these impaired cells (which die after a few hours) to infect hepatocytes. After a few days, the infected hepatocyte releases merozoites in batches called merosomes, which bud off from the hepatocyte's membrane. This membrane cloaks the merozoites, enabling them to sneak past the remaining Kupffer cells to exit the liver. at each stage of the life cycle it expresses a different variant of surface antigen, effectively a moving target which outpaces the adaptive immune system. To avoid this fate, the merozoite generates adhesive proteins which appear as knobs on the surface of infected RBCs. These work in two ways. They bind to uninfected RBCs forming clumps - nicknamed "rosettes" - in which the infected cell at the centre is shielded by the uninfected cells surrounding it; rosettes interfere with normal blood flow in capillaries. Alternatively infected RBCs can avoid passage through the spleen by adhering (sequestering) to the walls of blood vessels in tissues such as the brain, lungs, and intervillous spaces (in pregnancy). Both sequestered and rosetted types interfere with the normal organ functions, leading to complications such as cerebral malaria and pregnancy-associated malaria. The effect of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the haemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries; however, when the modified haemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to distort into a curved sickle shape. In these strands, the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces the frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal haemoglobin beta allele) have sickle-cell anaemia, while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anaemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavour the trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form. ==Diagnosis==

for malaria diagnosis. s of Plasmodium falciparum in human blood Due to the non-specific nature of malaria symptoms, diagnosis is typically suspected based on symptoms and travel history, then confirmed with a laboratory test to detect the presence of the parasite in the blood (parasitological test). In areas where malaria is common, the World Health Organization (WHO) recommends clinicians suspect malaria in any person who reports having fevers, or who has a current temperature above 37.5 °C without any other obvious cause. Malaria should be suspected in children with signs of anemia: pale palms or a laboratory test showing hemoglobin levels below 8 grams per deciliter of blood. Malaria is usually confirmed by the microscopic examination of blood films or by antigen-based rapid diagnostic tests (RDT). Microscopy—i.e. examining Giemsa-stained blood with a light microscope—is the gold standard for malaria diagnosis. Rapid tests also cannot quantify the parasite burden in a person, nor the species of Plasmodium involved. It requires specialised laboratory equipment so is rarely available in developing countries; it is generally used in developed world to confirm diagnosis in returning travellers. In April 2026, WHO prequalified three rapid diagnostic tests designed to detect P. falciparum strains with pfhrp2 deletions, which can evade commonly used HRP2-based tests and cause false-negative results. The new tests target the parasite protein pf-LDH and are recommended where more than 5% of malaria cases are missed because of pfhrp2 deletions. ==Treatment==

as a malaria treatment from 1927 Malaria is treated with antimalarial medications. To ensure a complete cure and prevent the parasite from developing drug resistance, treatment guidelines since 2001 generally require two drugs in combination, with one of them being a derivative of artemesinin and the other a complementary drug. The exact combination of drugs depends on the Plasmodium species involved, the probability of drug resistance, relevant facts from the patient's medical and travel history, and any previous use of antimalarials. Treatment regimens in national formularies are generally based on guidelines issued by WHO which are updated regularly. Several classes of drugs can be used as components of combination therapies. Artemisinin-based drugs include artemether and artesunate. Quinoline derivatives include chloroquine, quinine, and mefloquine. Antifolate compounds include pyrimethamine, proguanil, and sulfadoxine. Malaria is generally classified as either "severe" or "uncomplicated". This treatment is not always suitable, so other drug combinations are recommended. In case of infection by P. vivax or P. ovale (which form dormant hypnozoites in the liver) treatment should continue for a further 7 to 14 days. Even with treatment, the fatality rate is estimated between 13% and 20%, with survivors often facing long term after-effects. The standard treatment is intravenous artesunate, switching to oral medication once the patient is stable. Patients may