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Definitive vs. Intermediate Host (needs correction)[edit]

In the section Pathology, the Article states: "Since the gametocytes are formed in the blood of the vertebrate host, the vertebrate host is the definitive host of the disease." This is incorrect.

In parasitology, the definitive host is defined as the host where sexual reproduction takes place. Sexual reproduction is defined as the exchange of genetic material (DNA). With respect to the malaria virus, the exchange of genetic material takes place when a male gametocyte fuses with a female gametocyte (to form a zygote). This process takes place in the mosquito gut, after the mosquito has taken up the gametocytes during its blood meal.

I am a bit surprised that this obvious error has persisted for so long in the Article. For this reason, I am a bit reluctant to correct it right away myself, as there could be some opposition to it (but I recommend checking the relevant literature if someone remains skeptical). If nobody else springs to action, I'll add a correction in the near future. Marcolop (talk) 23:01, 29 November 2011 (UTC)

Moved here until issues can be adressed[edit]

===Malarial Hepatopathy===

Hepatic dysfunction as a result of malaria is rare and is usually a result of a coexisting liver condition such as viral hepatitis and virus[1]. To be clear, the term "malarial hepatitis" is sometimes used to describe liver compromise in severe malaria; however, actual inflammation of the liver parenchyma is rarely seen[2]. While traditionally considered a rare occurrence, malarial hepatopathy has seen an increase in malaria endemic areas, particularly in South East Asia and India[3]. Liver compromise in malaria patients correlates with a greater likelihood of complications and mortality[4].

In a study following adult patients with malarial hepatopathy, when compared to patients without liver damage, these patients were 3 times as likely to develop renal failure, 10 times more likely to develop Acute Respiratory Distress Syndrome and twice more likely to develop septicemia. In addition, the patients with severe liver damage were twice as likely to die from malaria[5]. In another study from Thailand, out of the 390 patients with acute P. falciparum malaria, 124 had jaundice and had more complications in the form of cerebral malaria, acute renal failure, pulmonary edema and shock[6]. It is recommended that laboratory tests such as bilirubin and alanine transaminase levels be taken on malaria patients to assess liver integrity. The more aggressively liver dysfunction is treated in malaria patients, the greater likelihood of recovery[7]. For example, in a study by Kausar et al., a rise in serum alkaline phosphatase in malarial patients indicated a leakage of that enzyme from the membranes of the hepatic drainage system[8]. This is an important biomarker to assess liver integrity, with high levels suggesting liver damage. Kausar study suggests hepatocyte damage may be linked to malarial infection.

One mechanism by which Malaria may adversely affect the liver is through its effect on hepatic blood flow and tissue perfusion[9]. When the P. falciparum parasite matures within red blood cells and causes the formation of sticky knobs on the surface of the erythrocytes[10]. These knobs bind to receptors on endothelial cells in capillaries and venules. This cell adherence and sequestration of red cells within the small vessels leads to obstruction of blood flow . Compounding the problem, infected red cells may stick to uninfected red cells and form rosettes which are formations that may further cause obstruction[11]. If this obstruction of blood flow occurs in hepatic vasculature, ischemia may result causing liver dysfunction[12]. Due to this blockage, the liver’s normal physiology may be compromised and may result in a number of adverse conditions in the liver such as steatosis, focal hepatocyte necrosis, cholestasis, bile stasis, granulomatous lesions, and hepatic encephalopathy[13].

Severe Malaria and Fulminant Hepatic Failure[edit]

Fulminant Hepatic Failure (FHF) is severe acute liver failure complicated by encephalopathy. This is a serious condition where the liver cells are injured and die. Subsequently, hepatocytes are replaced by scar tissue instead of normal liver cells; this continues until there are not enough liver cells to carry out normal hepatic physiology. Fulminant Hepatic Failure interferes with liver function, but, moreover, it also has adverse effects on other organ systems[14].

Fulminant Hepatic Failure and malaria have very similar clinical presentations in adults, such as jaundice and fever[15]. Although FHF and malaria may appear similar, the laboratory results are distinct. There is significantly more hepatomegaly in malaria patients and FHF patients are more likely to have a greater prothrombin count. A normal prothrombin count with signs of hepatomegaly in a malaria endemic area may suggest malaria. It is important for clinicians to make this distinction when coordinating treatment plans because FHF is irreversible and the prognosis for malaria is much better[16].

  1. ^ WHO Communicable Virus Cluster. Severe falciparum malaria. Trans Roy Soc Med Hyg 2000; 94(Suppl.):1–90.
  2. ^ Bhalla A, Suri V, Singh V.Malarial hepatopathy. J Postgrad Med. 2006. 52:315–320.
  3. ^ ibid
  4. ^ ibid
  5. ^ Murphy GL, Sahay RK, Sreenivas DV, Sundaram C, Shantaram V. Hepatitis in falciparum malaria. Trop Gastroenterol 1998;19:152-4.
  6. ^ Wilairatana P, Looareesuwan S, Charoenlarp P. Liver profile changes and complications in jaundiced patients with falciparum malaria. Trop Med Parasitol 1994;45:298-302.
  7. ^ Singh, R et al. A Prospective Study of Hepatic Involvement in Plasmodium Falciparum Malaria Cryotherapy – A Review. Journal of Clinical and Diagnostic Research. 2010 April; 4:2190-2197.
  8. ^ Kausar. Correlation of Bilirubin with Liver Enzymes in Patients of Falciparum Malaria International Journal of Pathology; 2010; 8(2): 63-67
  9. ^ Newbold C, Craig A, Kyes S, Rowe A, Fernadez RD, Fagan T. Cytoadherance, pathogenesis and the infected red cell surface in Plasmodium falciparum . Int J Parasitol 1999;29:927-37.
  10. ^ Oh SS, Chishti AH, Palek J, Liu SC. Erythrocyte alterations in Plasmodium falciparum malaria sequestration. Curr Opin Hematol 1997;4:148-54.
  11. ^ Newbold, 1999
  12. ^ ibid
  13. ^ ibid
  14. ^ Children’s Hospital of Pittsburgh website. Fulminant Hepatic Failure. Viewed November 29, 2011.
  15. ^ Devarbhavi H, Alvares JF, Kumar KS. Severe falciparum malaria simulating fulminant hepatic failure. Mayo Clin Proc 2005;80:355-8.
  16. ^ ibid
  1. Please use high quality source per WP:MEDRS
  2. Please add PMIDs to the refs
  3. You cannot use Ibid here

Doc James (talk · contribs · email) 04:16, 17 December 2011 (UTC)


"does not yet exist" is more clear than "is yet to be met" [1] IMO Doc James (talk · contribs · email) 13:10, 19 January 2012 (UTC)

I don't object to that change at all, it's just that the sentence in its current form makes no grammatical sense: The challenge of producing a widely available vaccine that provides a high level of protection for a sustained period does not yet exist, although several are under development implies that the challenge itself does not exist (rather than the vaccine, which indeed does not exist), and also renders the part of the sentence after the comma a non sequitur. We could instead simply say Despite a clear need, no vaccine offering a high level of protection currently exists. What do you think? Basalisk inspect damageberate 13:15, 19 January 2012 (UTC)
How about Despite a clear need, no vaccine offering a high level of protection currently exists. Efforts are ongoing to develop one.?--Doc James (talk · contribs · email) 13:20, 19 January 2012 (UTC)
Yeah sounds great. I'll put it in. Thanks Basalisk inspect damageberate 13:26, 19 January 2012 (UTC)
Thank you both for correcting my misreading as well as making the paragraph flow much better. It looks good now. Shadowjams (talk) 23:08, 19 January 2012 (UTC)

global death rate[edit]

A new study in The Lancet says that the WHO figures are much too low. Murray et al, Global malaria mortality between 1980 and 2010: a systematic analysis, Volume 379, Issue 9814, pp413–431. Needs adding. Zerotalk 23:57, 4 February 2012 (UTC)

Malaria on the decline[edit]

According to a study by the University of Copenhagen, in countries such as Eritrea, Zanzibar, Tanzania, Kenia and Zambia, there are increasingly less infections and malaria-releated deaths. In Tanzania there has been a reduction with 55-77% between 1998 and 2001, between 2003 and 2009, there has been a 99% reduction. ref=

There has been no known cause for the reduction, certain is that mosquito nets had nothing to do with it.

Add in article. Perhaps it's also useful to make a map with countries in which malaria is endemic and which also shows the areas where the temperature is high enough to support mosquito's carrying malaria. One of the causes of the decline (and potential resurgence) is climate change and the increase/decrease of areas where the temperature is high enough to support the mosquito's carrying malaria. (talk) 06:21, 16 April 2012 (UTC)

You have a good source for this information so feel free to add it or add it to the article History of Malaria. I might get a chance to look at it in the next week. Ryan Vesey Review me! 16:00, 16 April 2012 (UTC)
Please use secondary sources per WP:MEDRS rather than primary sources such as the one above.--Doc James (talk · contribs · email) 22:12, 16 April 2012 (UTC)

GA/FA push[edit]

I plan to format all of the references in this article to the standard "Diberri" format for medical articles. For those who don't know, an example would be like this:

  • Dondorp A, Nosten F, Stepniewska K, Day N, White N (2005). "Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial". Lancet 366 (9487): 717–25. doi:10.1016/S0140-6736(05)67176-0. PMID 16125588. 

I would also like to name all the references and make them list-defined, for ease of editing and later maintenance. If there is any objection to these proposed formatting changes, please state so. After the references are cleaned up, I plan to verify each one (i.e. make sure it accurately reflects the source, and check for close-paraphrasing/copyvio), and replace (where necessary), primary sources (like the one above!) with secondary sources per WP:MEDRS recommendations. This will be followed by a GA nomination, a peer review, and, eventually a FA nomination. Any help is welcomed, either along the way, or with critical comments at any one of the review stages. Thanks, Sasata (talk) 19:48, 1 May 2012 (UTC)

Wonderful. A push for GA / FA is an excellent idea. We are planning on translating this article into as many other languages as possible with the help of Translators Without Borders after it is GA per [2]. I am not a big fan of list defined refs. Are they compatible across other language versions?
BTW hopefully we will be using recent secondary sources rather than primary sources such as you have listed above? If you need help getting evidence BTW drop me a note. Doc James (talk · contribs · email) 20:26, 1 May 2012 (UTC)
The translation initiative was one of my motivations to tackle this article. Yes, recent secondary sources will be preferred; I'll post a list soon after I do some reading. I can live without list-defined refs I guess, but it makes the editing easier for me, as I always know exactly where the ref is located, and I simply open a second window or tab with the references section if needed. There weren't any complaints at talk:Fungus#Ref formatting – but of course I'll defer to the established style if required. Not sure about compatibility with other language versions - good question. Sasata (talk) 20:43, 1 May 2012 (UTC)
Okay if it is compliant with other languages go ahead. I know vcite is not and I had to manually go through all of them. There is this new option which shows you the ref when you put your cursor over it [3]. Just started using it.Doc James (talk · contribs · email) 20:59, 1 May 2012 (UTC)
I like list-defined refs. I disagree that "Diberri" format is standard or best, but if you use that tool to get your citations then it is handy and I don't object to your change. Doc James, if you have PopUps then you've already got a better ref-tooltip: the one in popups also gives you links to the other places the ref is used, much like the actual footnote does. If you don't have PopUps, then I don't know how you manage. Colin°Talk 22:48, 6 May 2012 (UTC)
Where does one find these "popups"? Doc James (talk · contribs · email) 22:51, 6 May 2012 (UTC)
In "My Preferences" -> "Gadgets" -> "Browsing" -> Tick "Navigation Popups" box. Graham Colm (talk) 22:57, 6 May 2012 (UTC)
Thanks Doc James (talk · contribs · email) 00:34, 7 May 2012 (UTC)
It is not compliant with other languages thus I think we should switch back. Doc James (talk · contribs · email) 16:44, 15 June 2012 (UTC)

GA Review[edit]

This review is transcluded from Talk:Malaria/GA2. The edit link for this section can be used to add comments to the review.

Reviewer: Biosthmors (talk · contribs) 18:48, 21 May 2012 (UTC)

I'll do this. Biosthmors (talk) 18:48, 21 May 2012 (UTC)

Some addressed comments[edit]

Lead comments

In the lead, change "The disease results from the multiplication of Plasmodium parasites" --> "The protists act as parasites"? Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • Better, changed. Sasata (talk) 04:50, 23 May 2012 (UTC)

::*Maybe also specify that they "The protists first infect the liver, then act as parasites..." to summarize #Pathogenesis

Specify if disease from P. knowlesi infection also mild? Biosthmors (talk) 20:16, 21 May 2012 (UTC)

The fourth paragraph of the lead seems like it should be swapped with the third. That way "Despite a clear need" is much more clear. Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • I've reorganized the lead. Sasata (talk) 04:50, 23 May 2012 (UTC)

The four significant figures in the estimate aren't necessary. Consider reducing all estimates to two sig figs. In general, I think there is undue recentism on comparing WHO numbers to The Lancet numbers. Also, I think readers would be better informed by recent historical averages and trends. Something more like "Over 200 million cases of malaria are estimated to occur annually, with around a million deaths per year attributed. In the 2000s, a trend of X (or not) was observed with ..." Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • I agree completely and have reduced the details. Need to read some more about trends, as I've seen different conclusions from different sources. Sasata (talk) 04:50, 23 May 2012 (UTC)
Signs and symptoms comments

Link hemolytic anemia instead Biosthmors (talk) 20:16, 21 May 2012 (UTC)

"has been found to" --> can Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • This phrase has been removed. Sasata (talk) 05:51, 23 May 2012 (UTC)

Start a prognosis section (per this) with the info about neurologic damage and the sentences that start at "Severe malaria can progress extremely rapidly..." Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • Good idea, done. Sasata (talk) 05:51, 23 May 2012 (UTC)

Per that guideline also consider a classification section to introduce important malarial variants such as severe, cerebral, etc. Biosthmors (talk) 20:16, 21 May 2012 (UTC)

  • Will ponder about the best way to present this and get back to you. Sasata (talk) 05:51, 23 May 2012 (UTC)
  • Severe is defined now in the diagnosis section. I think we're good for now but maybe a FA-level article should include this type of section. Biosthmors (talk) 19:21, 26 June 2012 (UTC)
Cause comments

The material that starts with "Malaria parasites contain..." seems like it belongs in the Research section Biosthmors (talk) 20:16, 21 May 2012 (UTC)

Perhaps reword a sentence to "The primary hosts for malaria parasites are female mosquitoes of the Anopheles genus, who act as transmission vectors to humans and other vertebrates, the secondary hosts." And make one link in the sentence as double linking occurs with secondary hosts and definitive hosts both going to host (biology). Biosthmors (talk) 19:50, 22 May 2012 (UTC)

"and the infected Anopheles mosquitoes carry" --> "and the infected Anopheles mosquitoes eventually carry" as the following sentences detail the steps after initial infection. Biosthmors (talk) 19:50, 22 May 2012 (UTC)

In "Life cycle" change the instances that only refer to an "infected human" to an "infected vertebrate". Biosthmors (talk) 19:50, 22 May 2012 (UTC)

"This type of transmission is occasionally referred to as anterior station transfer. The sporozoites are injected into the skin, alongside saliva, when the mosquito takes a subsequent blood meal." Might the order of these sentences be reversed? Biosthmors (talk) 19:50, 22 May 2012 (UTC)

"(i.e., relapses begin the year after the mosquito bite)" --> "with relapses beginning the year after the mosquito bite"? Biosthmors (talk) 19:50, 22 May 2012 (UTC)

  • Have implemented all the suggestions/fixes above. Sasata (talk) 05:51, 23 May 2012 (UTC)

"Parasitic Plasmodium species also infect birds, reptiles, monkeys, chimpanzees and rodents.[13] There have been documented human infections with several simian species of malaria; however, with the exception of P. knowlesi—a zoonotic species that causes malaria in macaques[10]—these are mostly of limited public health importance.[14]" could go into a new "In other animals" section. Biosthmors (talk) 20:23, 23 May 2012 (UTC)

Pathogenesis comments

"Malaria develops via two phases: an exoerythrocytic and an erythrocytic phase. The exoerythrocytic phase involves infection of the hepatic system, or liver, whereas the erythrocytic phase involves infection of the erythrocytes, or red blood cells." --> "Malaria infection develops in two phases: one which involves the liver, or hepatic system (exoerythrocytic), and one which involves red blood cells, or erythrocytes (erythrocytic)."? Biosthmors (talk) 20:23, 23 May 2012 (UTC)

  • Better, changed. Sasata (talk) 17:53, 25 May 2012 (UTC)

"High endothelial venules (the smallest branches of the circulatory system) can be blocked by the attachment of masses of these infected red blood cells. The blockage of these vessels..." is followed by a source but I didn't see the word HEVs mentioned in the source. That HEVs are the smallest branches of the circulatory system comes off as an extraordinary claim needing a citation. Biosthmors (talk) 20:23, 23 May 2012 (UTC)

  • I couldn't verify the statement using other sources either, so I've removed it. Sasata (talk) 17:53, 25 May 2012 (UTC)

"Fertilization and sexual recombination of the parasite occurs in the mosquito's gut. (Because sexual reproduction of the parasite defines the definitive host, the mosquito is the definitive host, whereas humans are the intermediate host.)" I'm not sure the sentence in parenthesis is there for a good reason. It seems to be there just to teach readers the definitions of "intermediate host" and "definitive host". Maybe that's necessary but I think that should occur up in the Cause#Life cycle sentence "The definitive hosts for malaria parasites are female mosquitoes of the Anopheles genus, which act as transmission vectors to humans and other vertebrates, the secondary hosts." if helpful. Biosthmors (talk) 20:23, 23 May 2012 (UTC)

  • Changed as suggested. Sasata (talk) 05:56, 28 May 2012 (UTC)

