{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:11:44Z","timestamp":1772169104853,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/openresafrica.15809.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000}}],"reference-count":37,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"African Research Excellence Fund"}],"content-domain":{"domain":["openresearchafrica.org"],"crossmark-restriction":false},"short-container-title":["Open Res Africa"],"abstract":"<ns3:p>Background Asymptomatic malaria is responsible for persistent malaria transmission. The prevalence of malaria in children under 5 years in Anambra State, Nigeria, is declining. The sustained transmission of malaria threatens to reverse this decline, as indicated by the high severe malaria cases during the rainy transmission season. We ascertained the prevalence of asymptomatic malaria using the malaria Rapid Diagnostic Test (mRDT) and the determinants of asymptomatic malaria. Methods A community-based cross-sectional study was conducted at the end of the rainy season in November 2024 among 130 consenting apparently healthy adults aged 18 years and above residing in the Nnewi North Local Government Area of Anambra State using a standardised self-administered questionnaire and a P. falciparum mRDT. The questionnaire sought information on the participants\u2019 sociodemographic and socioeconomic factors, malaria healthcare-seeking behaviour, use of malaria prevention measures, environmental conditions, and perceptions of malaria risk. A finger-prick was used for the mRDT kit. Data were analysed using Stata 17\/BE. Binary logistic regression was used to identify the factors associated with asymptomatic malaria. Results Of the 130 participants, 26.15% (34\/130) were confirmed to be infected with Plasmodium falciparum. There was an overreliance on personal feelings for malaria diagnosis. Covering water containers around a house could be an effective protective measure against asymptomatic malaria. The odds (odds ratio (OR): 0.29\/0.27, 95% (CI): 0.07\/0.06 \u2013 1.24) of having asymptomatic malaria were lower in those who agreed that \u2018the cost of malaria prevention tools, such as Insecticide-treated nets (ITNs), insecticides and mosquito repellents, is reasonable\u2019 compared to those who did not. Conclusion The prevalence of asymptomatic malaria among semi-immune adult participants residing in the Nnewi North Local Government Area (LGA) was 26.15%. Having the financial means to access resources for malaria prevention can lead to healthier behaviours and actions that reduce malaria transmission.<\/ns3:p>","DOI":"10.12688\/openresafrica.15809.2","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T18:40:07Z","timestamp":1759776007000},"page":"5","update-policy":"https:\/\/doi.org\/10.12688\/openresafrica.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic empowerment and various preventive strategies play a role in reducing asymptomatic malaria towards the end of the rainy season"],"prefix":"10.12688","volume":"8","author":[{"given":"Chibuike","family":"Okpala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ifeoma","family":"Umeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2243-1616","authenticated-orcid":false,"given":"Linda Onyeka","family":"Anagu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"ref-1","article-title":"WHO guidelines for malaria, 30 November 2024.","year":"2024"},{"key":"ref-2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004250","article-title":"Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria.","volume":"6","author":"W Oyibo","year":"2021","journal-title":"BMJ Glob Health."},{"key":"ref-3","article-title":"National Malaria Elimination Programme Federal Ministry of Health Abuja Nigeria","year":"2020"},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.3390\/ijerph21121656","article-title":"Malaria prevention for pregnant women and under-five children in 10 sub-Saharan Africa countries: socioeconomic and temporal inequality analysis.","volume":"21","author":"D Okova","year":"2024","journal-title":"Int J Environ Res Public Health."},{"key":"ref-5","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-17650-7","article-title":"Prevention of malaria in pregnancy through health education intervention programs on insecticide-treated nets use: a systematic review.","volume":"24","author":"O Onyinyechi","year":"2024","journal-title":"BMC Public Health."},{"key":"ref-6","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-024-05037-3","article-title":"WHO antenatal care policy and prevention of malaria in pregnancy in sub-Saharan Africa.","volume":"23","author":"B Olapeju","year":"2024","journal-title":"Malar J."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"337-46","DOI":"10.1093\/heapol\/czi043","article-title":"Fever and its treatment among the more and less poor in sub-Saharan Africa.","volume":"20","author":"D Filmer","year":"2005","journal-title":"Health Policy Plan."},{"key":"ref-8","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-9-235","article-title":"Poverty and fever vulnerability in Nigeria: a multilevel analysis.","volume":"9","author":"O Yusuf","year":"2010","journal-title":"Malar J."