deteriorate rapidly so close monitoring, preferably in a high dependency unit, is vital. Pregnancy Malaria in pregnancy is more likely to be serious, possibly fatal, for both mother and child; pregnant women are three times more likely to develop severe malaria. Some drugs could injure the developing embryo, especially during the first trimester. Special treatment regimens are recommended, which vary according to the trimester and pose minimal risk. Drug resistance Drug resistance poses a growing problem in malaria treatment; Plasmodium populations have a high level of genetic diversity and a rapid reproduction rate which enable them to adapt and evade challenges from antimalarials. P. falciparum parasites began to develop resistance to the first synthetic antimalarial, chloroquine, in the 1950s; since then chloroquine resistance has spread to almost the entire range of this species. Resistance to proguanil developed even more rapidly; the drug was introduced in 1948 and resistance began to be noted the next year, in 1949. In order to overcome resistance, drugs may be given in combination, in higher doses, or for longer periods; there is an urgent need for new drugs to be brought on line. ==Prognosis==

When properly treated, people with uncomplicated malaria can usually expect a complete recovery. During childhood, malaria causes anaemia during a period of rapid brain development, and also direct brain damage resulting from cerebral malaria. ==Prevention==

'' mosquito shortly after obtaining blood from a human (the droplet of blood is expelled as a surplus). This mosquito is a vector of malaria, and mosquito control is an effective way of reducing its incidence. Methods used to prevent malaria include vaccination, prophylactic medication, mosquito elimination and the prevention of bites. There are five species of plasmodium; each of these has three life stages in the human host—sporozoite, merozoite, and gametocyte. Each stage has different antigens on its surface, meaning that an immune response against one stage is not effective against the others. In addition, genetic variation in the parasites means that the antigens themselves can vary even within a single life stage. As a consequence, natural immunity seems to develop slowly—acquired through multiple infections—is only partial, and is not long lasting. The Malaria Vaccine Technology Roadmap has set a target for new malaria vaccines to have a protective efficacy of at least 75% against clinical malaria. , two malaria vaccines have been licensed for use. which completed clinical trials in 2014. The WHO adopted a cautious approach to awarding it prequalification and, as part of the Malaria Vaccine Implementation Programme (MVIP) approved pilot programs in three sub-Saharan African countries—Ghana, Kenya and Malawi—starting in 2019. These programs targeted children under 5, who are particularly at risk of severe infection and death. Up to 2023, three million children had received the vaccine, showing a significantly reduced incidence of malaria as well as a reduction in childhood mortality (from all causes) of 13%. The second vaccine is R21/Matrix-M, with a 77% efficacy rate shown in initial trials and significantly higher antibody levels than with the RTS,S vaccine. The R-21/Matrix M malaria vaccine was found to reduce cases of malaria by 75% in areas with seasonal spread and by 68% in areas of year-round spread in children in sub-Saharan Africa. The R-21/Matrix M malaria vaccine was endorsed by the WHO for the prevention of malaria in children in 2023. Personal protection Insect repellent, such as DEET or picaridin, is recommended for travellers. Loose clothing that covers most of the body is also recommended. Clothing may be treated with permethrin as an additional safeguard. Environmental control Since many mosquitoes breed in standing water, source reduction can be as simple as emptying water from containers around the home, by filling or draining puddles, swampy areas, and tree stumps. Eliminating such mosquito breeding areas can be an extremely effective and permanent way to reduce mosquito populations without resorting to insecticides. It is also possible to use larvicides to kill mosquito larvae in pools or puddles that cannot be drained. Indoors Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are effective, have been widely used to prevent malaria, and their use has contributed significantly to reducing the prevalence of malaria in the 21st century. ITNs and IRS may not be sufficient to eliminate the disease, as these interventions depend on how many people use nets, how many gaps in insecticide there are (low coverage areas), if people are not protected when outside of the home, and an increase in mosquitoes that are resistant to insecticides. In areas where mosquitoes are resistant to pyrethroids, other ingredients are being combined with pyrethroids in mosquito