Also under #Genetic resistance the first sentence "Malaria is thought to have been the greatest selective pressure on the human genome in recent history" might be beefed up in certainty as the lead of the main article says "Malaria has placed the strongest known selective pressure on the human genome since the origination of agriculture within the past 10,000 years.[2][3]" Biosthmors (talk) 20:23, 23 May 2012 (UTC)

  • Done, and added another recent review to corroborate this strong statement. Sasata (talk) 05:56, 28 May 2012 (UTC)

The sentence that starts with "To be clear..." in #Malarial hepatopathy could specify that "malarial hepatitis" is not used in hepatitis+ cases (if this is accurate) and that inflammation is key to hepatitis. Maybe something like, "Hepatitis, which is characterized by inflammation of the liver, is not actually present in what is called 'malarial hepatitis'; the term invokes the reduced liver function associated with severe malaria." Biosthmors (talk) 20:23, 23 May 2012 (UTC)

  • I like that wording, now changed. Sasata (talk) 06:28, 28 May 2012 (UTC)
Diagnosis comments

"discovered" --> "developed"? Biosthmors (talk) 19:16, 30 May 2012 (UTC)

Prevention comments

I'm not sure why "used to prevent the spread of disease, or to protect individuals in areas where malaria is endemic" couldn't be shortened to "to prevent malaria". Biosthmors (talk) 20:54, 23 May 2012 (UTC)

"continued existence" --> "presence". Biosthmors (talk) 20:54, 23 May 2012 (UTC)

The phrase "can be controlled" regarding the economist's estimate is vague. Maybe it has a specific definition which should be included, if there is one. Biosthmors (talk) 20:54, 23 May 2012 (UTC)

  • I've removed this estimate after reading the original paper the news reports cites. Sachs doesn't really give a clear definition of what he considers "comprehensively controlled", and papers (e.g. PubMed) have been published concerning the exact meaning of terms like "control" and "elimination"; further, his estimate was for a specific time frame (2007–2010) and limited to Africa. Sasata (talk) 06:32, 6 June 2012 (UTC)

I recommend removing "conducive country conditions, a targeted technical approach using a package of effective tools" as they sound like vague PR speak and a fancy sounding summary of the following factors, which individually make more sense. Biosthmors (talk) 20:54, 23 May 2012 (UTC)

The paragraphs that start with "A 2008 study..." and "Brazil, Eritrea, India, and Vietnam..." both cite primary studies, so I am not sure how giving this much weight to these two primary studies is in line with the guideline for sourcing standards (WP:MEDRS). Trim/use secondary sources? But I wouldn't want us to lose content that puts the global picture in context either. Biosthmors (talk) 20:54, 23 May 2012 (UTC)

  • I removed the info cited to these studies and replaced with some analysis sourced to a 2010 review. There's a lot more that could be said, so let me know if you think more discussion is warranted. Sasata (talk) 06:32, 6 June 2012 (UTC)

In the picture caption remove "very"? Biosthmors (talk) 19:16, 30 May 2012 (UTC)

Under #Medications I think "and proguanil hydrochloride (Malarone)" should be "or proguanil hydrochloride (Malarone)," with a comma at the end. Or maybe a pair of em dashes could segregate the three medications. Biosthmors (talk) 19:16, 30 May 2012 (UTC)

  • Malarone is a combination of atovaquone and proguanil, so the word is needed there, but perhaps you meant the previous "and" (", and the combination of"), which I've now switched to the correct "or". Used emdashes as suggested. Sasata (talk) 17:24, 4 June 2012 (UTC)

"Quinine was used historically; however, the development of more effective alternatives such as quinacrine, chloroquine, and primaquine in the 20th century reduced its use." This seems like it should be incorporated into the history section per the MEDMOS guideline. Biosthmors (talk) 19:16, 30 May 2012 (UTC)

Under #Vector control there is "In 2002, there were 1,059 cases of malaria reported in the US, including eight deaths, but in only five of those cases was the disease contracted in the United States." It should be sourced and in the epidemiology section, but it is a bit random so maybe exclude or expand to include multiple years. Biosthmors (talk) 19:16, 30 May 2012 (UTC)

  • In retrospect it does seem a bit random, so I've removed it for now. Sasata (talk) 16:04, 6 June 2012 (UTC)

The part that says malaria was "successfully eradicated or controlled also in several tropical areas by removing or poisoning the breeding grounds of the mosquitoes or the aquatic habitats of the larva stages, for example by filling or applying diesel oil to places with standing water" seems to imply diesel oil was successful. I didn't see that verified so I suggest changing diesel oil to Paris Green as that is what the Lancet source appears to credit in Brazil and Egypt. As Paris Green is an outdated technique due to its toxicity, maybe it should go in the history section too. Biosthmors (talk) 19:16, 30 May 2012 (UTC)

  • Changed to Paris Green per sources, but am not convinced that every mention of a historical technique should be transferred to the history section... will ponder higher-level organization some more. Sasata (talk) 16:04, 6 June 2012 (UTC)

In #Vector control the paragraphs that start with "Sterile insect technique..." and "Another way to..." completely cite primary studies or news pieces, not the standard WP:MEDRS. One review I spotted from 2011 that has been cited 6 times is doi:10.1007/s00436-010-2232-0. Biosthmors (talk) 20:03, 6 June 2012 (UTC)

  • Combined and rewrote the two offending paragraphs (they both fall into the category of "genetic manipulation"), removed the less-than-ideal sources, and sourced to suggested review. Sasata (talk) 05:45, 12 June 2012 (UTC)

In #Mosquito nets and bedclothes "help keep mosquitoes away from people and greatly reduce the infection and transmission of malaria" --> "provide a barrier to significantly reduce the transmission of malaria"? It sounds like the sentence is also saying "reduce the infection of malaria" which is awkward. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Tweaked prose. Sasata (talk) 18:07, 12 June 2012 (UTC)

"only 13%" --> "only about 13%" or "little more than 10%" or "a minority"? It seems odd to confidently put a precise number on it. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Changed to "about 13%". Sasata (talk) 18:07, 12 June 2012 (UTC)

"center of a bed such that it drapes down and covers the bed completely" --> "center of a bed to drape over it completely"? Biosthmors (talk) 21:11, 6 June 2012 (UTC)

There's nothing about bedclothes. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Trimmed subheader. Sasata (talk) 18:07, 12 June 2012 (UTC)

In #Other methods "Education in recognizing the symptoms of malaria has reduced the number of cases in some areas of the developing world by as much as 20%" needs a cite. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Couldn't source this figure specifically, so made the text more general, and added citations. Sasata (talk) 19:49, 12 June 2012 (UTC)

"a killer" --> "fatal" Biosthmors (talk) 21:11, 6 June 2012 (UTC)

The mosquito laser sounds cool but I think we need some medical sources instead of physics ones here so that content might need removing. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Agree, removed. Sasata (talk) 06:20, 12 June 2012 (UTC)
Other comments

In signs and symptoms, link "severe malaria" down to the classification section in diagnosis? Biosthmors (talk) 19:21, 26 June 2012 (UTC)

In Prevention#Medications can we move it down towards the bottom of the section and specify it is for travelers at the beginning? I think the section should start off with how to prevent malaria in people who live in endemic areas. Biosthmors (talk) 19:38, 27 June 2012 (UTC)

  • Done x 2. Sasata (talk) 16:05, 29 June 2012 (UTC)

I think the DDT content in Prevention#Indoor residual spraying might over-imply the idea that "backlash against DDT was too severe and it should be used more for this purpose." The article says:"Since the use of DDT has been limited or banned for agricultural use for some time, DDT may now be more effective as a method of disease-control" while the absract of the source it cites says:"There are signs that more malaria vectors are becoming resistant to the toxic action of DDT, and that resistance is spreading to new countries." Many things may be true, but I think the prevention section in general highlights potential or plausible things too much. Biosthmors (talk) 19:48, 27 June 2012 (UTC)

  • I've removed this sentence; see also below. Sasata (talk) 07:11, 4 July 2012 (UTC)

In #IRS see the sentence "Although DDT has never been banned for use in malaria control and there are several other insecticides suitable for IRS, some advocates have claimed that bans are responsible for tens of millions of deaths in tropical countries where DDT had once been effective in controlling malaria" is followed by the editorial comment of "these claims seem less and less notable". Can we get a MEDRS for this content or remove it? Seems a bit ORish. I doubt this sentence is sourced to the French language reference. Biosthmors (talk) 20:03, 6 June 2012 (UTC)

  • I'm reluctant to outright remove this, for fear of sweeping a valid opinion under the rug (WP:NPOV and all). Instead, I've attributed the statement to Robert Gwadz of the NIH and cited the paragraph more accurately. Sasata (talk) 17:17, 12 June 2012 (UTC)
  • Link to another page number? Page 3 of 7 doesn't have Gwadz saying that as far as I can tell. Biosthmors (talk) 18:55, 26 June 2012 (UTC)
  • Oops – page 4. Sasata (talk) 15:36, 29 June 2012 (UTC)
  • Thanks. I also think this type of non WP:MEDRS doesn't belong in the Prevention section. And maybe we can get more and/or better estimates. And the article text currently reads "said in 2007 that bans are responsible for tens of millions of deaths" while when quoted he only said "may have killed 20 million children". The word may is imprecise; is he only 2% confident the actual number is that high, or is he 40% confident that the number is higher? Maybe something like "possibly 20 million children died due to the difficulty in accessing DDT after agricultural bans." Then that begs the question (for FA, I guess): why was it so hard to get a hold of for approved uses? Were chemical companies afraid of possible penalties from regulators? Were there no vendors with licenses to sell DDT in the African countries? Were the profit margins to set up shop selling it too small or non-existent? Biosthmors (talk) 20:15, 3 July 2012 (UTC)
  • After some reflection, I understand your point better now and agree that it's best here to stick with simple explanations of what works and why. I've removed the paragraph on DDT-use apologetics; opinions on the merits of DDT in malaria prevention can be more fully elucidated in the daughter articles. Sasata (talk) 07:11, 4 July 2012 (UTC)

In Epidemiology, if the WHO estimate based off of documented cases while the Lancet estimate is not, I think that should be stated. Biosthmors (talk) 20:46, 2 July 2012 (UTC)

  • Good idea, done. Sasata (talk) 07:34, 4 July 2012 (UTC)
  • That looks great, maybe in the lead put the word "documented" and that estimates that include undocumented cases are higher? Biosthmors (talk) 20:01, 5 July 2012 (UTC)
  • I added "documented", but think that the notion that undocumented cases are higher is perhaps too obvious to state explicitly here? Also, the disparity in documented/undocumented death stats is mentioned in the following sentence. Sasata (talk) 08:19, 21 July 2012 (UTC)

Should IRS and mosquito nets have level 4 headings under "Vector control" in Prevention? Biosthmors (talk) 20:15, 3 July 2012 (UTC)

  • Makes sense, done. Sasata (talk) 07:14, 4 July 2012 (UTC)

The first sentence of the Treatment section -- "When properly treated, people with malaria can usually expect a complete recovery" -- sounds like it should start of the Prognosis section. Biosthmors (talk) 20:47, 9 July 2012 (UTC)

  • Agree, moved. Sasata (talk) 08:06, 21 July 2012 (UTC)

Under Cause, the first sentence has the words "are genus". Maybe this wording is standard. If not then "are of genus" or "are from genus"? Biosthmors (talk) 20:02, 13 July 2012 (UTC)

Is the sentence in Epidemiology, "The global endemic levels of malaria have not been mapped since the 1960s", contradicted by the 2007 publication/folowing sentence? If so it seems unnecessary. Biosthmors (talk) 20:59, 27 July 2012 (UTC)

  • Removed contradictory statement and reorganized text. Sasata (talk) 20:41, 29 July 2012 (UTC)

In Treatment#Uncomplicated malaria put a year on the emergence(s) instead of saying recently? Biosthmors (talk) 22:26, 27 July 2012 (UTC)

In Treatment#Severe malaria can we specify what supportive measures are? Biosthmors (talk) 22:28, 27 July 2012 (UTC)

  • Gave some examples. Sasata (talk) 19:49, 29 July 2012 (UTC)

Also in #IRS "According to a study published on Mosquito Behavior and Vector Control" is unnecessary as is introducing the definitions of "endophilic" and "exophilic", it seems. Biosthmors (talk) 21:11, 6 June 2012 (UTC)

  • Trimmed. Sasata (talk) 17:34, 12 June 2012 (UTC)
  • "Mosquito" should be made plural, and if it has limited effectiveness due to the fact mosquitos still come indoors to feed (even if they live and rest outdoors) maybe we should mention that. The prose wasn't all that clear to me. Biosthmors (talk) 18:55, 26 June 2012 (UTC)

Should the paragraph that begins "Although coinfection with HIV..." in Epidemiology be in the Prognosis section? Biosthmors (talk) 20:55, 9 July 2012 (UTC)

  • I think so. Moved. Sasata (talk) 13:43, 14 August 2012 (UTC)

In Society and culture, the content that begins "A study on the effect of malaria on IQ in a sample of Mexicans..." is inadequately sourced to a primary source. Remove or add content from a review that puts this type of study in context? Biosthmors (talk) 19:49, 1 August 2012 (UTC)

  • Removed the primary source & its conclusions; added a general statement about neurological sequelae from a recent review. Sasata (talk) 19:48, 23 August 2012 (UTC)

"Cerebral malaria" should be defined as it is used several times in the article. Biosthmors (talk) 19:55, 1 August 2012 (UTC)

  • I glossed a brief definition in the "Signs and symptoms" section. Sasata (talk) 13:43, 14 August 2012 (UTC)

In Epidemiology, the sentence "Indeed, if the prevalence of malaria stays on its present upwards course, the death rate could double in the next twenty years" is sourced to a 2001 paper. Remove or update with a more current trend? Biosthmors (talk) 19:36, 1 August 2012 (UTC)

  • I've removed it for now; I haven't yet found a similar, more recent prediction. Sasata (talk) 18:08, 4 September 2012 (UTC)

In Society and culture#Economic impact, the section ends with "April 25 is World Malaria Day" and this seems out of place. Put the link in a See also section? Biosthmors (talk) 18:38, 27 August 2012 (UTC)

  • Done. Sasata (talk) 07:46, 1 September 2012 (UTC)

Also in Prevention#IRS, reword slightly from "will be killed" --> "can be killed" as a lethal dose has to be absorbed, and won't always be absorbed. Biosthmors (talk) 21:05, 27 August 2012 (UTC)

  • Done. Sasata (talk) 07:46, 1 September 2012 (UTC)

The first paragraph in Research sounds technical and is based off of a primary study. The study as been cited by several reviews: doi:10.1002/cyto.a.20766, doi:10.1016/, doi:10.1002/cbic.201000084, and doi:10.1096/fj.10-174383. I think the article probably needs a comprehensive check to see how many primary studies are still cited. Biosthmors (talk) 21:04, 9 July 2012 (UTC)

  • I used the first review you listed, by one of the same authors (didn't need to change the article text!). Will sweep the article again for non-MEDRS-compliant articles now. Sasata (talk) 15:53, 10 September 2012 (UTC)

In Prevention#IRS, the sentence "However, because of its legacy, many developed countries previously discouraged DDT use even in small quantities." is sourced to a news source. I say that's fine if it is the history or society and culture section, but I think it is off the mark for a prevention section. If we had a Prevention of malaria article this could be part of the history there and I think it would fit there just fine. Biosthmors (talk) 20:54, 27 August 2012 (UTC)

  • Agree with your points, and the story doesn't lose anything without it -- so removed. Sasata (talk) 07:46, 1 September 2012 (UTC)
  • As this was in a paragraph I am now recommending to be moved to the history section anyways, maybe it should come back. Biosthmors (talk) 19:23, 4 September 2012 (UTC)
  • The history section ends off with the sentence "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.", which says about the same. Sasata (talk) 15:43, 10 September 2012 (UTC)

In the lead, make "The protists first infect the liver, then act as parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma or death." two sentences and include the fact that female mosquitos are how the protists enter the body? That fact seems important enough for the lead. Biosthmors (talk) 19:02, 4 September 2012 (UTC)

  • Done, Sasata (talk) 17:21, 9 September 2012 (UTC)

In Prevention#IRS, is the sentence "The overuse of antibacterial soaps and antibiotics led to antibiotic resistance in bacteria, similar to how overspraying of DDT on crops led to DDT resistance in Anopheles mosquitoes." necessary? It seems readers could click on antibiotic resistance if necessary in the previous sentence. Biosthmors (talk) 19:05, 4 September 2012 (UTC)

  • Done. Sasata (talk) 17:21, 9 September 2012 (UTC)

In Prevention#IRS, put the paragraph that begins with "The first pesticide used for IRS was DDT" into the history section? Biosthmors (talk) 19:15, 4 September 2012 (UTC)

  • Moved. Sasata (talk) 17:21, 9 September 2012 (UTC)

In Prevention#IRS, change "currently" to "as of 2006" on the WHO recommendations and see if one can find a more updated list? Six years seems old (and potentially irrelevant or outdated) for this important of a disease. Biosthmors (talk) 19:15, 4 September 2012 (UTC)

  • Added the date, will try to find updated source. Sasata (talk) 19:14, 9 September 2012 (UTC)

In Prevention#IRS, make it read "Indoor residual spraying (IRS)" to abbreviate the term. Biosthmors (talk) 19:29, 4 September 2012 (UTC)

  • Done. Sasata (talk) 19:14, 9 September 2012 (UTC)
  • Are we near the review being wrapped up? It's been nearly four months since the review began, so ideally it should be about finished. Wizardman Operation Big Bear 21:02, 9 September 2012 (UTC)
  • We'll get there eventually. Sasata (talk) 15:35, 10 September 2012 (UTC)

In Prevention#Vector control should the paragraphs that start with "A more targeted..." and "Sterile insect technique..." be merged? The prose seems to be duplicated. Biosthmors (talk) 06:58, 12 September 2012 (UTC)