},{"key":"ref-9","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2012.048","article-title":"Social implications of malaria and their relationships with poverty.","volume":"4","author":"F Ricci","year":"2012","journal-title":"Mediterr J Hematol Infect Dis."},{"key":"ref-10","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-017-1849-1","article-title":"Exploring the role of socioeconomic factors in the development and spread of anti-malarial drug resistance: a qualitative study.","volume":"16","author":"P Anyanwu","year":"2017","journal-title":"Malar J."},{"key":"ref-11","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-023-01110-2","article-title":"What are the pathways between poverty and malaria in sub-Saharan Africa? 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Thank you very much for your input and insight. Here are my responses.  1. The sample size may be small for the association analysis, but we had to calculate the sample size based on our&nbsp;main objective -&nbsp;determining&nbsp;the positive rate.  2. Yes,&nbsp;RDTs are much less sensitive than nucleic acid tests to detect asymptomatic parasitemia due to the expected low parasitemia. This is a limitation of this study, but this is what we could afford to do.&nbsp; 3. The result supporting this is in the supplement and will now be presented in the main body of the report. 4. To double-check this,&nbsp;we will redo the statistics analysis on&nbsp;the 'agreement&nbsp;that the cost of malaria prevention was acceptable had lower malaria rates', and recalculate the CI. However, please note that this is a 90% CI and was mislabelled as 95%, but the p-value is listed as &lt; 0.1. 5. We had an item in section B of the questionnaire that covers signs and symptoms, as shown in the deposited underlying 'Consent forms and RESEARCH QUESTIONNAIRE_Malaria_Epi Study.pdf'. The actual data is not presented in the questionnaire responses either. however, this data was collected and even presented by the student at his defence. I missed this while reporting and compiling this report, and I believe it is essential to include it. This is an oversight. Thank you for pointing this out.&nbsp; &nbsp; We will upload&nbsp;a second version that contains&nbsp;all the necessary corrections.","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v2#referee-comment-3292","order":1,"name":"referee-comment-3292","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Linda Onyeka Anagu<\/b>; \n<i>Posted: 08 Sep 2025<\/i>; Dear Joana, thank you for reviewing my manuscript. It is indeed a privilege. Please see my responses below: 1. Yes, the sample size may not be enough to test additional associations, and this is the limitation of this study, but we had to focus on our primary objective in calculating the sample size.&nbsp;  2. Yes, other&nbsp;nucleic acid tests would be more appropriate, but we had limited funding.&nbsp; 3. Yes, you missed the result; it was in the supplement section. The title has been equally adjusted to show that it is an association.  4. The&nbsp;CI in this case crosses 1, but is still statistically significant at p &lt; 0.1.  5. We did ask&nbsp;if fever was a sign of malaria; unfortunately, this was not included while compiling the data for the manuscript. I apologize for this. It was certainly presented in the student's external examination.","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v2#referee-comment-3294","order":2,"name":"referee-comment-3294","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/openresafrica.16984.r32325, Le Minh Dat, Hanoi Medical University, Hanoi, 19 Aug 2025, version 1, indexed","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v1#referee-response-32325","order":3,"name":"referee-response-32325","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Linda Onyeka Anagu<\/b>; \n<i>Posted: 21 Aug 2025<\/i>; Dear Le Minh Dat, Thank you for your engaging and comprehensive review. We will include additional information and provide clarifications&nbsp;where necessary, as suggested. Thank you also for the suggestions for our future study.","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v2#referee-comment-3293","order":4,"name":"referee-comment-3293","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/openresafrica.16984.r32320, Solomon Oyeleye, Caleb University, Imota, 23 Aug 2025, version 1, indexed","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v1#referee-response-32320","order":5,"name":"referee-response-32320","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/openresafrica.16984.r32323, Emmanuel Akpan, Federal College of Medical Laboratory Science and Technology, Jos, 23 Aug 2025, version 1, indexed","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v1#referee-response-32323","order":6,"name":"referee-response-32323","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/openresafrica.16984.r32300, Allan Schapira, Bicol University College of Medicine, Legazpi City, 25 Aug 2025, version 1, indexed","URL":"https:\/\/openresearchafrica.org\/articles\/8-5\/v1#referee-response-32300","order":7,"name":"referee-response-32300","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"African Research Excellence Fund","order":8,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}