netting; these include piperonyl butoxide, chlorfenapyr and pyriproxyfen. UNICEF notes that the use of insecticide-treated nets has been increased since 2000 through accelerated production, procurement and delivery, stating that "Almost 2.5 billion ITNs have been distributed globally since 2004, with 2.2 billion (87 per cent) distributed in sub-Saharan Africa". By 2023, 52% of children in sub-Saharan Africa were sleeping under ITNs; however there were large regional differences in coverage. The report warned that progress has slowed due to plateauing ITN coverage and emphasized that expanding access to ITNs remains essential. Chemicals recommended by WHO for IRS fall into the following classes; • Pyrethroids such as Alpha-cypermethrin, Bifenthrin • Organophosphates such as malathion • Carbamates: Bendiocarb, Propoxur • Organochlorides: DDT (very restricted use) In order to be effective, IRS should be applied to a minimum of 80% of households in a community. It is estimated that IRS has contributed to 10% of the malaria cases averted in parts of Africa. In 2021, the World Health Organization's (WHO) Guideline Development Group conditionally recommended screening houses in this manner to reduce malaria transmission. Screening eaves can also have a community-level protective effect, ultimately reducing mosquito-biting densities in neighboring houses that do not have this intervention in place. Mosquitoes with these advantageous traits can pass them on to their offspring, increasing the proportion of resistant mosquitoes in the population over time. Anopheles mosquitoes have traditionally exhibited endophagy, meaning they prefer to bite humans indoors, and endophily, meaning they rest indoors after feeding. They also typically bite at night, when individuals are protected by bed nets. They may also rest outdoors rather than on indoor walls that have been sprayed, exhibiting exophily. As a result, malaria transmission can continue even in areas with widespread use of LLINs and IRS. These adaptations indicate a key limitation of current strategies, which primarily rely on interrupting the human mosquito contact during nighttime indoor feeding. The protective effect does not begin immediately, and people visiting areas where malaria exists are recommended to start taking the drugs one to two weeks before they arrive, and continue taking them for four weeks after leaving (except for atovaquone/proguanil, which only needs to be started two days before and continued for seven days afterward). Giving antimalarial drugs to infants through intermittent preventive therapy can reduce the risk of having malaria infection, hospital admission, and anaemia. Antimalarial mass drug administration to an entire population at the same time may reduce the risk of contracting malaria in the population. In the 1950s, the WHO included mass drug administration (MDA) of antimalarial drugs as a tool for malaria eradication in exceptional conditions when conventional control techniques have failed. In 1971, the WHO expert committee on malaria still recommended MDA in special circumstances. Others Community participation and health education strategies promoting awareness of malaria and the importance of control measures have been successfully used to reduce the incidence of malaria in some areas of the developing world. Recognising the disease in the early stages can prevent it from becoming fatal. Education can also inform people to cover over areas of stagnant, still water, such as water tanks that are ideal breeding grounds for the parasite and mosquito, thus cutting down the risk of the transmission between people. This is generally used in urban areas where there are large centers of population in a confined space and transmission would be most likely in these areas. ==Epidemiology==

According to the World Health Organization's 2025 World Malaria Report, there were an estimated 282 million new malaria cases globally in 2024, in 80 endemic countries. The number of deaths attributed to malaria stood at 610,000 in 2024. Children under five years old were the most affected, accounting for 75% of malaria deaths in Africa during 2024. The optimum temperature for the parasite is but it can develop in temperatures between and . Malaria is uncommon at altitudes above 1,500 meters, where temperatures tend to be lower, and in urban environments where good drainage eliminates pools of water. Malaria is presently endemic in a broad band around the equator, in areas of the Americas, many parts of Asia, and much of Africa. Anopheles mosquitoes are still present in these areas, so there is a risk of the disease returning. • Since 2015, the WHO European Region has been free of malaria. Travel-related cases still occur occasionally. • The United States eradicated malaria as a major public health concern in 1951. A small number of cases are detected each year, mostly in