  • Missed that ... now merged. Sasata (talk) 21:38, 12 September 2012 (UTC)

In the History section, towards the bottom, there is "now the recommended treatment for falciparum malaria". "Now" seems like it should be "as of" or another historical phrasing. And falciparium as used here definitely means P. falicparium and is not being used as a synonym for severe malaria, right? Biosthmors (talk) 07:47, 12 September 2012 (UTC)

  • Changed "now" to "became" and "falciparium" to P. falicparium. Sasata (talk) 21:38, 12 September 2012 (UTC)

In Society and Culture#Economic impact add "to lower birth and death rates" after demographic transition so readers don't have to click on the link to understand the sentence? Biosthmors (talk) 19:24, 13 September 2012 (UTC)

  • Done. Sasata (talk) 17:53, 16 September 2012 (UTC)

In Society and Culture#Economic impact, change "the poor" to "those in poverty"? Biosthmors (talk) 19:26, 13 September 2012 (UTC)

  • Done. Sasata (talk) 17:53, 16 September 2012 (UTC)

In the lead "Infection is initiated by" --> "It begins when"? It seems like it should be made more accessible. Biosthmors (talk) 00:36, 24 September 2012 (UTC)

  • Done. Sasata (talk) 16:07, 24 September 2012 (UTC)

In Signs and symptoms, the complications section should be Prognosis, I think. And link complications to Complication (medicine) on first use? Biosthmors (talk) 17:50, 19 September 2012 (UTC)

Hmmm... or maybe some of what is in prognosis should just go under complications... Biosthmors (talk) 22:48, 20 September 2012 (UTC)
  • I've shuffled some of this information. Sasata (talk) 16:07, 24 September 2012 (UTC)

In Society and Culture#War, the claim "infliction of the disease as a biological warfare agent" comes off as extraordinary, so it needs an inline citation. Biosthmors (talk) 19:26, 15 September 2012 (UTC)

  • Added a source. Sasata (talk) 16:07, 24 September 2012 (UTC)

In Society and Culture#War, the text that starts with " 'Malaria Site: History of Malaria During Wars' ..." is not clear prose. Consider taking out the title of the webpage, making sure the author is reliable, and pulling the information out of quotes or resourcing the content? The paragraph reads as a survey of internet sites, instead of plainly citing facts. Biosthmors (talk) 19:26, 15 September 2012 (UTC)

  • I've trimmed most of this paragraph. There is still one remaining citation to here, but I think the author could be considered reliable based on this. Sasata (talk) 16:51, 24 September 2012 (UTC)

In Society and Culture#War, it is unclear to me what the paragraph/quote with italics about executive and disciplinary powers is getting at. Consider checking the source to see what might be best said in regards to war? Biosthmors (talk) 19:29, 15 September 2012 (UTC)

  • I've added a more germaine quote from the Colonel. (Still not completely satisfied with this section, and I predict more changes before FAC) Sasata (talk) 17:10, 24 September 2012 (UTC)
  • Much better thanks. Biosthmors (talk) 20:00, 24 September 2012 (UTC)

In History, reword "... in Algeria named Charles Louis Alphonse Laveran observed parasites for the first time, inside the red blood cells of people suffering from malaria." to "in Algeria—Charles Louis Alphonse Laveran—observed parasites in the red blood cells of infected people for the first time."? Just seemed like it use a copy edit and I wasn't sure if the comma is correct. Biosthmors (talk) 19:47, 24 September 2012 (UTC)

  • Fixed the prose. Sasata (talk) 05:28, 25 September 2012 (UTC)

In Society and Culture#War, the last paragraph starts to go off-topic when it transitions into "and, during these activities, to...", in my opinion. The CDC spelled out is also Centers for Disease Control and Prevention, which could be linked. Biosthmors (talk) 19:55, 24 September 2012 (UTC)

  • Agree; trimmed the rambling and linked/defined CDC. Sasata (talk) 05:28, 25 September 2012 (UTC)

In Society and Culture#Economic impact, use a source to root the paragraph about cognitive changes (which currently seems better in prognosis) to expected economic effects? Maybe some material should go in prognosis and some should stay. Biosthmors (talk) 19:30, 13 September 2012 (UTC)

In Research, the section seems like it should start with the vaccine information (as that is what the lead mentions). It is currently segregated above and below a level three heading, but maybe no level 3 subheading is necessary. The technical information in the first paragraph seems like it should be at the bottom. The paragraph that starts with "Malaria vaccines have been an elusive goal of research..." seems like it should be in the history section, except for the last sentence, which sounds like it should stay but it shouldn't include the words "It has been determined", which are extraneous if this is just a fact. Biosthmors (talk) 20:21, 26 September 2012 (UTC)

  • How does it look now? Sasata (talk) 05:26, 27 September 2012 (UTC)
  • Much better, thanks. Biosthmors (talk) 17:01, 27 September 2012 (UTC)

In Signs and symptoms, the sentence that starts with "The presentation may include fever, shivering, arthralgia..." does not include the top left one of headache in the picture. That seems like an incongruity. Biosthmors (talk) 21:05, 26 September 2012 (UTC)

  • Added. Sasata (talk) 05:43, 27 September 2012 (UTC)

In Cause#Recurrent malaria, make "Recrudescence" --> "Recurrence (recrudescence)" so readers are confident on the meaning with just the prose? Biosthmors (talk) 17:13, 27 September 2012 (UTC)

  • Done. Sasata (talk) 18:00, 27 September 2012 (UTC)

I was trying to verify some symtoms and I see that the source "Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases" has the pages listed as Chapter 275. That could be right. Is it? Biosthmors (talk) 21:11, 27 September 2012 (UTC)

  • Yes; I tightened up the details for that reference and gave a page range for the chapter. Sasata (talk) 21:27, 27 September 2012 (UTC)

In signs and symptoms, we are using a 2001 source to present classical symptoms. What was classical in 2001 may not be the case anymore. Can we get an updated MEDRS? Biosthmors (talk) 21:36, 27 September 2012 (UTC)

  • Still classical in 2009 – updated source. Sasata (talk) 22:30, 27 September 2012 (UTC)
  • Thanks. If it had been a 2002 source I think I would have let it slide but I guess one needs to draw the line somewhere. Biosthmors (talk) 17:19, 28 September 2012 (UTC)

I hate to be a pain, but we're nearing the five month mark on this review. No reason any review should take this long. Let's get it wrapped up. Wizardman 05:08, 8 October 2012 (UTC)

In signs and symptoms, it says "For reasons that are poorly understood, but that may be related to high intracranial pressure, children with malaria frequently exhibit abnormal posturing, a sign indicating severe brain damage". The source says "brainstem signs (abnormalities in posture, pupil size and reaction, ocular movements or abnormal respiratory patterns) are commonly observed". While the article does say "mechanisms of neural injury in cerebral malaria are poorly understood", I think saying "For reasons that are poorly understood" is off-topic for this section, as it isn't the pathogenesis or cause section. Remove? And rewording so we mentioning that the characteristic is general problematic signs of the brainstem with a bit more detail or putting the specific signs in a note seems better than focusing on posture, based off of this source. Biosthmors (talk) 17:27, 28 September 2012 (UTC)

  • Removed the offending bits as you suggested, swapped out the source for one (open access) that more generally summarizes clinical aspects of the disease, and added some more symptoms of cerebral malaria. Sasata (talk) 20:59, 30 September 2012 (UTC)

In signs and symptoms the sentence "Non-falciparum species have however been found to be the cause of ~14% of cases of severe malaria in some groups" seems like it belongs in causes. Biosthmors (talk) 19:06, 28 September 2012 (UTC)

  • Done. Sasata (talk) 21:09, 30 September 2012 (UTC)

In signs and symptoms#complications, "with P. falciparum malaria" should be "with severe P. falciparum malaria", according to the abstract. Biosthmors (talk) 19:13, 28 September 2012 (UTC)

  • Done. Sasata (talk) 21:09, 30 September 2012 (UTC)

In the lead, instead of "many of whom were children under the age of five" maybe say something like "most of whom are children in Africa"? Source is first page of Taylor 2012, "Respiratory Manifestations of Malaria". Biosthmors (talk) 19:17, 28 September 2012 (UTC)

  • Done. Sasata (talk) 21:09, 30 September 2012 (UTC)

In signs and symptoms, "Consequences of severe malaria include coma and death if untreated—young children and pregnant women are especially vulnerable" sounds prognosisish. Can we reword to give detail on how coma is seen as a sign? I guess death is a sign of having malaria and I'm not saying it needs to come out entirely, but it's not worded right for this section, in my opinion. Biosthmors (talk) 20:11, 28 September 2012 (UTC)

  • I took this sentence out. The vulnerability of children and women is discussed elsewhere, and I mentioned coma as a possible consequence of cerebral malaria in the following paragraph. Sasata (talk) 21:52, 30 September 2012 (UTC)

In Signs and symptoms, the sentence "The causes of this problem are diverse and include respiratory compensation of metabolic acidosis, noncardiogenic pulmonary oedema, concomitant pneumonia, and severe anaemia" seems like a too close paraphrase of the abstract. Maybe reword this portion: "The causes of this problem are diverse"? Biosthmors (talk) 23:18, 28 September 2012 (UTC)

  • Done. Sasata (talk) 21:56, 30 September 2012 (UTC)

In Cause#Life cycle, the second sentence of "Young mosquitoes first ingest the malaria parasite by feeding on an infected vertebrate carrier and the infected Anopheles mosquitoes eventually carry Plasmodium sporozoites in their salivary glands. A mosquito becomes infected when it takes a blood meal from an infected vertebrate." largely repeats material found in the first sentence. Make into one sentence? Biosthmors (talk) 02:00, 9 October 2012 (UTC)

In Signs and symptoms, the sentence that says "Individuals with severe malaria frequently exhibit neurological symptoms that indicate brain damage, including abnormal posturing, nystagmus, strabismus, opisthotonus, seizures, or coma" has some problems. I didn't find nystagmus or strabismus in the source. I stopped checking after not finding those two. Also, the source presents symptoms of cerebral malaria as transient. Brain damage sounds permanent to me. Biosthmors (talk) 01:30, 9 October 2012 (UTC)

  • In the source it's spelled "nistagmus"; the source lists "disconjugate gaze" as a symptom, I thought (perhaps incorrectly?) that this was synonymous to strabismus. Not quite sure what you want me to do with the other–even coma can be a transient symptom. Yes, brain damage can result, but this is the Signs and symptoms section, not Prognosis. Sasata (talk) 21:52, 9 October 2012 (UTC)
  • I shouldn't be making unqualified assumptions about medical terminology, so I posted a query at the wp:MED talk page. Sasata (talk)
  • Serves me right for making assumptions ... have changed it per the source and glossed a definition. Sasata (talk) 23:00, 9 October 2012 (UTC)
  • Remove "that indicates brain damage", as the source says they are often transient? Sorry I wasn't clearer. Biosthmors (talk) 22:07, 9 October 2012 (UTC)
  • Gotcha – done. Sasata (talk) 23:00, 9 October 2012 (UTC)

In the history section, remove "new" from "Some new evidence..." as it is unclear when the evidence will stop being new. Biosthmors (talk) 22:11, 9 October 2012 (UTC)

In Cause#Life cycle, I don't see the value in saying "and the infected Anopheles mosquitoes eventually carry Plasmodium sporozoites in their salivary glands". Remove? The term is introduced later with context. Biosthmors (talk) 22:21, 9 October 2012 (UTC)

In Cause#Life cycle, "the parasite gametocytes taken up in the blood will further differentiate into male or female gametes and then fuse in the mosquito's gut"? Biosthmors (talk) 22:27, 9 October 2012 (UTC)

Use the emedicine source on the talk page to incorporate the new content temporarily until traditional MEDRS can be found? Biosthmors (talk) 17:40, 10 October 2012 (UTC)

  • I'm not sure if if agree with the new additions; the statements "... they now have only a limited role in the actual clinical decision making process with regards to arriving at a diagnosis of Malaria.[7] With the easy availability of laboratory tests ..." is contradicted by sourced material in "Diagnosis": "Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria.[37] Polymerase chain reaction based tests have been developed, though these are not widely implemented in malaria-endemic regions as of 2012, due to their complexity.[3]" I'll do some more reading and amend the new text tonight. Sasata (talk) 19:00, 10 October 2012 (UTC)
  • That sounds good. Maybe we just need a sentence of clarification about how in some areas symptoms are diagnostic but in others when they should prompt labwork -- aka "microscopic examination of blood using blood films or using antigen-based rapid diagnostic tests". I think that was the salient point of the new contribution. Biosthmors (talk) 19:16, 10 October 2012 (UTC)
  • I've shuffled the new text to the "diagnosis" section and balanced it with some text about the drawbacks of presumptive diagnosis. Sasata (talk) 06:14, 11 October 2012 (UTC)

In the lead, "Despite a clear need, no vaccine offering a high level of protection currently exists". That implies there is one with a moderate level of protection. Is that true? It not, reword to be more accurate? Biosthmors (talk) 21:47, 15 October 2012 (UTC)

  • I've reworded to "no effective vaccine currently exists" Sasata (talk) 22:29, 15 October 2012 (UTC)

There should be a sentence summarizing the diagnosis section in the lead. Mention both the technology/low technology approaches? Biosthmors (talk) 22:03, 15 October 2012 (UTC)

  • Added. Sasata (talk) 22:42, 15 October 2012 (UTC)

In the lead, "Malaria is prevalent in tropical regions because the significant amounts of rainfall, consistently high temperatures and high humidity, along with stagnant waters in which mosquito larvae readily mature, provide them with the environment they need for continuous breeding." is pretty wordy. Maybe, "Malaria is prevalent in tropical regions because significant amounts of rainfall, warm temperatures, and stagnant waters provide habitat for mosquito larvae? Biosthmors (talk) 22:09, 15 October 2012 (UTC)

  • Reworded along the lines of what you suggested. Sasata (talk) 06:51, 16 October 2012 (UTC)

"Despite a clear need" --> "Despite a need" in the lead? The word "clear" seems to be belaboring the point/opinionish. Biosthmors (talk) 22:10, 15 October 2012 (UTC)

  • Done. Sasata (talk) 22:29, 15 October 2012 (UTC)

Same kind of POVish language in Research with "new strategies are required" because of "required". How about something like "are being developed" instead of required? Biosthmors (talk) 22:12, 15 October 2012 (UTC)

  • Good idea, fixed. Sasata (talk) 06:51, 16 October 2012 (UTC)

In Research, can we get clarification on the word "irradiated"? To me, it begs questions like these: What about non-irradiated mosquitoes? What kind of irradiation? Why were the mosquitoes irradiated? Biosthmors (talk) 22:15, 15 October 2012 (UTC)

  • Done. Sasata (talk) 07:12, 16 October 2012 (UTC)
  • Thanks, that makes much more sense now. Biosthmors (talk) 18:55, 16 October 2012 (UTC)

We've gone back to a version of the lead where there is excessive text about the # of deaths. A recent review (doi:10.1016/S1473-3099(12)70064-6) states, "Between 655 000 and 1·2 million people die every year from Plasmodium falciparum infection.1,2". Something like that is in a much more encyclopedic format. The Lancet study is just a primary study after all and it shouldn't be given so much text to indroduce it. MEDRS asks that we respect secondary sources, so we shouldn't trumpet this one study per WP:MEDREV. Biosthmors (talk) 21:38, 15 October 2012 (UTC)

  • I agree. What about do you think of this as a compromise? Sasata (talk) 22:20, 15 October 2012 (UTC)
  • Better. Can we also clean the article of the unnecessary details such as "An estimate in The Lancet, based on a systematic analysis of all available mortality data combined with empirical methods for estimating causes of death..."? Using a MEDRS compliant secondary source to compare and contrast the two studies would be much better than citing journalists resource though I'm not opposed to citing reliable lay summaries. The lay summary includes the point that "about twice as many deaths than are estimated in the World Malaria Report 2011, with substantially more malaria deaths in adults in Africa and in both adults and children outside of Africa than previously recognized". This might creates a problem for the text because I'm not sure it is verifiable that most of the 1.24 million were children under 5 from Africa. That summary applied to only the 655,000 estimate. Reword? Biosthmors (talk) 22:34, 15 October 2012 (UTC)
  • In the lead, I've reworded "most" to "many" and cited the 0.655–1.2 mil range to the 2012 review you mentioned. In the article, the text "The majority of cases occur in children under five years old.[72]" is sourced to a review article with an independent death rate estimate, viz.: "Most estimates suggest that malaria directly causes about 1 million deaths per year or 3000 deaths a day, and that most of these deaths occur in African children", so I don't think the article statement is incompatible with any of the preceding data presented. I've trimmed the Lancet sentence; is it too much? I prefer to leave the lay summary in there as it's accessible, and the Lancet article is behind a paywall. Sasata (talk) 07:44, 16 October 2012 (UTC)
  • I think saying "A 2012 study places the number of deaths in 2010 at 1.24 million." is enough. This way we eliminate the risk of using scientific sounding words to indicate to readers they should give the study more weight. Also, systematic analysis is piped over to systematic review, but the article is not labeled as a review article. Biosthmors (talk) 19:09, 16 October 2012 (UTC)
  • Or "A 2012 study estimated the number of documented and undocumented deaths in 2010 was 1.24 million." If that's what the study did. Biosthmors (talk) 19:19, 16 October 2012 (UTC)
  • I think that's a good way to summarize it – changed. Sasata (talk) 07:23, 17 October 2012 (UTC)

In signs and symptoms, around or in "frequently exhibit neurological symptoms", add cerebral malaria to that sentence? The source says they are symptoms for cerebral malaria. Biosthmors (talk) 23:00, 16 October 2012 (UTC)

  • Done. Sasata (talk) 06:05, 17 October 2012 (UTC)

