- N Engl J Med 2022; 387:460-461
In 2020, a total of 241 million cases of malaria and 627,000 malaria-related deaths were reported.1 In this issue of the Journal, Wu and colleagues2 present a new approach to provide immune protection with a next-generation monoclonal antibody against Plasmodium falciparum malaria...
- N Engl J Med 2022; 387:397-407
This phase 1 trial examined an engineered monoclonal antibody, L9LS, targeting the sporozoite. L9LS protected against malaria infection in a human challenge model.
- N Engl J Med 2022; 387:462-465
Monoclonal antibodies are commonly used in the treatment of diseases, including cancer. A next-generation antibody for the prevention of malaria exploits different vulnerabilities of Plasmodium falciparum, the major cause of malaria.
- N Engl J Med 2022; 386:1559-1559
A 64-year-old man had mild diarrhea and an itchy, migratory, serpiginous rash develop after initiation of glucocorticoid therapy for malignant spinal cord compression.
- N Engl J Med 2022; 386:e35
A 53-year-old man presented with itching of the right eye after gardening near a sheep farm. On examination, numerous mobile, translucent larvae were observed on the cornea and conjunctiva, as shown in a video. The larvae were removed and identified as Oestrus ovis, the sheep bot fly.
- N Engl J Med 2022; 386:1282-1283
Attempts to control malaria have been making good progress in South America, and two countries, Paraguay and Argentina, have recently been certified by the World Health Organization (WHO) as having achieved elimination of malaria. Brazil has the highest incidence of malaria in South America,1 with 143,381 indigenous cases...
- N Engl J Med 2022; 386:1244-1253
The hypnozoite form of Plasmodium vivax malaria can lead to recrudescent infection months after primary infection. Primaquine is used as prophylaxis to prevent such relapses. In this report, a higher total dose of primaquine (7.0 mg per kilogram over 14 days) was found to be more efficacious than...
- N Engl J Med 2022; 386:1005-1007
Malaria continues to devastate people’s health and livelihoods worldwide. In October 2021, the WHO for the first time recommended the large-scale use of a malaria vaccine for children living in areas with moderate-to-high malaria transmission.
- N Engl J Med 2022; 386:463-477
FUO despite a high-quality workup after a reasonable amount of time has elapsed to rule out self-limited fevers remains a challenge. The clinician must pay close attention to the patient history, aided by the development of molecular diagnostic tests, to distinguish infections from other causes.
- N Engl J Med 2022; 386:490-491
Malaria is a mosquito-borne parasitic disease. In sub-Saharan Africa, the vast majority of cases are caused by Plasmodium falciparum infection in young children. In this region in 2020, there were an estimated 228 million cases and 602,000 deaths from malaria; 80% of the deaths occurred in children younger...
- N Engl J Med 2022; 386:428-436
Hypothetically, in high-transmission settings, malaria control in early childhood might delay acquisition of functional immunity and shift child deaths from younger to older age. This 22-year study of early-life malaria control in such a setting showed that the survival benefit from early-life use of treated nets persisted to adulthood.
- N Engl J Med 2021; 385:1894-1902
A 38-year-old man was evaluated in the emergency department because of altered mental status and a first seizure. Examination revealed an involuntary upward gaze and confusion. Laboratory evaluation revealed leukocytosis and lactic acidosis. A diagnosis was made.
- N Engl J Med 2021; 385:e39
A 34-year-old man reported the sensation of a foreign body and itching in his right eye. Examination showed two worms beneath the upper eyelid (shown in a video). The worms were removed and identified as Thelazia callipaeda.
- N Engl J Med 2021; 385:1163-1171
Artemisinin compounds are the backbone of global malaria treatment strategies, but resistant strains are emerging in Southeast Asia. In this report, the investigators report the emergence of artemisinin-resistant Plasmodium falciparum strains in Northern Uganda, with the predominant mutations observed in the kelch13 gene.
- N Engl J Med 2021; 385:1231-1232
The artemisinins are the cornerstone of current antimalarial treatments. Artesunate is the drug of choice for severe malaria. Artemisinin combination therapies are first-line treatments for uncomplicated falciparum malaria and serve as alternatives to chloroquine for the other types of malaria. These highly effective and well tolerated antimalarials have contributed substantially...
- N Engl J Med 2021; 385:1005-1017
This trial assessed the efficacy of the vaccine RTS,S/AS01E as compared with chemoprevention in preventing malaria. The protective efficacy of RTS,S/AS01E was noninferior to that of chemoprevention, and the combination of RTS,S/AS01E and chemoprevention was more effective than either intervention alone.
- N Engl J Med 2021; 385:e28
A 36-year-old woman presented with a moving wormlike structure in her left eyelid (shown in videos). Microscopic examination of a fresh-blood wet smear revealed fast-moving worms, and Giemsa-stained blood films confirmed the presence of microfilaria consistent with Loa loa.
- N Engl J Med 2021; 385:803-814
Malaria remains a cause of substantial global morbidity and mortality. In this report, an engineered monoclonal antibody showed protection against malaria infection in a controlled human infection model.
- N Engl J Med 2021; 385:e20
A 62-year-old woman presented with pruritic, draining nodules on her back and buttocks after recent travel to South America. The physical examination showed nodules with drainage, and larval movement was observed. Six human botfly larvae were extracted (shown in a video).
- N Engl J Med 2021; 384:2067-2069
In this report, patients living in a malaria-endemic area underwent trauma-related splenectomy. In these asymptomatic patients who were naturally infected with Plasmodium falciparum or P. vivax, the predominant biomass of intact, infected red cells was in the spleen.