travellers returning from malaria endemic areas. Those most at risk of severe malaria if they are exposed to the disease are: • infants & children under 5 years, who have not yet developed immunity to the parasite. • pregnant women, because pregnancy modifies the immune response. • maternal malaria also affects the unborn foetus, leading to premature delivery and low birth weight, a leading cause of infant mortality. Greater rainfall in certain areas of India, and following an El Niño event is associated with increased mosquito numbers. Since 1900 there has been substantial change in temperature and rainfall over Africa. However, factors that contribute to how rainfall results in water for mosquito breeding are complex, incorporating the extent to which it is absorbed into soil and vegetation for example, or rates of runoff and evaporation. Recent research has provided a more in-depth picture of conditions across Africa, combining a malaria climatic suitability model with a continental-scale model representing real-world hydrological processes. Rising temperatures allow mosquitoes to survive in regions that were once too cold for them, including highland areas in Africa, South America, and parts of Asia. Increased transmission season Malaria transmission is highly sensitive to temperature and rainfall patterns. Research suggests that in parts of sub-Saharan Africa, the malaria transmission season has lengthened by several months, particularly in regions where warming has pushed temperatures into the optimal range for Plasmodium falciparum development. Flooding provides ideal breeding grounds for mosquitoes by forming stagnant water pools, while droughts can also exacerbate malaria by forcing human populations to store water in open containers, which serve as mosquito habitats. Resistance and adaptation of vectors Higher temperatures accelerate the development of Plasmodium parasites within mosquitoes, potentially leading to increased transmission efficiency. Additionally, rising temperatures and changing environmental conditions have been linked to the spread of insecticide resistance in mosquito populations, complicating malaria control efforts. ==History==

Although the parasite responsible for P. falciparum malaria has been in existence for 50,000–100,000 years, the population size of the parasite did not increase until about 10,000 years ago, concurrently with advances in agriculture Malaria may have contributed to the decline of the Roman Empire, Scientific studies on malaria made their first significant advance in 1880, when Charles Louis Alphonse Laveran—a French army doctor working in the military hospital of Constantine in Algeria—observed parasites inside the red blood cells of infected people for the first time. He, therefore, proposed that malaria is caused by this organism, the first time a protist was identified as causing disease. In 1898, Bignami, Giovanni Battista Grassi and Giuseppe Bastianelli succeeded in showing experimentally the transmission of malaria in humans, using infected mosquitoes to contract malaria themselves which they presented in November 1898 to the Accademia dei Lincei. The first effective treatment for malaria came from the bark of cinchona tree, which contains quinine. This tree grows on the slopes of the Andes, mainly in Peru. The indigenous peoples of Peru made a tincture of cinchona to control fever. Its effectiveness against malaria was found and the Jesuits introduced the treatment to Europe around 1640; by 1677, it was included in the London Pharmacopoeia as an antimalarial treatment. In 1596, Li Shizhen recommended tea made from qinghao specifically to treat malaria symptoms in his "Compendium of Materia Medica", however the efficacy of tea, made with A. annua, for the treatment of malaria is dubious, and is discouraged by the World Health Organization (WHO). Artemisinins, discovered by Chinese scientist Tu Youyou and colleagues in the 1970s from the plant Artemisia annua, became the recommended treatment for P. falciparum malaria, administered in severe cases in combination with other antimalarials. For her work on malaria, Tu Youyou received the 2015 Nobel Prize in Physiology or Medicine. Plasmodium vivax was used between 1917 and the 1940s for malariotherapy—deliberate injection of malaria parasites to induce a fever to combat certain diseases such as tertiary syphilis. In 1927, the inventor of this technique, Julius Wagner-Jauregg, received the Nobel Prize in Physiology or Medicine for his discoveries. The technique was dangerous, killing about 15% of patients, so it is no longer in use. , October 1942 The first pesticide used for indoor residual spraying was DDT. Although it was initially used exclusively to combat malaria, its use quickly spread to agriculture. In time, pest control, rather than disease control, came to dominate DDT use, and this large-scale agricultural use led to the evolution of pesticide-resistant mosquitoes in many regions. The DDT resistance shown by Anopheles mosquitoes can be compared to antibiotic resistance shown by bacteria. During the 1960s, awareness of the negative consequences of its indiscriminate use increased, ultimately leading to bans on agricultural applications of DDT in many countries in the 1970s. Before DDT, malaria was successfully eliminated or controlled in tropical areas like Brazil and Egypt by removing or poisoning the breeding grounds of the mosquitoes or the aquatic habitats of the larval stages, for example by applying the highly toxic arsenic compound Paris Green to places with standing water. ==Eradication efforts==