The article "Malaria Prevention in Short-Term Travelers" is used in Prevention#Medications. Should it be cited behind the sentence that ends with "continued for seven days afterwards)." The source seems to directly support only that sentence. Biosthmors (talk) 22:48, 17 October 2012 (UTC)

  • Done, and added a couple of additional reviews to source the other sentences. Sasata (talk) 16:33, 18 October 2012 (UTC)

In Cause#Recurrent malaria, I wasn't able to quickly verify the "Approximately one in five of P. vivax malaria cases" portion of that sentence. Where did the statistic about one in five come from? Is it better to say "often" or something else a bit vague? Biosthmors (talk) 23:36, 17 October 2012 (UTC)

  • I couldn't find it either, replaced with "often" as you suggested. Sasata (talk) 16:51, 18 October 2012 (UTC)

In Society and culture#War, "in the fortunes" --> "in the outcomes" or something similar? I was thinking plunder as a reader. Biosthmors (talk) 23:53, 22 October 2012 (UTC)

  • Changed "fortunes" to "fates", better? Sasata (talk) 16:59, 23 October 2012 (UTC)

In #Mosquito nets, the sentence "Since the Anopheles mosquitoes feed at night, the preferred method is to hang a large "bed net" above the center of a bed to drape over it completely" and the source seem to conflict a bit. The source mentions dusk to dawn, and I'm not sure draping over captures the sourc either. It recommends tucking in. Also, the word "preferred" begs questions. Reword? Biosthmors (talk) 00:05, 23 October 2012 (UTC)

  • Reworded this to bring it closer to the source recommendations. Sasata (talk) 17:23, 23 October 2012 (UTC)

In Epidemiology, "associated with an estimated 200,000" --> "associated with up to 200,000"? The source contains the important qualifier "up to". Biosthmors (talk) 00:15, 23 October 2012 (UTC)

  • Done. Sasata (talk) 17:25, 23 October 2012 (UTC)

In #Economic impact, the term "acute" is used twice. Replace with "severe" for consistent prose, if that is accurate? Biosthmors (talk) 19:29, 23 October 2012 (UTC)

  • Done. Sasata (talk) 04:10, 24 October 2012 (UTC)

In the lead, could the sentence "Resistance has developed to several antimalarial drugs, most notably chloroquine and artemisinin." mention the geographical dependence? That seems to be a main point from the article. Biosthmors (talk) 20:36, 23 October 2012 (UTC)

  • Great, thanks. I think that helps readers get oriented to the topic. Biosthmors (talk) 02:15, 25 October 2012 (UTC)

In Epidemiology, "This mortality rate is equivalent to roughly 2000 deaths every day" shouldn't link to mortality rate. Mortality rate has a specific definition. Maybe, "Deaths due to malaria occur at a rate of approximately 2000 a day according to this estimate"? Or save it until later in the section when we can get to ~2000 to 3000? Biosthmors (talk) 21:01, 23 October 2012 (UTC)

  • Good point! I've removed the link. Sasata (talk) 04:15, 24 October 2012 (UTC)

In #Uncomplicated malaria, the article says "This is done to reduce the risk of resistance against artemisinin" but the source says "The less effective single-drug treatments increase the chance of parasites evolving and becoming resistant to the treatment; combining anti-malarial drugs with independent modes of action can impede the development of resistance to each individual component of the combination." Reword to mirror the source's emphasis that it helps prevent drug resistance in general, and not just against artemisinin? Biosthmors (talk) 00:04, 24 October 2012 (UTC)

In #Economic impact, the article says "Malaria is not just a disease commonly associated with poverty but also a cause of poverty and a major hindrance to economic development." But the source says "The causality of this relationship is complicated, however. Does malaria cause poverty? Or does poverty cause malaria? Both channels of causation seem reasonable. It is also possible, as noted by Sachs and Malaney (2002), that the correlation could be spurious, caused perhaps by some other direct connection between climate and geography with growth rates or income levels. Resolving these causality issues has been difficult for researchers trying to assess the economic impact of malaria. In spite of the difficulties involved, two widely publicized papers have found that malaria appears to slow economic growth in poor countries" in the review, and "it is entirely possible for an economy to arrive at a 'malaria trap,' in which sickness begets poverty and poverty makes disease prevention unaffordable" in the conclusions. It seems this paper is being cited as a primary source for its conclusions. Weaken the language somewhat or source to a secondary source? Biosthmors (talk) 00:41, 24 October 2012 (UTC)

  • "Some evidence suggests" --> "evidence suggests"? "Some evidence suggests" is weak, so it might be a tad too watered down, but I haven't looked at Worrall 2005 to really gauge this. Biosthmors (talk) 02:15, 25 October 2012 (UTC)
  • It's intended to be weak: "We found mixed evidence on malaria incidence, with a number of studies identifying no relationship between socio-economic status and incidence, although a larger number of studies do find a link." Sasata (talk) 16:20, 25 October 2012 (UTC)

In Research, clarify what "channeled into the parasite" means? Biosthmors (talk) 21:25, 26 October 2012 (UTC)

  • Done. Sasata (talk) 07:32, 27 October 2012 (UTC)

In Eradication efforts, "According to director Inder Singh, the U.S.-based Clinton Foundation has significantly reduced the cost of drugs to treat malaria, and is working to further reduce the spread of the disease" is not true to the source, in my opinion. That wasn't attributed to Singh. A more accurate summary might say "the CF has worked to manage demand and stabilize prices in the artemisin market". Biosthmors (talk) 22:13, 26 October 2012 (UTC)

  • I agree and like your summary, thanks. Sasata (talk) 07:47, 27 October 2012 (UTC)

In Eradication efforts, I think the paragraph that starts with "Malaria has been successfully eradicated in certain areas" is undue, by giving so much text/detail to that one source. Trim? Or perhaps remove/replace? Also, the tense is off: "DDT is used in moderate amounts", though the source is from 2004. The text also might border on the promotional: "These actions have produced positive results. The program has cut infection and death rates tremendously, and is cost effective". Biosthmors (talk) 23:19, 26 October 2012 (UTC)

  • I've rewritten and re-sourced this paragraph. Sasata (talk) 09:02, 27 October 2012 (UTC)

Remove the mention of mass drug administrations in Prevention#Other methods per [4], which says, "this approach is not currently recommended". Prevention/treatment/diagnosis sections are designed to only contain what works/is recommended. Consider incorporating into the historical section instead? Biosthmors (talk) 23:37, 26 October 2012 (UTC)

  • Removed. I might include it in the history section later, or perhaps in a daughter article. Sasata (talk) 09:25, 27 October 2012 (UTC)

In War, the article says "cinchona bark and quinine proved to be inadequate to supply military personnel" while the source says "inability to procure or maintain adequate stocks of quinine". Perhaps supplies were adequate, just with low-inventory levels. Weaken to "inconsistent supplies of cinchona bark and quinine to military personnel" or something similar? Biosthmors (talk) 19:26, 28 October 2012 (UTC)

  • Done. Sasata (talk) 21:05, 28 October 2012 (UTC)

In History, the source "Early Origin and Recent Expansion of Plasmodium falciparum" could use updating to make sure the content is accurate. Biosthmors (talk) 23:03, 28 October 2012 (UTC)

  • Resourced to a 2011 review, with text amended. Sasata (talk) 17:30, 29 October 2012 (UTC)

In Epidemiology, the article says "Malaria is more common in rural areas than in cities; this is in contrast to dengue fever where urban areas present the greater risk" but the only spot the source mentions malaria is "Although A. aegypti was common in the Mediterranean region prior to World War II [19], it also disappeared from southern Europe and North Africa following this period. The reason for this is unclear, although it is probably attributable to malaria eradication efforts and widespread use of DDT [16]." I don't know why comparing/contrasting the epidemiology of malaria with dengue fever is necessary for even a FA. Remove? Biosthmors (talk) 23:19, 28 October 2012 (UTC)

  • Removed. Sasata (talk) 18:12, 29 October 2012 (UTC)

In Pathogenesis, the article says "The parasite switches between a broad repertoire of PfEMP1 surface proteins, thus staying one step ahead of the pursuing immune system". The closest thing I saw in the source was "The helices are decorated with a number of polymorphic flexible loops that are likely to be involved in ligand binding and immune evasion". The phrase "one step" is awkward, I think, because it implies one biochemical reaction. Resource? Biosthmors (talk) 23:32, 28 October 2012 (UTC)

  • Rewrote to "The parasite switches between a broad repertoire of PfEMP1 surface proteins, thereby avoiding detection by protective antibodies." and re-sourced the paragraph to a more appropriate review. Sasata (talk) 18:56, 29 October 2012 (UTC)

The sentence "Despite efforts to reduce transmission and increase treatment, there has been little change in which areas are at risk of this disease since 1992" should have a more recent source than 2004. Remove for now and maybe resource for FA? Covering overall death trends seem more pertinent than getting into the geography of it, though. Biosthmors (talk) 17:33, 29 October 2012 (UTC)

  • Removed. I'll add more recent epidemiology data before FAC. Sasata (talk) 19:28, 29 October 2012 (UTC)

In War, the newspaper cited for the biological warfare portion attributes this particular view to one historian. It is possible this is not a consensus view of history, so I think it is insufficient to verify the claim of its use in biological warfare as fact. Biosthmors (talk) 02:32, 29 October 2012 (UTC)

  • True that; I had difficulty finding corroborating opinions on this. Removed. Sasata (talk) 19:33, 29 October 2012 (UTC)

In Epidemiology, portions of a sentence -- "The Wellcome Trust, UK, has funded ... a more contemporary and robust means" -- are promotional in my opinion. We should cite facts from the article if they are relevant. Remove funding details? Source "a more contemporary and robust means" to a secondary source or remove? Extract relevant data from the source? Biosthmors (talk) 16:41, 29 October 2012 (UTC)

  • I kept the source but removed the promotional tone. Sasata (talk) 19:57, 29 October 2012 (UTC)

In Economic impact, "In some countries with a heavy malaria burden, the disease may account for as much as 40% of public health expenditure, 30–50% of admissions to hospital, and up to 50% of outpatient visits" is verified. But the wording and the sentence structure are very similar. Adapt/reorder/reword some more? Biosthmors (talk) 17:45, 31 October 2012 (UTC)

  • Reworded to "The disease has a heavy burden in some malaria-endemic countries, where it is responsible for up to 50% of outpatient visits, 30–50% of hospital admissions, and up to 40% of public health spending." Sasata (talk) 19:26, 31 October 2012 (UTC)

The portion in Vector control that begins with "A more targeted and ecologically friendly vector control strategy" and ends with "technological problems have hindered its effective deployment" doesn't appear to belong. If it doesn't work, or isn't recommended, reduce to a sentence and put in Research? Biosthmors (talk) 17:10, 29 October 2012 (UTC)

  • Trimmed a bit and moved to Research.

In Genetic resistance, the article should link to sickle cell trait at least once, and it should clarify the role between the trait (heterozygous form) and the disease (homozygous form). Biosthmors (talk) 22:12, 28 October 2012 (UTC)

  • Done. Sasata (talk) 22:35, 28 October 2012 (UTC)
  • The Hedrick source says, "The sickle-cell allele is widely known as a variant that causes red blood cells to be deformed into a sickle shape when deoxygenated in AS heterozygotes, in which A indicates the non-mutant form of the β-globin gene, and also provides resistance to malaria in AS heterozygotes. In SS homozygotes, S causes the severe disease sickle-cell anemia. It is generally assumed that individuals with genotype SS had very low or zero fitness when, or if, there was no modern medical care." The article currently says "The impact of sickle cell anemia on malaria immunity is of particular interest." But I don't think that is where the interest is. Sickle cell anemia is a redirect to sickle-cell disease (aka SS), whereas the protective sickle cell trait is AS. Change instances of sickle cell disease or anemia to sickle cell trait, where appropriate? Cite Hedrick instead of Barnes? Biosthmors (talk) 01:43, 29 October 2012 (UTC)
  • I've think I've fixed the errors with disease/allele/trait (also per Axl on the talk page), and replaced Barnes with Hedrick. Sasata (talk) 21:51, 31 October 2012 (UTC)

In Pathogenesis, the section ends with "Pregnant women are especially attractive to the mosquitoes, and malaria in pregnant women is an important cause of stillbirths, infant mortality and low birth weight,[28] particularly in P. falciparum infection, but also in other species infection, such as P. vivax.[29]" Move to complications section?

  • Done, and trimmed some duplicative life cycle info. Sasata (talk) 16:00, 30 October 2012 (UTC)

In the lead, "prevalent in tropical regions because significant amounts of rainfall" --> "prevalent in sub-tropical and tropical regions because rainfall" to generalize and make it more accurate? The body of the article could probably use adjusting too. Biosthmors (talk) 18:58, 30 October 2012 (UTC)

  • Done. Sasata (talk) 07:42, 31 October 2012 (UTC)

In Economic impact, "The slow demographic transition to lower birth and death rates in Africa may be partly attributed to malaria" is a pretty weak statement. After all, the source says neonatal disorders, diarrhea, and pneumonia kill more children. But I don't think that means this idea should be included in all of those articles. And the two places where malaria are mentioned in the discussion do not sound important for this article. "Total fertility rates were best explained by child mortality, as measured indirectly by infant mortality, in a 2007 study" sounds off-topic. Remove these two sentences due to weakness/questionable relevance? Biosthmors (talk) 20:02, 30 October 2012 (UTC)

  • Agree, done. Sasata (talk) 07:50, 31 October 2012 (UTC)

Chen Q, Schlichtherle M, Wahlgren M (2000). "Molecular aspects of severe malaria". should be replaced with a more recent source. Biosthmors (talk) 20:31, 30 October 2012 (UTC)

  • Replaced with a 2011 review, PubMed. Sasata (talk) 07:19, 31 October 2012 (UTC)

In Other methods, Mehlhorn H, Armstrong PM (2001). Encyclopedic Reference of Parasitology: Diseases, Treatment, Therapy. should be updated. Biosthmors (talk) 20:33, 30 October 2012 (UTC)

  • I've updated this to the 3rd edition (2008), which essentially says the same as the 2nd. Sasata (talk) 00:51, 1 November 2012 (UTC)

In Diagnosis, I couldn't verify "Rapid diagnostic tests that detect P. vivax are not as effective as those targeting P. falciparum" to the cited source. The source is mainly about pregnancy/placental malaria, and the article could mention that while peripheral blood is what is generally used, RDT and PCR are possibilties and placental histology is the gold standard. Biosthmors (talk) 22:48, 29 October 2012 (UTC)

  • I'm glad you're checking these so carefully! I've expanded the paragraph and re-sourced to a 2012 review. I decided not to mention any differences in diagnostics of placental malaria (there's so many details one could include, but I think it's better in most cases to leave details to the daughter article–feel free to disagree). Sasata (talk) 16:59, 30 October 2012 (UTC)
  • No problem. I figure with this important of a topic it deserves the attention. Biosthmors (talk) 23:02, 1 November 2012 (UTC)

In Economic impact, there is the more certain "Poverty is both a cause and effect of malaria", which is in contrast to what preceeds it. Weaken? Biosthmors (talk) 22:52, 1 November 2012 (UTC)

  • Now "Poverty can increase the risk of malaria, ..." Sasata (talk) 19:10, 6 November 2012 (UTC)

In Genetic resistance, sickle cell is introduced as possibly providing protection, then definitely providing protection. Reword for consistency? Perhaps "may provide resistance" --> "provide or may provide resistance"? Biosthmors (talk) 22:56, 1 November 2012 (UTC)

  • I just removed the waffling "may"; the sentence is stronger (and correct) without it. Sasata (talk) 18:32, 6 November 2012 (UTC)

In History, "The indigenous peoples of Peru made a tincture of cinchona to control malaria. The Jesuits noted the efficacy of the practice and introduced the treatment to Europe during the 1640s, where it was rapidly accepted" is problematic. The source describes its established use for fever control and attributes its antimalarial application to a serendipitous discovery. Also, it says "around 1640" which could mean before. The source also says the medication generated significant controversy and it wasn't until 1681 that it was universally accepted. Biosthmors (talk) 23:33, 29 October 2012 (UTC)

  • Now aligned more closely with the source. Sasata (talk) 16:00, 30 October 2012 (UTC)
  • Thanks. How about "malaria. The Jesuits introduced the treatment" --> "fever. Its effectiveness against malaria was found and the Jesuits introduced". I don't think we can definitely conclude American natives used it for malaria at that time. Biosthmors (talk) 23:02, 1 November 2012 (UTC)
  • Sounds good, done. Sasata (talk) 19:13, 6 November 2012 (UTC)

The first two paragraphs of text in Vector control are based on giving a historical overview, instead of focusing on what is recommended today. Put in History? Trim? Update? Biosthmors (talk) 17:26, 29 October 2012 (UTC)

  • I've trimmed some, moved some to History, and some to Eradication efforts. Sasata (talk) 06:40, 31 October 2012 (UTC)

Remove "Generally, these drugs are taken daily or weekly, at a lower dose than is used for treatment of a person who contracts the disease" per Wikipedia:MEDMOS#Drugs.2C_medications_and_devices, which says "Do not include dose, titration or pricing information except when they are extensively discussed by secondary sources, or necessary for the discussion in the article"? Biosthmors (talk) 17:30, 10 November 2012 (UTC)

  • Done. Sasata (talk) 18:50, 14 November 2012 (UTC)

In Genetic resistance, should the text say something like "thalassaemia traits" instead of "thalassemia" per Hedrick? This looks like it could be a similar case of what was happening with sickle cell anemia/trait earlier. Hedrick says, "detrimental genetic diseases, such as sickle-cell anemia, thalassemia" and "On the other hand, there are multiple variants that alter expression levels and provide protection within each of the categories known as α-thalassemia, β-thalassemia ..." Biosthmors (talk) 19:04, 10 November 2012 (UTC)

  • Agree, done. Sasata (talk) 18:50, 14 November 2012 (UTC)

In Signs and symptoms, rearrange "Severe malaria is usually caused by P. falciparum" to introduce the malaria type as P. falciparium malaria, per the source? Biosthmors (talk) 14:58, 31 October 2012 (UTC)

  • Also, this source is from 2003. It should be replaced. With such an important topic, I don't think it is best to be so far away from WP:MEDDATE. Biosthmors (talk) 17:13, 31 October 2012 (UTC)
  • I've replaced two of the four uses of this source with a 2012 review (will take a bit more digging to find sources to replace the other two instances). Is this what you had in mind to introduce the malaria type? Sasata (talk) 20:00, 31 October 2012 (UTC)
  • Sorry, I should have made that clearer. The source characterizes the time frame as specific to falciparium malaria. It doesn't have to be severe to manifest within this timeframe. Also, another parasite species that may cause severe malaria could present in different time frames, right? Biosthmors (talk) 23:24, 1 November 2012 (UTC)
  • I made these changes to clarify the time range as associated with falciparium malaria. I didn't want readers thinking severe vivax malaria exhibits the same time frame, becuase that's not what the source says/said. Any comments or concerns? Biosthmors (talk) 21:29, 5 November 2012 (UTC)
  • I've removed the word "typically" before 9–30 days, as the source says it's most commonly 9–14 days. Maybe this latter time frame should be included as well? Sasata (talk) 18:23, 6 November 2012 (UTC)


In Epidemiology, "global spatial limits of the disease and to assess disease burden" --> "global range of the disease" or "its global range"? Disease burden links to a page with a definition that is beyond the scope of the source, it appears. Biosthmors (talk) 21:46, 5 November 2012 (UTC)

  • Assessing disease burden is an important aspect of the malaria mapping initiative, so I've added another source to the sentence that should emphasize this association. Sasata (talk) 18:23, 6 November 2012 (UTC)

"Malaria attributable to the HIV-1 epidemic, sub-Saharan Africa", used in Signs and symptoms#Complications, is a primary source but the sentence itself is cited to a recent review. However, might there be a bit of OR through linking the two? Also "an effect which from" is unclear prose. Biosthmors (talk) 23:59, 22 October 2012 (UTC)

  • That article (PubMed) is marked as a review for me. Have reworded the prose and included the word "may" to match the uncertainty in the conclusions of the cited review. Sasata (talk) 16:59, 23 October 2012 (UTC)
  • I'm trying to find a sentence in here that says something along the lines of "an increased viral HIV viral load during malaria infection may cause death". That's what I'm trying to verify. Is that what you're trying to say? Biosthmors (talk) 22:47, 15 November 2012 (UTC)
  • Ok, understood. Yeah, in retrospect I connected the two in an unacceptable OR-y fashion. How about I just trim the sentence to just "Coinfection with HIV and malaria increases mortality." and leave the possible reasons out? Sasata (talk) 18:59, 16 November 2012 (UTC)
  • Sounds good, thanks. Biosthmors (talk) 19:01, 16 November 2012 (UTC)
  • Done. 19:25, 16 November 2012 (UTC)

In Cause#Life cycle, the sentences "A sporozoite travels in blood vessels to liver cells, where it reproduces asexually. Some offspring (called merozoites) enter red blood cells and liver cells, where they divide asexually." start introducing a level of complexity that needs more verification, in my opinion. Do some sporozoites leave liver cells as merozoites to enter other liver cells as merozoites? It's a bit unclear what we're supposed to think as readers. Biosthmors (talk) 18:47, 26 October 2012 (UTC)

  • I've worked on this paragraph, hopefully it flows better. I still need to figure out how to optimize/trim the repeating information in "Life cycle", the image caption, and "Pathogenesis". Sasata (talk) 07:32, 27 October 2012 (UTC)

In Prevention#Medications, the article seems to understate the source a bit. Right now the article says "mefloquine is associated with higher rates of neurological and psychiatric symptoms". But the abstract of the source says "we also found 22 published case reports of deaths, including five suicides, associated with mefloquine use at normal dosages. No other currently used drugs were reported as causing death, at normal dosages". Rephrase to convey the seriousness of these reported adverse events? Biosthmors (talk) 18:04, 31 October 2012 (UTC)

  • I changed the relative "higher" to the absolute "high"; do you think this will suffice? Sasata (talk) 20:41, 31 October 2012 (UTC)
  • How about "mefloquine is associated with death, suicide, and higher rates of neurological and psychiatric symptoms"? Biosthmors (talk) 22:34, 15 November 2012 (UTC)
  • Done. Sasata (talk) 19:25, 16 November 2012 (UTC)

If you happen to have a copy of Gay 2012 could you email it to me? PMID 22386676. Thanks. Biosthmors (talk) 22:19, 15 November 2012 (UTC)

  • Switched out the Gay citations to an open-access review to make it easier to verify. Sasata (talk) 16:58, 16 November 2012 (UTC)

Can we round up "and up to 29% of pregnant women" to 30% in complications? It just seems odd to see all the other stats in the paragraph ending in 0 or 5 then that one. Biosthmors (talk) 22:42, 15 November 2012 (UTC)

  • Hmmm, this one I'd prefer leave as is; I don't think it's a good idea to change stats from the source just so they don't offend our sense of aesthetics ;-) Sasata (talk) 19:31, 16 November 2012 (UTC)
  • Fine by me! Silly I am. I thought the slightest annoyance deserved attention at a good article nomination. Thanks for your patience. =) Biosthmors (talk) 19:35, 16 November 2012 (UTC)

In Prevention, maybe we should remove the sentence that says "Many countries are seeing an increasing number of imported malaria cases owing to extensive travel and migration". It's a 2006 source and the 2012 Lancet study gave decreasing statistics globally. It might not be considered a factual statement according to the recent literature. Biosthmors (talk) 23:26, 15 November 2012 (UTC)

  • Good call – according to PubMed, this trend has been reversing in recent years. Deleted. Sasata (talk) 20:01, 16 November 2012 (UTC)

"The longest incubation period reported for a P. vivax infection is 30 years" is sourced to a 2003 paper. Update? It might be inaccurate now. Biosthmors (talk) 17:22, 16 November 2012 (UTC)

I've removed it; the most recent review on the subject (PMC 3228849) doesn't make any such extraordinary claims, instead restricting themselves to saying "Sometimes the latency could be as long as one year, and there were well documented, but apparently unusual, cases reported of latencies greater than two years." Sasata (talk) 20:25, 16 November 2012 (UTC)

In vector control, the source for "As of 2006, the World Health Organization advises the use of 12 insecticides in IRS operations, including DDT as well as alternative insecticides (such as the pyrethroids permethrin and deltamethrin)" didn't mention permethrin. Cyfluthrin was listed. I'm not sure why the phrase "alternative insecticides" is necessary. Reword to replace permethrin and remove "alternative insecticides"? Biosthmors (talk) 17:48, 16 November 2012 (UTC)

  • Done. Sasata (talk) 20:33, 16 November 2012 (UTC)

Okay, seriously. Reviews are not supposed to take over two weeks. This is hitting the six month mark. Pass or fail it, please, before someone else has to. --Rschen7754 03:21, 17 November 2012 (UTC)

As you can see from this series of edits[5], we are still actively going through the article to ensure it meets the good article criteria. Two dedicated people are happily improving the content of this important global disease to make sure it meets the good article criteria, for whatever that's worth! Biosthmors (talk) 15:55, 17 November 2012 (UTC)
No, this is more like a FA review, to be honest. See WT:GAN. --Rschen7754 19:17, 17 November 2012 (UTC)
Thanks. I commented there. Biosthmors (talk) 20:15, 17 November 2012 (UTC)
I am passing the article. Please see WP:GAN: "The review process itself should take, at most, two weeks." Please also see WP:GAN/R where you are the outlier by far. GAN is supposed to be a lightweight review, not a six month-long drawn out thing. --Rschen7754 20:17, 17 November 2012 (UTC)
I've reverted your actions. If if matters so much to you, I'll withdraw this GA review, work on it and resubmit later. Sasata (talk) 20:39, 17 November 2012 (UTC)
This review has far exceeded the GA standards. The consensus at WT:GAN is to promote it, because the reviewer has failed to do so in a reasonable amount of time. --Rschen7754 20:46, 17 November 2012 (UTC)
Then I withdraw this review. Sasata (talk) 20:47, 17 November 2012 (UTC)
This is completely unnecessary. The article is at GA standards already. --Rschen7754 20:48, 17 November 2012 (UTC)

Ideas for FA[edit]

I've removed the word "typically" before 9–30 days, as the source says it's most commonly 9–14 days. Maybe this latter time frame should be included as well? Sasata (talk) 18:23, 6 November 2012 (UTC)

Something to think about. Biosthmors (talk) 22:30, 15 November 2012 (UTC)

Kajfasz P (2009). "Malaria prevention". International Maritime Health 60 (1–2): 67–70. PMID 20205131 mentions DEET as being preffered with picaridin-based repellents also effective. Incorporate into Vector control? Biosthmors (talk) 17:08, 10 November 2012 (UTC)

It seems we should get at least a paragraph of detail in Prevention#Medications (with perhaps an adjacent map) of what areas/drugs are recommended/disadvised. This source makes a big point of making these distinctions. Biosthmors (talk) 17:15, 10 November 2012 (UTC)
This source also says there are "numerous mistakes with prophylaxis" in the conclusion, which could be incorporated into a future clinical practice section. Biosthmors (talk) 17:18, 10 November 2012 (UTC)
And that about 900 in Europe died in a span of recent years. Epi-worthy. Biosthmors (talk) 17:23, 10 November 2012 (UTC)
Some numbers on this: "Approximately 110 countries endemic for malaria are visited by 125 million international travellers every year, and more than 30,000 of them contract malaria [1]." could be in Epi. Biosthmors (talk) 17:27, 10 November 2012 (UTC)
I can't access this source; might you be able to email it to me? Sasata (talk) 19:45, 14 November 2012 (UTC)
Sure, when I get it. Maybe we're having the same issue. The url from PubMed doesn't pull up the PDF like it did before. Biosthmors (talk) 03:51, 15 November 2012 (UTC)

In History, I think "The malarial parasite was called Plasmodium by the Italian scientists Ettore Marchiafava and Angelo Celli." is verified. All that the source says is something like "Plasmodium, Marchiafava and Celli, 1885." I guess they got to name it? Biosthmors (talk) 17:41, 31 October 2012 (UTC)

  • Yes, the names given after a taxon are the authors ("authority") and tell who first named it (see binomial nomenclature). Now that you mention it, I'm thinking that this sentence is unnecessary detail for this overview article? Sasata (talk) 19:05, 31 October 2012 (UTC)
  • Removed (this info is already in the history article). Sasata (talk)

In Vector control, it is stated that ~13% of sub-Saharan homes have nets. Are there any estimates on what % of them use them? Or reasons as to why they do not? Biosthmors (talk) 19:38, 5 November 2012 (UTC)

In other methods, add that prengnant women/infants can also be targeted for intermittent preventive treatment (doi:10.1517/14656566.2012.703651). Biosthmors (talk) 18:15, 31 October 2012 (UTC)

  • Added. Sasata (talk) 07:34, 1 November 2012 (UTC)

I remember seeing the WHO estimate ~107 countries had endemic malaria in 2010. If this is right then "As of 2010, 99 countries have endemic malaria" could be also cited to that and generalized to about 100. Biosthmors (talk) 20:39, 30 October 2012 (UTC)

  • Done. Sasata (talk) 08:07, 31 October 2012 (UTC)

In Epidemiology, giving the context that malaria "is responsible for at least one in every five child deaths in sub-Saharan Africa"[6] (not the best source to cite) would be good. Mentioning the other causes would be good too I think. Biosthmors (talk) 19:49, 30 October 2012 (UTC)

A section such as "Clinical practice" may be worthy to document clinical practice and the reception of those practices. For example, "Although other studies from Africa have noted that access to laboratory testing is an important barrier to testing, the findings of the Ghana study are similar to those of other studies regarding the use of tests to guide treatment of patients with malaria, as well as the WHO finding of overprescription of antimalarial drugs despite widespread use of diagnostic tests." is mentioned in doi:10.1093/cid/cis228. Biosthmors (talk) 19:14, 30 October 2012 (UTC)

Along the same lines, this source concludes that "It would be a wiser use of resources to direct future efforts on improving access to these tests and how they are used to guide treatment, rather than pursuing ever-diminishing incremental improvements in diagnostic sensitivity and specificity." These types of expert opinions would be valuable to include in the article. Biosthmors (talk) 19:18, 30 October 2012 (UTC)

doi:10.1111/j.1469-0691.2011.03639.x is a 2011 review on diagnosis that could be incorporated. Biosthmors (talk) 19:04, 30 October 2012 (UTC)

Other useful images may be found at [7][8]. Biosthmors (talk) 18:33, 30 October 2012 (UTC)

"use human blood as a means to provide nourishment for their developing eggs" was mentioned in doi:10.1002/anie.200400663. While not the ideal source, perhaps, this way of presenting the parasite to readers could be useful. Biosthmors (talk) 23:08, 29 October 2012 (UTC)

That malaria was brought to the New World by Europeans is mentioned in the same source. That's a fact worth incorporating. Biosthmors (talk) 23:25, 29 October 2012 (UTC)

Draining marshes would logically cause ecological harms to some sorts of amphibians, fish, reptiles, or bird species and so it deserves a mention if it is discussed in sources. Biosthmors (talk) 17:15, 29 October 2012 (UTC)

The company Sanaria and their work might be worth a mention in research per coverage in Biosthmors (talk) 16:28, 29 October 2012 (UTC)

  • Done. Sasata (talk) 19:44, 6 November 2012 (UTC)

Use consistent definitions for the words "eradicate" (worldwide) and "eliminate" (localized areas)? In Eradication efforts, there is "Malaria has been successfully eradicated in certain areas." Biosthmors (talk) 23:15, 26 October 2012 (UTC)

  • Done (although sources don't seem to use these terms consistently). Sasata (talk) 19:30, 14 November 2012 (UTC)

In Prevention#Vector control, the cited source for the first paragraph doesn't support the entire paragraph. There is a sentence in the article that says "In some areas, the draining of wetland breeding grounds and better sanitation were adequate." Is that, or parts of the paragraph, common knowledge? Might some of this be OR? The source just says malaria was eliminated and the elimination program used X, Y, and Z. Biosthmors (talk) 23:44, 16 October 2012 (UTC)

  • I've added a new source and changed the text to better align with the source. Sasata (talk) 07:14, 17 October 2012 (UTC)
  • The source[9] cited for the sentence "Malaria was eliminated from most parts of the USA in the early 20th century by such methods, and the use of the pesticide DDT and other means eliminated it from the remaining pockets in the South by 1951" doesn't explicitly say DDT or other methods were responsible, does it? I want us to avoid the possibility of original research. Also, the source appears to be primary, so it could probably use replacing with a secondary source anyways. Biosthmors (talk) 22:56, 17 October 2012 (UTC)
  • From the source: "The program commenced operations on July 1, 1947. It consisted primarily of DDT application to the interior surfaces of rural homes or entire premises in counties where malaria was reported to have been prevalent in recent years." The "South" is mentioned earlier: "The center was located in Atlanta (rather than Washington, DC) because the South was the area of the country with the most malaria transmission." "Other methods" is supported by this sentence: "It also included drainage, removal of mosquito breeding sites, and spraying (occasionally from aircrafts) of insecticides. Total elimination of transmission was slowly achieved." How does a CDC summary count as a primary source? Sasata (talk) 16:59, 18 October 2012 (UTC)
  • Isn't it primary because it is their history? Biosthmors (talk) 17:01, 18 October 2012 (UTC)
  • Ok, maybe it's secondary with COI :) I'll see if I can find something to replace this. Sasata (talk) 17:03, 18 October 2012 (UTC)
  • I guess it would have made more sense had I suggested an independent source. =) Biosthmors (talk) 17:06, 18 October 2012 (UTC)
  • What do you think about PMC 1253858 as a source? It's not listed as a "review" in pubmed as such, but it clearly is a review (and calls itself a "brief historical review" in the introduction). Although it's old, it covers most of the points in the sentence it would be citing (would have to change the text a bit in some places; it doesn't, for example, explicitly give 1951 as the year of elimination), and the author was associated with the WHO, not the CDC (and honestly, I don't think this material is contentious or likely to be challenged). Sasata (talk) 17:27, 18 October 2012 (UTC)
  • Done. Sasata (talk) 18:03, 18 October 2012 (UTC)
  • I'm not going to let this affect the GA review, but on second thought, I think we need something from the 2000s. For those who look to this page to understand how malaria can be prevented should have the convenience of us citing the best possible sources, and I think that means citing something more recent. Biosthmors (talk) 23:43, 22 October 2012 (UTC)
  • Will keep looking for a more recent source. Sasata (talk) 16:59, 23 October 2012 (UTC)

Switch with the life cycle picture in Or maybe include,_sporozoite,_merozoite.png somehow? It seems things should be rearranged a little bit to match the prose. Also, putting arrows on some of the microscopic pictures to identify particular aspects, like ring forms/gametocytes, could be helpful. Biosthmors (talk) 19:31, 16 October 2012 (UTC)

  • I move the life cycle diagram to the proper location. Will look at more closely at image selection, layout, and other similar tweaks before FAC. Sasata (talk) 06:29, 22 October 2012 (UTC) might be best suited for the top of the article. It catches my eye, at least. The caption could be worded something like this: "A Plasmodium in the form that enters humans and other vertebrates from the saliva of female mosquitoes (a sporozoite) traverses..." Biosthmors (talk) 22:42, 16 October 2012 (UTC)
Sure, we'll give it a try, swapped positions. Sasata (talk) 07:35, 17 October 2012 (UTC)

In Epidemiology, maybe a sentence on the three highest countries from the 2012 Lancet study would be appropriate at the end after "As of 2010, countries with the highest death rate per 100,000 population are Ivory Coast with 86.15, Angola (56.93) and Burkina Faso (50.66) – all in Africa". Biosthmors (talk) 19:17, 16 October 2012 (UTC)