There have been two major global malaria eradication efforts: the first, led by the World Health Organization between 1955 and 1969, and the second, initiated by the United Nations in the 21st century through the Millennium and Sustainable Development Goals. , malaria has been eliminated or significantly reduced in many regions of the world, but remains widespread in others. Most of Europe, North America, Australia, North Africa and the Caribbean, along with parts of South America, and Asia are now free from malaria, while much of the central part of Africa continues to experience high levels of transmission. Initial WHO program (1955–1969) In 1955 the WHO launched the Global Malaria Eradication Program (GMEP). The program relied largely on DDT for mosquito control and rapid diagnosis and treatment to break the transmission cycle. The program eliminated the disease in "North America, Europe, the former Soviet Union", and in "Taiwan, much of the Caribbean, the Balkans, parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific" and dramatically reduced mortality in Sri Lanka and India. However, failure to sustain the program, increasing mosquito tolerance to DDT, and increasing drug resistance (e.g. to chloroquine) led to a resurgence. In many areas early successes partially or completely reversed, and in some cases rates of transmission increased. Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased irrigation. WHO suspended the program in 1969 and attention instead focused on controlling and treating the disease. Efforts shifted from spraying to the use of bednets impregnated with insecticides and other interventions. 21st century At the start of the 21st century, several global initiatives renewed efforts to control and eventually eradicate malaria. In 2000, malaria control became a key objective of the United Nations Millennium Development Goals, followed in 2015 by the Sustainable Development Goals, which aim to end the malaria epidemic by 2030. From 2005 to 2014, global financing for malaria programmes rose sharply from about US $960 million to US $2.5 billion, largely driven by international donors and focused on the WHO African Region. This surge in funding, channelled through programmes such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and Malaria No More supported an extensive scale-up of malaria control tools such as insecticide-treated nets, indoor spraying, rapid diagnostic tests, and artemisinin-based combination therapies, though overall resources remained below the estimated US $5 billion needed annually to meet global targets. Conflicts and resulting humanitarian crises have also disrupted health services and displaced millions of people into areas with little access to prevention or treatment. At the same time, growing resistance to both insecticides and artemisinin-based therapies has made malaria harder to control and treat. These overlapping pressures—climate change, conflict, displacement, and resistance—have together undermined the progress achieved in earlier decades. == Society and culture ==

Economic consequences Malaria is not just a disease commonly associated with poverty; some evidence suggests that it is also a cause of poverty and a major hindrance to economic development. War Throughout history, the contraction of malaria has played a prominent role in the fates of government rulers, nation-states, military personnel, and military actions. Malaria was the most significant health hazard encountered by U.S. troops in the South Pacific during World War II, where about 500,000 men were infected. During World War II, both Germany and the Axis powers suffered troop losses caused by malaria and committed resources to malaria prevention. In Germany, concentration camp inmates in Dachau and Buchenwald were used as guinea pigs for sometimes lethal experimental drug treatments. Early in 1942, the U.S. established a program called Malaria Control in War Areas (MCWA), "established to control malaria around military training bases in the southern United States and its territories, where malaria was still problematic". This organisation evolved into the present day Centers for Disease Control and