  • I'm not sure what the stats mean, exactly. The source says, "Cumulative probability of dying from malaria in the absence of all other causes from birth to age 80 years in 2010." So this isn't a mortality rate, see Mortality_rate#Statistics for comparison. I reworded this because I thought it could be misunderstood. Biosthmors (talk) 20:59, 23 October 2012 (UTC)

In Epidemiology, the systematic analysis ("Global malaria mortality between 1980 and 2010: a systematic analysis") estimates that children under 5 in Africa experienced "699 000 (415 000–1 112 000) deaths in 2010." Children under 5 outside of Africa experienced "15 000 (4300–31 000) [deaths] in 2010." If we have a recent secondary source that cites the 2012 paper and wants to say that this amounts to most deaths depsite the wide confidence intervals, then OK. The 2012 paper says "Our findings show substantially more deaths across all ages and regions than the World Malaria Report 201121 assessment for 2010: 1·3 times higher for children younger than 5 years in Africa, 8·1 times higher for those aged 5 years or older in Africa, and 1·8 times higher for individuals of all ages outside of Africa." The 2012 paper suggests things can change significantly in 6 years, so I don't think we should be citing the 2005 paper in the Lancet about where most of the cases come from. Replace? Biosthmors (talk) 18:29, 16 October 2012 (UTC)

  • Ok; I've replaced this stat with the 65% deaths under 15 years old from the 2012 Lancet article. Sasata (talk) 07:26, 17 October 2012 (UTC)

Trends in the global malaria burden/death count are mentioned in doi:10.1016/S0140-6736(12)61127-1 "As with HIV, overall frequency of malaria has decreased, from 233 million cases in 2000, to 216 million cases in 2010. Over the same period deaths from malaria have fallen by more than a third—from nearly 985 000 to 655 000—according to WHO.73 A more recent estimate suggests more deaths and even greater rate of reduction (from 1·8 million deaths in 2004, to 1·1 million deaths in 2010) with technology playing a key part in this progress, most notably artemisinin-based combination therapies and insecticide-treated bednets.74" This type of content would be great because it suggests which interventions are likely to produce results. Biosthmors (talk) 23:12, 15 October 2012 (UTC)

There is also more content in this source. I suggest it be incorporated into the article. Biosthmors (talk) 23:18, 15 October 2012 (UTC)
I added the epidemiological trends and some other details from this article. Anything else you think should be included? Sasata (talk) 20:45, 14 November 2012 (UTC)

The article mentions the issue of funding difficulties in less-developed regions. Is there any estimate on total governmental/NGO/charity spending on malaria prevention per year and trends? And perhaps a comparision with HIV prevention funding would be nice too. Biosthmors (talk) 22:23, 15 October 2012 (UTC)

"Global malaria mortality between 1980 and 2010: a systematic analysis" has a helpful paragraph that mentions funding the danger of the financial crisis to disturb recent improvements in malaria mortality. Biosthmors (talk) 18:22, 16 October 2012 (UTC)

In Pathogenesis#Genetic resistance, it says "it is thought to have placed the greatest selective pressure on the human genome in recent history". If sources say it has "placed the greatest selective pressure on the human genome in recent history" then we can just cite it as fact and remove "it is thought". Biosthmors (talk) 21:50, 15 October 2012 (UTC)

  • Done. Sasata (talk) 08:51, 16 October 2012 (UTC)

In Cause#Life cycle, readers are presented with the information "Anopheles mosquitoes eventually carry Plasmodium sporozoites in...". My emphasis. Then there are lots more of these fancy words. Maybe we should get some explanatory prose in a summary style paragraph of how Apicomplexa lifecycle stages apply to malaria. That way readers aren't put off by all the new vocabulary. Biosthmors (talk) 01:58, 9 October 2012 (UTC)

  • Rewrote the intro paragraphs of that subsection; how's this? Sasata (talk) 09:16, 16 October 2012 (UTC)
  • Much clearer, thanks. Biosthmors (talk) 18:49, 16 October 2012 (UTC)

The paragraph in the Signs and symptoms#Complications portion that starts with "Coinfection with HIV and malaria does increase mortality, although this is less of a problem than with HIV/tuberculosis coinfection..." seems overly focused on comparing things to HIV/TB. I'm not sure this matters at all to readers. I'd suggest removing it and clarifying the most important facts about HIV/malaria. Biosthmors (talk) 23:22, 8 October 2012 (UTC)

  • Done. Sasata (talk) 09:34, 16 October 2012 (UTC)

Taylor 2012, "Respiratory Manifestations of Malaria" gives case counts for Western Europe and the Americas, which should be in the Epidemiology section for comparison. Biosthmors (talk) 23:22, 8 October 2012 (UTC)

  • Added. Sasata (talk) 08:08, 11 October 2012 (UTC)

Tertian malaria is a term that could use some classification in a new classification section perhaps (and cerebral, severe, etc.). Biosthmors (talk) 21:31, 27 September 2012 (UTC)

The phrase benign malaria seems to have been popular. Not sure how much now. As is benign tertian malaria, though the 2010 review "Current status of Plasmodium vivax vaccine" suggests P. vivax isn't so benign. Biosthmors (talk) 21:43, 27 September 2012 (UTC) shouldn't be sourced to WebMD, ideally, it should be sourced to a traditional MEDRS. Biosthmors (talk) 21:03, 26 September 2012 (UTC)

  • Done. Sasata (talk) 06:06, 27 September 2012 (UTC)

Some facts and background on "several species of Plasmodium from higher apes" and "P. knowlesi, a zoonotic species that causes malaria in macaques", could go into the in other animals section for comprehensiveness. Biosthmors (talk) 21:01, 26 September 2012 (UTC)

The WHO site has an expected timeline on a vaccine under development. As research directions is a section, we could use some more detail on what is expected in 2014 or 2015. Or another source might have a more updated timeline. Biosthmors (talk) 20:11, 26 September 2012 (UTC)

  • Good idea, now added. Based on this, it looks like they will be updating this timeline in early 2013. Sasata (talk) 06:27, 27 September 2012 (UTC)

Nadjm 2012 mentions that at least 2000 die daily as a big take home summary bullet point. This method of presenting the statistics should probably be presented in the lead to make it a bit more real for readers. Biosthmors (talk) 20:52, 25 September 2012 (UTC)

  • I added this, but am not sure how they get a value of "more than 2000 people every day" when the WHO 2010 source they use gives "655 000 malaria deaths in 2010"? Sasata (talk) 05:55, 27 September 2012 (UTC)

See if the paragraph sourced to Sachs J, Malaney P (2002). "The economic and social burden of malaria". Nature 415 (6872): 680–5. doi:10.1038/415680a. PMID 11832956. can be updated with a more recent (and perhaps better) source that estimates the degree of causality? Biosthmors (talk) 20:52, 25 September 2012 (UTC)

Infant mortality caused by malaria deserves a paragraph of discussion, I would think, to be comprehensive. Biosthmors (talk) 02:09, 19 September 2012 (UTC)

My fault for linking you to a review by the same researchers, but the "Poisoning Pyridoxal 5-Phosphate-Dependent Enzymes: A New Strategy to Target the Malaria Parasite Plasmodium falciparum" content in the Research section shouldn't be cited to a review by the same researchers as they are not independent. Biosthmors (talk) 19:08, 15 September 2012 (UTC)

  • I trimmed out some of the biochemical details, and doubled up the citation with another review. Sasata (talk) 06:58, 22 October 2012 (UTC)

In Society and Culture#Economic impact, include sources that discuss lost tourism revenue? I imagine malaria can discourage tourism. Biosthmors (talk) 20:33, 13 September 2012 (UTC)

In the prognosis section, specify how often the most severe case of the disease occurs. Readers may wonder if it is 1% or 10% of the time. Biosthmors (talk) 18:29, 27 August 2012 (UTC)

Incorporate epidemiological data for severe/uncomplicated malaria if available. Biosthmors (talk) 22:31, 27 July 2012 (UTC)

"Severe malaria is much less of a problem in adolescents than in younger children.", for example. doi:10.1016/S1473-3099(06)70655-7 Biosthmors (talk) 21:38, 30 October 2012 (UTC)

In general, I think the prevention section could be improved by focusing on what works today and I guess some detail on why it works. For example, are mosquito nets, vector control and indoor residual spraying commonly employed together? Or are some areas of the world targeted with just one of those methods for some reason? Maybe we can split out the historical details such as the DDT and malaria content to other sections of the article. Biosthmors (talk) 19:38, 27 June 2012 (UTC)

  • Thanks for the comment and link. I think this type of big picture info should be described. Biosthmors (talk) 20:46, 2 July 2012 (UTC)
  • Big picture discussion is good; do you think this would fit better in the subsection "Eradication efforts"? Sasata (talk) 07:11, 4 July 2012 (UTC)
  • Hmmm... I was thinking prevention but if there are current eradication programs discussed in secondary sources I think their details (geography/strategy/funding/logistics) should be mentioned in the prevention section under a subheading. Biosthmors (talk) 20:01, 5 July 2012 (UTC)
  • I think the section should ideally be written so that if a philanthropist or a public health worker wants to prevent malaria, they would have some more concrete ideas on what to do or where resources should be allocated (more on what works and why). Biosthmors (talk) 19:29, 1 August 2012 (UTC)

Under #Genetic resistance I would put the speculative sentence ("A number of diseases may provide some resistance to it including...") at the end. In regards to sickle cell, it goes in to detail about why the homozygotes would benefit though they do not in the end. So that seems like it should be trimmed. Biosthmors (talk) 20:23, 23 May 2012 (UTC)

This reviewdoi:10.1038/hdy.2011.16 says this reviewdoi:10.1016/j.gene.2010.07.008 is excellent on the mechanisms so it may work well to help support the section. It has sections on a variety of mechanisms besides the sickle-cell trait. Biosthmors (talk) 21:28, 27 July 2012 (UTC)
I think the section may benefit from some more explanatory text on the other mechanisms of resistance. Biosthmors (talk) 19:29, 1 August 2012 (UTC)


In "The WHO has estimated that malaria annually causes over 200 million cases of fever" We need to mention the year the data is from as these number frequently change over time.Doc James (talk · contribs · email) 13:03, 11 June 2012 (UTC)

  • Done. Used 2010 data. It might be a worthwhile idea to make a graph showing number of episodes and deaths using WHO data going back however many years. Something to think about for FAC. Sasata (talk) 15:43, 14 June 2012 (UTC)


  • It is stated that "saliva and urine have been investigated as alternative, less invasive specimens" but what the conclusions are is not mentioned. If this is not in clinical practice than it should be moved to the section on research.
  • I can't find any reviews that discuss this, so to avoid the research section becoming a dumping ground for unsubstantiated primary research, I removed it completely. There's probably a place for it in the daughter article. Sasata (talk) 16:35, 14 June 2012 (UTC)
  • "Severe malaria" is mentioned a few times but never defined. It should be defined in the diagnosis section. There are WHO clinical and lab criteria. Doc James (talk · contribs · email) 12:26, 11 June 2012 (UTC)
It looks like "severe malaria" is now defined in the diagnosis section.Rytyho usa (talk) 22:08, 15 August 2012 (UTC)

Other methods[edit]

  • Where is the evidence to support this?

Education in recognizing the symptoms of malaria has reduced the number of cases in some areas of the developing world by as much as 20%. Recognizing the disease in the early stages can also stop the disease from becoming a killer. Education can also inform people to cover over areas of stagnant, still water e.g. water tanks which are ideal breeding grounds for the parasite and mosquito, thus cutting down the risk of the transmission between people. This is most put in practice in urban areas where there are large centers of population in a confined space and transmission would be most likely in these areas.

  • Now reworded and sourced. Sasata (talk) 19:53, 12 June 2012 (UTC)
  • Per "mass drug administrations". Yes but does it work?
    • The cited source (doi:10.1371/journal.pmed.1000402} says it has, when endemic in isolated "islands", but not in contiguous areasLeadSongDog come howl! 06:35, 28 June 2012 (UTC)
    • I've added a couple of sentences discussing the efficacy of MDA and intermittent preventive therapy. Sasata (talk) 15:55, 10 September 2012 (UTC)
  • Until something has secondary sources to support active use it should be in the research section e.g.

Furthering attempts to reduce transmission rates, a proposed alternative to mosquito nets is the mosquito laser, or photonic fence, which identifies female mosquitoes and shoots them using a medium-powered laser.[63] The device is currently undergoing commercial development, although instructions for a DIY version of the photonic fence have also been published.[64]

Doc James (talk · contribs · email) 12:54, 11 June 2012 (UTC)

  • This has been removed. Sasata (talk) 06:20, 12 June 2012 (UTC)


For a major disease like this all references should be secondary sources from the last 5 years (at most 10) per WP:MEDRS.

  • This is a primary source look at 290 children, one cannot conclude from this that "In endemic areas, treatment is often less satisfactory and the overall fatality rate for all cases of malaria can be as high as 10%."
  • I've removed this statement and the source. Sasata (talk) 18:31, 14 June 2012 (UTC)

Doc James (talk · contribs · email) 13:07, 11 June 2012 (UTC)

  • Now replaced with the Nadjm 2012 review. Sasata (talk) 18:03, 19 June 2012 (UTC)

Verifiable — criterion 2[edit]

I will be going through the article to gauge verifiability. I'll develop a list of verified facts here. Any concerns I develop I'll put above in comments. Biosthmors (talk) 20:30, 28 September 2012 (UTC)

  1. "However, symptoms may occur later in those who have taken antimalarial medications as prevention" checks out because the primary source says "In 134 of these cases (44.7 percent), the illness developed more than two months after the traveler's return". Biosthmors (talk) 21:56, 27 September 2012 (UTC)
  2. "In drier areas, outbreaks of malaria have been predicted with reasonable accuracy by mapping rainfall" in Epidemiology is verified. Biosthmors (talk) 00:27, 23 October 2012 (UTC)
  3. "According to Joseph Patrick Byrne, "Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns."" is verified. Biosthmors (talk) 20:41, 24 October 2012 (UTC)
  4. Counterfeits in China is verified by "it became clear the counterfeit artesunate situation was worsening in the Greater Mekong Sub-Region of South East Asia (comprising Cambodia, Lao People's Democratic Republic, Myanmar, Thailand, Vietnam, and Yunnan Province in the People's Republic of China)." Biosthmors (talk) 20:46, 24 October 2012 (UTC)
  5. That P. knowlesi is in macaques is verified.[10] No copyright on that source ("Plasmodium knowlesi: A Malaria Parasite of Monkeys and Humans" -- U.S. government) but not openly accessible from the publisher. Biosthmors (talk) 20:53, 24 October 2012 (UTC)
  6. "Malaria is typically diagnosed by the microscopic examination of blood using blood films or using antigen-based rapid diagnostic tests" is verified. Biosthmors (talk) 22:47, 28 October 2012 (UTC)
  7. "This public health use of small amounts of DDT is permitted under the Stockholm Convention on Persistent Organic Pollutants (POPs), which prohibits the agricultural use of DDT" is verified. Biosthmors (talk) 23:35, 28 October 2012 (UTC)
  8. "As of 2010, countries with the highest death rate per 100,000 population were Ivory Coast with 86.15, Angola (56.93) and Burkina Faso (50.66)." is verified. Biosthmors (talk) 23:40, 28 October 2012 (UTC)
  9. "The drawback of this practice, however, is overdiagnosis of malaria and mismanagement of non-malarial fever, which wastes limited resources, erodes confidence in the health care system, and contributes to drug resistance" is verified. Biosthmors (talk) 23:51, 28 October 2012 (UTC)
  10. "artesunate has been shown to be superior to quinine in both children and adults" is verfied. Biosthmors (talk) 02:38, 29 October 2012 (UTC)
  11. "The term malaria originates from Medieval Italian: mala aria — "bad air"; the disease was formerly called ague or marsh fever due to its association with swamps and marshland" is largely verified. Biosthmors (talk) 16:23, 29 October 2012 (UTC)
  12. "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" is verified. Biosthmors (talk) 23:38, 29 October 2012 (UTC)
  13. "Malaria in pregnant women is an important cause of stillbirths, infant mortality and low birth weight,[12] particularly in P. falciparum infection, but also in other species infection, such as P. vivax.[13]" is verified. Biosthmors (talk) 21:22, 30 October 2012 (UTC)
  14. " Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms" is verified. Biosthmors (talk) 21:24, 30 October 2012 (UTC)
  15. "although [hypnozoites] in P. ovale is uncertain" is verified. Biosthmors (talk) 21:26, 30 October 2012 (UTC)
  16. " proliferation of substandard antimalarial medicines resulting from inappropriate concentration of ingredients, contamination with other drugs or toxic impurities, poor quality ingredients, poor stability and inadequate packaging" is verified. Biosthmors (talk) 18:31, 31 October 2012 (UTC)
  17. "Some survivors of cerebral malaria have an increased risk of neurological and cognitive deficits, behavioural disorders, and epilepsy." is verified. Biosthmors (talk) 02:24, 10 November 2012 (UTC)
  18. "In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia" is verified. Biosthmors (talk) 17:32, 16 November 2012 (UTC)
  19. "This effort led to the publication of a map of P. falciparum endemicity in 2010" is verified. Biosthmors (talk) 20:44, 16 November 2012 (UTC)

1/3 of malaria drugs fail chemical analysis in Southeast Asia and sub-Saharan Africa[edit]

See this review [11]. Lots of commentary on the implications in newspapers. Some expert should probably summarize and put into the article. Academica Orientalis (talk) 15:40, 23 May 2012 (UTC)

I appended a short paragraph to the "Counterfeit drugs" subsection (although I don't claim to be an expert!) Thanks for your note. Sasata (talk) 16:46, 23 May 2012 (UTC)

Pill that makes person's blood poisonous to mosquitos[edit]

Perhaps the pill that makes a person's blood poisonous to humans should be mentioned in the article. It's appearantly made by a team led by Bart Knols. See , (talk) 13:35, 31 May 2012 (UTC)

Do you know of any secondary WP:MEDRS that cover the topic? Biosthmors (talk) 19:36, 6 June 2012 (UTC)


Doc James (talk · contribs ·email) 03:55, 23 December 2010 (UTC)

We are in luck. A new general review on this topic has just been published. Nadjm, B; Behrens, RH (2012 Jun). "Malaria:: an update for physicians.". Infectious disease clinics of North America 26 (2): 243–59. PMID 22632637.  Check date values in: |date= (help) Doc James (talk · contribs · email) 15:41, 15 June 2012 (UTC)
  • I'll read it and update this article soon. Sasata (talk) 16:16, 15 June 2012 (UTC)

This doesn't appear to be used either Doc James (talk · contribs · email) 17:29, 15 June 2012 (UTC)

Reference formatting[edit]

The formatting of references we are using in this article is not supported by Wikipedia's in other languages. It is a pain for this project [12]. Thus I propose we switch it back to how it was. Doc James (talk · contribs · email) 16:19, 15 June 2012 (UTC)

I think we could keep this easier-to-maintain format here, and switch back to the "old style" for other Wikipedias. It's simply a matter of moving the refs back into the article text, about 20 minutes of work. Sasata (talk) 16:34, 15 June 2012 (UTC)
The other issue is that this will make updating of the other languages more difficult going forwards. I remember discussing this somewhere but to do remember what the conclusion was before. Ah yes was here [13] with no real conclusion.
I disagree that this new format is easier to maintain. And with it being used less commonly than other styles will cause more confusion for new editors. Doc James (talk · contribs · email) 16:40, 15 June 2012 (UTC)
So can we can us both formats until discussion has concluded. Doc James (talk · contribs · email) 17:19, 15 June 2012 (UTC)

2012 ref[edit]

  • Nadjm, B; Behrens, RH (2012 Jun). "Malaria: an update for physicians.". Infectious disease clinics of North America 26 (2): 243–59. PMID 22632637.  Check date values in: |date= (help) Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 02:58, 25 July 2012 (UTC)

Wikipedia articles about Malaria[edit]

In the future, I think the article Prevention of malaria should be created, where social and historical issues could be discussed in depth. Malaria prophylaxis could probably be merged into that article. Biosthmors (talk) 20:26, 27 July 2012 (UTC)

what if untreated?[edit]

For people who have episodes of malaria that are left untreated, what are the consequences? How long can it linger unrecognised in the body, then pop up again? Can the dormant form be detected between bouts? (talk) 21:30, 23 August 2012 (UTC)Jo 24Aug2012

1. This is covered in "Signs and symptoms". 2. Covered in "Recurrent malaria" and "Pathogenesis". 3. Not sure about this; I suspect PCR would work (see "Diagnosis"), but it's not widely used yet. Sasata (talk) 07:24, 11 September 2012 (UTC)

Statements possibly needing better sources[edit]

I'm making a list of statements in this article that are not compliant with WP:MEDRS standards, and may need better sources.

  • "For reasons that are poorly understood, but that may be related to high intracranial pressure, children with malaria frequently exhibit abnormal posturing, a sign indicating severe brain damage.[7]"
  • Found a 2011 review that supports this statement. Sasata (talk) 03:37, 11 September 2012 (UTC)
  • "Among these is the development of respiratory distress which occurs in up to 25% of adults and 40% of children with falciparum malaria.[10]"
  • For some reason, this is not indicated as being a review article in Pubmed, but it sure reads like a review to me, so I'm leaving this as is (please let me know if I'm mistaken). Sasata (talk) 01:52, 11 September 2012 (UTC)
  • "P. falciparum accounts for the majority of deaths.[13]"
  • Replaced with review. Sasata (talk) 19:33, 10 September 2012 (UTC)
  • "these are mostly of limited public health importance.[15]" (referring to various less common Plasmodium species from higher apes)
  • I'm going to leave this one as is. PubMed 19284287 is not a research report, it seems to be more like an opinion paper from a leading expert (PubMed 19835479 evinces his expertise), and I think the statement is not controversial and unlikely to be challenged. Sasata (talk) 03:22, 11 September 2012 (UTC)
  • "In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia.[61][62]" (latter ref is primary)
  • Replaced latter citation with a review. Sasata (talk) 03:00, 11 September 2012 (UTC)
  • "… but artesunate has been shown to be superior to quinine in both children[63]…"
  • Now cited to 2012 Cochrane review Sasata (talk) 23:43, 10 September 2012 (UTC)
  • "Malaria is prevalent in tropical regions because of the significant amounts of rainfall, consistent high temperatures and high humidity, along with stagnant waters in which mosquito larvae readily mature, providing them with the environment they need for continuous breeding.[80]"
  • Now cited to a book. Sasata (talk) 04:05, 11 September 2012 (UTC)
  • "For example, several cities in Vietnam, Laos and Cambodia are essentially malaria-free, but the disease is present in many rural regions.[83]"
  • Statement amended and now sourced to a 2012 review. Sasata (talk) 04:53, 11 September 2012 (UTC)
  • "This effort led to the publication of a map of P. falciparum endemicity in 2010.[86]"
  • Think this is ok, as it's cited only to verify the existence of this map. Sasata (talk) 03:22, 11 September 2012 (UTC)
  • "As of 2003, 466 proteins have been found to be produced by apicoplasts[133]"
  • Replaced with 2010 review. Sasata (talk) 23:30, 10 September 2012 (UTC)
  • "Immunity (or, more accurately, tolerance) does occur naturally, but only in response to repeated infection with multiple strains of malaria.[136]"
  • Re-sourced to 2012 review (and amended statement). Sasata (talk) 01:04, 11 September 2012 (UTC)
  • "Parasitic Plasmodium species also infect birds, reptiles, monkeys, chimpanzees and rodents.[140]"
  • The section containing this sentence has now been expanded and sourced to two recent reviews. Sasata (talk) 07:02, 11 September 2012 (UTC)

These statements have been flagged as they are cited to non-secondary sources. I haven't included citations from the "History" or "Society and culture" as sourcing requirements should be not quite as rigorous (but please add anything to this list if you disagree). I'll also go through the list and and check for sources that could be updated (MedRS suggests to "Look for reviews published in the last five years or so, preferably in the last two or three years.") Sasata (talk) 17:23, 10 September 2012 (UTC)

This is an excellent policy, and you did a good job pulling primary material. I almost fainted when I saw you pull articles from Nature and Lancet for this list. Excuse the sarcasm, but I might as well bang my head against the wall as try to explain to editors that they should not use the original, well-cited Lancet article, but use something that cites it instead and use the information from the secondary source, not the primary. In spite of the policies spelling this out, Wikipedia is rabid with original research and primary sourcea, and this is the most egregious area, medical and health articles. I used to edit human health articles, malaria, TB, influenza, but got too frustated with the primary material and, in the case of microbes, plagiarism from .edu websites.
Good job. I am on vacatioan, and I watch this article regularly, maybe I can find time to pull secondary sources soon. Eau (talk) 19:31, 10 September 2012 (UTC)
The timing of the review depends upon the informtion you are sourcing. For human medicine these are pretty good guidelines, but for characteristics and descriptions of pathogens older sources, up to 10 years, sometimes more, my be fine. Eau (talk) 19:39, 10 September 2012 (UTC)
Thanks for the note. The article's a work in progress, and I hope to eventually take it to FAC. After the GAN is completed and I incorporate some FAC suggestions of Biosthmors, I'll open a peer review. Perhaps you might be willing to have a closer look and offer some critique? Sasata (talk) 07:02, 11 September 2012 (UTC)

is just added reference from emedicine regarding the fact that pattern of fever is not clinically useful to my entry[edit] — Preceding unsigned comment added by Yannako (talkcontribs) 10:03, 10 October 2012 (UTC)



The malaria distribution image is wrong - Taiwan is since 50 years free of malaria - and all referenced sources do describe it correctly (!)( 26 November 2012

From "Pathogenesis", paragraph 4: "Some P. vivax sporozoites do not immediately develop into exoerythrocytic-phase merozoites, but instead produce hypnozoites that remain dormant for periods ranging from several months (6–12 months is typical) to as long as three years." However "Cause", subsection "Recurrent malaria", paragraph 2 states: "The longest incubation period reported for a P. vivax infection is 30 years." Axl ¤ [Talk] 12:56, 26 October 2012 (UTC)

  • I've added a source for this paragraph and adjusted the text so it is not contradictory. Sasata (talk) 15:59, 26 October 2012 (UTC)
Okay. Axl ¤ [Talk] 16:29, 26 October 2012 (UTC)

From "Pathogenesis", paragraph 1: "Malaria infection develops via two phases: one that involves the liver or hepatic system (exoerythrocytic)." Is isn't clear to me what the "hepatic system" is, nor how this is different to the liver. Axl ¤ [Talk] 12:58, 26 October 2012 (UTC)

  • I suspect this is there to help less knowledgeable readers associate a familiar word (liver) with medical jargon (hepatic system), similar to the second half of the sentence ("and one that involves red blood cells, or erythrocytes (erythrocytic)"). Open to suggestions on how to reword if you think it's written confusingly. Sasata (talk) 16:01, 26 October 2012 (UTC)
How about this: "Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase)." Axl ¤ [Talk] 17:35, 26 October 2012 (UTC)
Sure, I guess "hepatic" isn't used a lot later in the article, so there's no real need to include it here. Done. Sasata (talk) 18:27, 26 October 2012 (UTC)

From "Pathogenesis", paragraph 5: "In cerebral malaria the sequestered red blood cells can breach the blood–brain barrier possibly leading to coma." Why is coma specifically called out? It isn't likely to be the earliest feature, nor is it the most serious result. (Death is the most serious outcome.) Axl ¤ [Talk] 22:13, 30 October 2012 (UTC)

  • I changed this to "The sequestered red blood cells can breach the blood–brain barrier possibly leading to cerebral malaria." Sasata (talk) 21:28, 31 October 2012 (UTC)
I have adjusted the syntax. Axl ¤ [Talk] 22:18, 31 October 2012 (UTC)

From "Pathogenesis", "Genetic resistance", paragraph 1: "Due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history." Is that really true? Compared to infectious diarrhoea and cystic fibrosis mutations? Axl ¤ [Talk] 22:16, 30 October 2012 (UTC)

  • According to the source (and other sources that corroborate it), yes. Sasata (talk) 21:31, 31 October 2012 (UTC)
Okay, I accept that the source says so (although I'm not convinced). Axl ¤ [Talk] 23:05, 31 October 2012 (UTC)
It might be best to weaken (although I suggested strengthening before). Hedrick says, "it is thought to be the strongest evolutionary selective force in recent human history". Biosthmors (talk) 18:13, 10 November 2012 (UTC)
Suggestions for weakening? How about "it has placed great selective pressure on the human genome in recent history."?
I would be happy with that statement. Axl ¤ [Talk] 23:10, 2 December 2012 (UTC)

"Pathogenesis", "Genetic resistance", paragraph 2 needs to be fixed. The first paragraph uses "sickle cell disease" while the second describes "sickle cell anemia". These should be standardized for consistency. It is not possible to be "homozygous for the sickle cell trait". It is unclear if "survival" refers to malaria or sickle-cell disease. Axl ¤ [Talk] 22:23, 30 October 2012 (UTC)

  • I think I've fixed these. Sasata (talk) 21:45, 31 October 2012 (UTC)
It is still unclear if "survival" and "immunity" refer to sickle-cell disease or malaria. Axl ¤ [Talk] 23:10, 31 October 2012 (UTC)
This should do it. Sasata (talk) 23:52, 31 October 2012 (UTC)
"Individuals who are homozygous (with two copies of the abnormal hemoglobin beta allele) rarely survive sickle-cell disease." Sickle-cell disease is a congenital disease that lasts lifelong. In what sense can a person "survive sickle-cell disease"? Axl ¤ [Talk] 00:29, 1 November 2012 (UTC)
Changed "rarely survive" to "have". Sasata (talk) 01:52, 1 November 2012 (UTC)
Thanks. Axl ¤ [Talk] 09:33, 1 November 2012 (UTC)
Revised somewhat, but someone please check me. LeadSongDog come howl! 20:00, 18 December 2012 (UTC)

From "Pathogenesis", subsection "Malarial hepatopathy": "Hepatitis, which is characterised by inflammation of the liver, is not actually present in what is called malarial hepatitis; the term as used here invokes the reduced liver function associated with severe malaria." How about "The syndrome is sometimes called malarial hepatitis, although inflammation of the liver (hepatitis) does not actually occur." Axl ¤ [Talk] 23:17, 31 October 2012 (UTC)

  • That's better, changed. Sasata (talk) 23:52, 31 October 2012 (UTC)

In "Pathogenesis", subsection "Malarial hepatopathy", there is no need for the same reference to be cited immediately after every sentence. Axl ¤ [Talk] 21:43, 1 November 2012 (UTC)

  • That is true, fixed. Sasata (talk) 21:48, 1 November 2012 (UTC)

From "Pathogenesis", subsection "Malarial hepatopathy": "While traditionally considered a rare occurrence, malarial hepatopathy has seen an increase in malaria-endemic areas, particularly in Southeast Asia and India." Is it necessary to state that the increase is "in malaria-endemic areas"? Perhaps delete that phrase? Axl ¤ [Talk] 22:02, 1 November 2012 (UTC)

  • Sorry, I missed this comment before. I've trimmed as you suggested. Sasata (talk) 19:51, 15 November 2012 (UTC)

In "Signs and symptoms", I am surprised that blackwater fever and cerebral malaria are considered separately from the "Complications" subsection. Axl ¤ [Talk] 23:25, 2 December 2012 (UTC)

Fixed here, I think. Please check me.LeadSongDog come howl! 22:19, 20 February 2013 (UTC)


IMO we need third party sources. Thus removed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:14, 24 November 2012 (UTC)

The distribution of insecticide treated mosquito nets (ITNs) by organisations such as the Against Malaria Foundation (AMF) is recommended by intervention evaluators Giving What We Can and Givewell as one of the most cost-effective means of combating malaria in particular, and improving global health in general.[1] It costs AMF just over $5 per ITN distributed, and they have been shown to prevent deaths caused by malaria at $1,600 per person.[2]

Agreed. Third-party sources for organizational actions should be required (unless you're the WHO or something like that). Otherwise, this article would be covered with stuff. But we're an encyclopedia. Biosthmors (talk) 23:30, 24 November 2012 (UTC)

Agreed, absolutely required to have independent reliable secondary sources cover these organizations to establish notability and provide non-promotional factual information about them. Zad68 04:05, 25 November 2012 (UTC)

Review on Vivax[edit]

We may be underestimating the burden of severe disease from vivax... doi:10.1128/CMR.00074-12 JFW | T@lk 22:32, 7 January 2013 (UTC)

That doi doesn't work for me ... could you give a pmid or link? Sasata (talk) 23:22, 7 January 2013 (UTC)
Evidence and Implications of Mortality Associated with Acute Plasmodium vivax Malaria J. Kevin Baird Clin. Microbiol. Rev. January 2013 26:36-57; doi:10.1128/CMR.00074-12
Still getting to the various databases maybe RDBrown (talk) 05:20, 8 January 2013 (UTC)
Thanks, I've changed some information based on this. Very interesting that he quotes this article in his review ... Sasata (talk) 04:30, 23 January 2013 (UTC)

Scientists discover malaria's 'Achilles heel'[edit]

This seems notable:

This theory is clearly in its infancy and probably isn't ready for inclusion yet. Do we have access to the study mentioned in that article? Basalisk inspect damageberate 17:15, 14 February 2013 (UTC)

- Cablehorn (talk) 17:07, 14 February 2013 (UTC)

This is the cited article, but like Basalisk says, it's too early to be included here. Sasata (talk) 17:29, 14 February 2013 (UTC)
Very well - agreed. Let's keep an eye out for updates.--Peulle (talk) 21:10, 21 February 2013 (UTC)


  1. I am not sure why these two bits are linked "Pregnant women are also especially vulnerable: about 125 million pregnant women are at risk of infection each year" The number of pregnant women at risk is not related to how susceptible they are to infection.
  2. Were does it say that the WHO estimate is only based on documented cases? The ref simply states "There were an estimated 219 million cases of malaria (range 154–289 million) and 660 000 deaths (range 610 000–971 000) in 2010" In fact if you look at section 8.4 it states the opposite. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:01, 23 April 2013 (UTC)
  • The discrepancy between WHO numbers and those presented by Murray et al. 2012 is discussed in depth in that paper. e.g. "In 2008, we estimate that 24% of child deaths in Africa are due to malaria compared with the 16% reported by Black and colleagues,49 whose methods were used in deriving the World Malaria Report estimates. This discrepancy is attributable to both the larger numbers of malaria deaths in our analysis and the fact that we use child mortality estimates using a systematic analysis that suggests fewer deaths from all causes than did sources used by Black and colleagues.27 Furthermore, previous studies have not taken advantage of the MAP PfPR estimates, included the effect of interventions other than vector control, or developed models with rigorous out-of-sample predictive validity." ... "The important finding of this study is that 433 000 more deaths occurred worldwide in individuals aged 5 years or older in 2010 than was suggested by WHO estimates.2" ... "Outside of Africa, WHO estimates are based on case reports with an assumed case-fatality rate." There's much more, the entire paper should be read for context. Sasata (talk) 19:38, 23 April 2013 (UTC)
None of the above states that WHO estimates are based on "documented cases" only. And it states the opposite in the WHO document itself. The "Outside of Africa" sort of invalidates that bit. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:58, 23 April 2013 (UTC)

How about "As of 2010 malaria is believed to cause 660,000 to 1.24 million deaths a year". This ref comes in at 1.17 million [14] Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:13, 23 April 2013 (UTC)

I think it's important to indicate where the wide variance in reported deaths originates from. I changed it to "The WHO estimates that in 2010 there were 219 million cases of malaria resulting in 660,000 deaths. This is equivalent to roughly 2000 deaths every day. Using a different set of predictive models to estimate mortality, a 2012 study determined the number of documented and undocumented deaths in 2010 to be 1.24 million." How does that sound? Sasata (talk) 20:14, 23 April 2013 (UTC)


"claimed the lives of" is a euphemism for deaths and thus I do not think we should be using it. We need to simply state the fact. Thus I disagree with this edit [15] Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:33, 24 August 2013 (UTC)

The edit made this change, from "That year, between 660,000 and 1.2 million people died from the disease, many of whom were children in Africa" to "That year, the disease claimed the lives of between 660,000 and 1.2 million people, many of whom were children in Africa". The problem with the original sentence was that the modifier phrase "many of whom were children in Africa" was applied to "disease", making it sound like many of the disease were children. The edit fixes that but introduces the euphemism. To fix the grammar problem and avoid the euphemism you'd have to change it to: "That year, the disease killed between 660,000 and 1.2 million people, many of whom were children in Africa". Zad68 03:29, 25 August 2013 (UTC)
Change applied. Zad68 03:31, 25 August 2013 (UTC)

Biological Approaches to Vector Control[edit]


Example Bacillus thuringiensis israelensis

Request to Remove Semi-Protection from Page[edit]

This is unnecessary, against the spirit of Wikipedia and counterproductive to efficient updating on this very broad topic which has a substantial amount of emerging research. Malaria is not some political or celebrity topic where semi-protection may be of use. Kindly undo it.