Prevention. In 2015, it was reviewed and updated under 6 headings: "basic science and enabling technologies, insecticide and drug resistance, characterizing the reservoir and measuring transmission, tools for elimination, combination interventions and modeling, health systems and policy research." Vaccines The search for a malaria vaccine started in the 1960s, and is ongoing. , two malaria vaccines have completed clinical trials and are in use; they are RTS,S (Mosquirix) and R21/Matrix-MTM, both of which target the P. falciparum sporozoite; a further 25 clinical trials are in progress. There are three main types of vaccine candidate. Pre-erythrocytic vaccines aim to block infection completely by incapacitating the sporozoite before it reaches the liver. There is also ongoing research into existing drugs, to improve their effectiveness by testing drug combinations and dosage, and by improving diagnosis, availability and compliance in people who need them. An element of the search for new drugs is finding novel mechanisms which can be targeted. There are many candidates - some of these include the parasite's proteasome, proteases, and kinases. Vector biology and control This field of research looks at the mosquito vector, identifying and investigating the species which serve as vectors, as well as ways in which they can either be controlled, or prevented from harboring the parasite e.g. by genetic modification. Socioeconomic research Malaria is strongly linked to poverty. This field of research aims to investigate social and economic factors which obstruct eradication efforts. It includes studies on improving access to diagnostic tools and appropriate treatment in under-served regions. It is also important to understand and address community perceptions of malaria to improve the adoption of preventative measures like bed nets. Climate-informed malaria surveillance and early warning systems Recent research has focused on integrating climate data into malaria surveillance systems to improve prediction and prevention of outbreaks. Climate-informed early warning systems use environmental data such as temperature, rainfall, and humidity, combined with epidemiological and satellite data, to forecast malaria risk in specific regions. These systems allow public health authorities to implement targeted interventions, such as indoor residual spraying and distribution of insecticide-treated bed nets, before outbreaks occur. Advances in modeling and artificial intelligence have further improved the accuracy of malaria predictions by incorporating real-time climate and environmental data. These approaches are increasingly used in malaria-endemic regions, particularly in sub-Saharan Africa, to support proactive disease control strategies. Ongoing research aims to refine these tools and integrate them into national health systems to enhance preparedness and reduce malaria burden. Emerging Technologies Recent advances in genetic technologies offer new approaches to malaria control. One potential strategy is the genetic modification of mosquitoes using gene drive technologies, such as CRISPR-Cas9. Through CRISPR-Cas9 gene editing, scientists can introduce genes into mosquito populations that either make them resistant to Plasmodium parasites or enable population suppression, where mosquitoes are modified so that any progeny are sterile. They can complete development from egg to adult in approximately 10 to 14 days, with female mosquitoes laying 50-200 eggs at a time. While these approaches remain in early stages of development and raise ecological and ethical considerations, they present a promising strategy in addition to current interventions. ==Other animals==

While none of the main four species of malaria parasite that cause human infections are known to have animal reservoirs, P. knowlesi is known to infect both humans and non-human primates. Nearly 200 Plasmodium species have been identified that infect birds, reptiles, and other mammals, and about 30 of them naturally infect non-human primates. Some malaria parasites of non-human primates (NHP) serve as model organisms for human malarial parasites, such as P. coatneyi (a model for P. falciparum) and P. cynomolgi (a model for P. vivax). Diagnostic techniques used to detect parasites in NHP are similar to those employed for humans. Malaria parasites that infect rodents are widely used as models in research, such as P. berghei. Avian malaria primarily affects species of the order Passeriformes, and poses a substantial threat to birds of Hawaii, the Galapagos, and other archipelagoes. The parasite P. relictum is known to play a role in limiting the distribution and abundance of endemic Hawaiian birds. Global warming is expected to increase the prevalence and global distribution of avian malaria, as elevated temperatures provide optimal conditions for parasite reproduction. == References and notes==