The article is semi-protected because of long term vandalism. See the protection history log here. It apparently is necessary and does not prevent updating by autoconfirmed editors. Sean.hoyland - talk 06:27, 4 September 2013 (UTC)
Key topic that requires serious scholarship. Easy to register an account. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:24, 4 September 2013 (UTC)

Reference style[edit]

We have all the refs stored at the end of the article rather than within the text. This reference style is not supported in many other languages. As we are going to be translating this article once it is GA can we switch the reference style to one that is supported? Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:38, 21 September 2013 (UTC)

It will be easy enough to prepare a sandbox version of the article with the references in the text if that is what is needed. It would be retrogressive to revert to an older style here, especially when the final goal has not yet been attained and there's still much work to do on the article. Sasata (talk) 15:09, 21 September 2013 (UTC)
How is it an "older style"? The page used to be in the other style. It is simply different not older and it is more universally accepted. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:26, 21 September 2013 (UTC)
Well, list-defined refs are a newer style, hence the old system is an older style. It is accepted on the English Wikipedia. We can accommodate other language Wikipedias readily enough without having to change anything here. Sasata (talk) 17:49, 21 September 2013 (UTC)
How is that? It is a pain for translation as the references do not work when copied to other languages. So the old format is the better format. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:11, 21 September 2013 (UTC)
We should not be basing our formatting decisions for this article on the ease of convenience for future translators, ahead of the convenience of editors who are actually working to improve the article. When the article is ready for translation, I will provide a refs-in-article version sandbox version. Sasata (talk) 18:39, 21 September 2013 (UTC)
Yes I realize that you prefer this still. As we add new languages however we often use a more recent version of the article. Once you are done we should put the refs-in-article going forwards. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:17, 21 September 2013 (UTC)
I strongly oppose changing ref style just so suit translation to technically inferior wikis. Perhaps the solution, "going forwards" (oh I hate that phrase), is to enquire why other WP haven't adopted list-defined refs yet and persuade someone to get their finger out. Are they on an old MediaWiki version? Given how much work is involved in translation, I wouldn't have thought this matters much on the scale of things. Indeed the "all at the end" style makes it easy to have a text document with all your refs and you can snip them out and place them in-text as you use them in the translated version. Not sure what the big deal is really. Colin°Talk 21:22, 21 September 2013 (UTC)
English has these different referencing styles as we have build a mass of templates to support them. They are complicated. I personally prefer the more basic formatting. More complicated is not necessarily better. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:49, 21 September 2013 (UTC)
James, are you absolutely sure other languages don't support list-defined refs. They were added (as an extension to cite.php) in 2009. This is nothing to do with templates (which clearly can vary from wiki to wiki, and that's another reason to avoid them). Colin°Talk 07:36, 23 September 2013 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── I hear and understand both sides of this, my preferred ref style is definitely to have all the refs define at the end in the reflist refs= parameter, I really hate working on articles when the refs are defined in-line. However the bottom line is that we write articles to make information accessible to readers, and if the refs need to be defined in-line to make the information accessible to a wider audience through translation, I think that takes precedence over my preferred ref style. I really like Sasata's idea of providing an in-line version for the translators when requested, if that would be acceptable, and encourage the target Wikis to upgrade their software. Honestly I thought the reflist ref= parameter was a very fundamental feature, and am surprised to find it isn't implemented everywhere! Zad68 02:54, 23 September 2013 (UTC)

First priority is to our English Wikipedia readers. Second priority is to the editors who write and maintain these articles -- so any wiki markup preferences are theirs and theirs alone. Sorry, but I actually find it quite rude to suggest such editors change the wikitext. I know the translation is a worthy effort but, for reasons I gave above, I don't see this as a problem at all (and am sceptical about the claim they don't support something added to MediaWiki in 2009). Colin°Talk 07:36, 23 September 2013 (UTC)
Doc James, were you asking at the beginning of this thread for permission to change the referencing style? It's not clear from the diffs whether or not you were expecting Sasata to implement it or if you were proposing to do it yourself. I sympathize with Colin's emphasis on the value of English Wikipedia practices. That said, maybe this thread started with a misunderstanding. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 08:44, 23 September 2013 (UTC)
This article used to be in the old style. I have made the second most edits to this page [16] and plan to continue working on it. There was not clear consensus to change the article to the new style.[17] I let it go as I assumed that there was consensus to restore it to the old style once Sasata was done. Here is an example of how the refs breaks down in Swahili [18].
I see a fundamental goal of ours to be to "provide high quality, understandable health information to all in the language of their choosing". We should be working on consistency between languages and when it comes to formatting we should keep it simple so more can get involved. I was discussing me making the switch back to the old style. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:25, 23 September 2013 (UTC)
James I had a look at the Swahili article. I see that we do need one template: Reflist. Looking at the version on the Swahili wiki compared to the English wiki, the former is much more basic. I suspect nobody has bothered to upgrade it to the new template that supports list-defined refs. Do you know someone on that wiki who could fix it? The new template code isn't complex or long, so it shouldn't require a genius to do it. It might be as simply as copy/paste. When there's a technical flaw we should fix the flaw, not expect people to rework article text and produce something inferior. Colin°Talk 20:50, 23 September 2013 (UTC)
Mdennis (WMF), would it be unreasonable to think you could point someone here to perhaps help? I just jumped on IRC for tech and some mediawiki thing I was referred to. But no help after 15 min or so. Thanks. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 21:22, 23 September 2013 (UTC)
Nevermind! Fixed! Thanks to Colin. =) Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:47, 24 September 2013 (UTC)

I have "fixed" the references on [19]. I copied the en Reflist template as Reflist2 and used that instead. I didn't want to edit the actual Reflist template on that wiki, because it will be very widely used and if I broke anything I wouldn't understand the swear words used against me. The best solution would be to update their Reflist with their approval. In the mean time, Reflist2 does the job. There are other issues there with doi and PMID templates/magic but I assume you know about them. So this "problem" is easily solvable, as I suspected. -- Colin°Talk 07:40, 24 September 2013 (UTC)

Awesome. So I assume this means there's no reason to try to reach a consensus on moving away from the reference style then. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:55, 24 September 2013 (UTC)
Yes we need a universally supported reference style across all Wikipedias. Harvnb is not supported in some languages, neither is the "{{Reflist|refs=" per [20] in Guarani. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:24, 5 October 2013 (UTC)

Edit request on 23 September 2013[edit]

Hi there, just wondering if you could add a link to malariapp in the external links section of this wiki page. It's an app that displays tweets from around the globe and we plan to use this to help show global support for the fight against malaria.

Thanks! (talk) 09:16, 23 September 2013 (UTC)

Could you say something about why you feel that your website supports an encyclopedic presentation of malaria? Consider checking the external link guideline when you reply. Blue Rasberry (talk) 13:30, 23 September 2013 (UTC)

GA Review[edit]

This review is transcluded from Talk:Malaria/GA3. The edit link for this section can be used to add comments to the review.

Reviewer: LT910001 (talk · contribs) 23:00, 6 October 2013 (UTC)

Hi, I'll take this review. I haven't had any part in editing or creating this article. Any other editors are welcome to contribute. LT90001 (talk) 23:00, 6 October 2013 (UTC)

  • Note. I've noticed that there are a lot of malaria-related articles and it's quite hard to navigate. I've just created and added Template:Malaria to this page and other relevant pages in this regard, but I haven't made any other edits to the page. LT90001 (talk) 00:51, 7 October 2013 (UTC)

Overall this should be a quick and easy pass.

GA summary[edit]

Rate Attribute Review Comment
1. Well-written:
1a. the prose is clear and concise, it respects copyright laws, and the spelling and grammar are correct.

Yes. Minor fixes suggested below, but nothing preventing promotion.

1b. it complies with the manual of style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.


2. Verifiable with no original research:
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.

For the most part. One or two uncited sections and an image I have mentioned below.

2b. all in-line citations are from reliable sources, including those for direct quotations, statistics, published opinion, counter-intuitive or controversial statements that are challenged or likely to be challenged, and contentious material relating to living persons—science-based articles should follow the scientific citation guidelines.

See above.

2c. it contains no original research.

See above.

3. Broad in its coverage:
3a. it addresses the main aspects of the topic.


3b. it stays focused on the topic without going into unnecessary detail (see summary style).


4. Neutral: it represents viewpoints fairly and without bias, giving due weight to each.


5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.


6. Illustrated, if possible, by images:
6a. images are tagged with their copyright status, and valid fair use rationales are provided for non-free content.

Checked. One or two flags (noted below) but nothing preventing nomination.

6b. images are relevant to the topic, and have suitable captions.

Very relevant.

7. Overall assessment.

An excellent article.

Specific Comments[edit]


    • Sentence "Possible causes include ... severe anaemia. " is very technical and inconsistent with the easy-to-read language of the rest of the article. Suggest reword.
    • Cerebral malaria is mentioned in both complications and signs and symptoms sections.


    • The first half is very easy to read, the second half is difficult to follow.
    • Suggest first instance of "merozoite" be wikilinked.
    • Suggest new paragraph here: "Other merozoites develop into immature gametes" and then reword like the first half. This part is difficult to follow! (In fact I would go so far to say, the first half is one of the better representations of the malaria lifecycle I've read, so I'd love if the second half was that clear and easy to read)
I wikilinked merozoite earlier, added a paragraph break, and reworded like so. Is it better? Sasata (talk) 23:24, 9 October 2013 (UTC)
Much better! LT90001 (talk) 00:45, 11 October 2013 (UTC)
  • Recurrent malaria: bracketed term not needed here: "reappear (recur) "
I kept recur and removed reappear, as the former term appears in the following sentence. Sasata (talk) 05:13, 9 October 2013 (UTC)
  • Pathophysiology
    • One of the characteristic features of malaria infection, which you have mentioned earlier, is the reliability of the tertian and quaternian fever cycles. The putative mechanism for this should be mentioned.
  • Most sources I've seen do not discuss this, and many suggest that the classic presentation of predictably recurring chills and fever is highly variable, so I'm thinking we shouldn't dwell on the details too much in this broad overview article. Sasata (talk) 18:39, 17 October 2013 (UTC)
    • This paragraph "Although the red blood cell surface adhesive proteins " is quite specific and I'm not sure what the relevance is. Suggest move to biology section?
  • Trimmed this paragraph, it's already covered in the daughter article. Sasata (talk) 05:09, 15 October 2013 (UTC)

Genetic Resistance[edit]


    • "Approximately 30% of people ". This group is unspecified. Do you mean "people infected in the last (week)"?
This sentence has been removed. Sasata (talk) 18:45, 9 October 2013 (UTC)
    • "the presentation" -> "of symptoms"
Added. Sasata (talk) 20:37, 9 October 2013 (UTC)
    • "which might be elicited by any of the following: ... peripheral blood leukocyte count.[3]" is quite technical and medical. Suggest reword.
How does this sound? Sasata (talk) 20:37, 9 October 2013 (UTC)
Much better. LT910001 (talk) 09:31, 15 October 2013 (UTC)
  • Classification section is out of place; suggest this list be transferred to a table and moved up to the 'signs and symptoms' section.
I think this section was formatted this way by Jmh649 to better conform to WP:MEDMOS. Doc, do you have any objections to LT90001's suggestion? Sasata (talk) 20:53, 9 October 2013 (UTC)
I'm happy to leave the section where it is, but the list stands out like a sore thumb in comparison to the high quality discursive form of the rest of the article. LT910001 (talk) 09:31, 15 October 2013 (UTC)


    • Should 'vector control' mention the use of spraying mosquito-infected swamps? I believe this was one of the key reasons that the Americas, in particular North America, controlled the spread of malaria.
  • It used to be in the article, but was removed as it is a (mostly) historical method for mosquito control. This information can be found in the history daughter article, and in mosquito control. Sasata (talk) 05:31, 15 October 2013 (UTC)
    • This paragraph "Methods used to prevent malaria include medications, ... it could become re-established if conditions revert to a combination that favours the parasite's reproduction.[42]"
      • Does not seem to be supported by the source
  • Could you be more specific as to what you think is not supported by the source? If you think it's necessary, I can break the reference into short citations and cite each sentence more specifically with page numbers. Sasata (talk) 18:26, 17 October 2013 (UTC)
      • "favours" is not consistent with the use of American English.
  • Made the spelling consistent British English and added a template for this on the talk page. Sasata (talk) 18:26, 17 October 2013 (UTC)
      • Source mentions difficulty in removing from low population-density areas.
  • Added one reason. Sasata (talk) 18:26, 17 October 2013 (UTC)
      • Suggest add "high anopheles mosquito population density" to make clear this is not all mosquitoes.
  • Done. Sasata (talk) 18:26, 17 October 2013 (UTC)
      • In conclusion, needs a re-write


Prognosis, Epidemiology, History[edit]


I've removed this. I think it's useful, however, and will try to recreate with sourced data before this article goes to FAC. Sasata (talk) 19:14, 9 October 2013 (UTC)
Yes, if sourced it would have been a very useful image. LT90001 (talk) 00:46, 11 October 2013 (UTC)
  • It would be nice, but is certainly not a requirement of the GA review, if File:5901 lores.jpg could be replaced with a clearer image.


In conclusion, I would say this article is of very good quality. Kind regards, LT90001 (talk) 11:24, 7 October 2013 (UTC)

Thank-you kindly for taking on this review. I am currently vacationing in a different country, so internet access will be spotty, but I should be able to address your concerns within a few days. Sasata (talk) 15:18, 7 October 2013 (UTC)
No worries, there is no rush. Have a lovely vacation, LT90001 (talk) 09:55, 8 October 2013 (UTC)
  • LT90001, how many sources have you checked to make sure they are verified? Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 17:01, 9 October 2013 (UTC)
Thanks for your attention. On every review, as well as completing a survey of all the sources used as they are reported in the article, I check as reading the summaries of about 1/3-1/4 of all citations, paying particular attention to assertions or contentious statements. If the abstracts do not support the text, then I seek a full text article and the relevant section. LT90001 (talk) 02:16, 10 October 2013 (UTC)

With the changes that have been made, I would be happy to promote this article to GA status at this time, but will wait several days in the hope that the few remaining quality-based concerns are addressed. LT910001 (talk) 09:37, 15 October 2013 (UTC)

I find this article to match the GARC in being well-written and broad, neutral and well-sourced, and without any outstanding issues. I have updated the table above and will make the required changes to promote to GA status shortly. Well done, thanks for bringing this article back up to GA standards, and I wish you well on your wiki-travels. LT910001 (talk) 01:02, 18 October 2013 (UTC)

Thanks kindly for your review! Sasata (talk) 01:40, 18 October 2013 (UTC)


We're currently at 80kB of prose, which is perhaps punishing to readers to swallow per WP:Length. The biggest opportunity I saw for shortening things was in the history section. There is a parent article. Can we go WP:SS and perhaps reduce the word count there by half or 2/3rds or so? Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 00:36, 10 October 2013 (UTC)

I agree, and plan to trim this section before FAC. I think the entire suite of daughter articles (i.e., everything in Template:Malaria) should ultimately be organized and integrated as a functional whole. Sasata (talk) 05:17, 15 October 2013 (UTC)

When will this article be translated?[edit]

Doc James, when will this article be translated? I met someone this weekend who knows a lot about malaria. I told them their suggestions for improvement might end up affecting many versions of this article. As far as I know this is still true because I don't see malaria mentioned here. Could you please advise? Thanks. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:44, 11 November 2013 (UTC)

I have not had time to review and simplify it yet. Will be a while. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:41, 11 November 2013 (UTC)
Thanks. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:56, 12 November 2013 (UTC)

Close paraphrasing?[edit]

I am helping review contributions by an editor who has some copyright issues. He made one short contribution here that survives in the present version of the article. The source is here. He did not copy it verbatim, but you may want to review the abstract to ensure that it's not too closely paraphrased here. Thanks. Maralia (talk) 15:43, 13 November 2013 (UTC)

Thanks Maralia, I've reworded that sentence to further distance it from the source. Sasata (talk) 16:28, 13 November 2013 (UTC)
Thank you, I knew I could trust you would get to this quickly! I have been following the article's improvement, but only from afar, so I can review it with fresh eyes when it shows up at FAC. Maralia (talk) 16:32, 13 November 2013 (UTC)

Plase check/review paragraph[edit]

(added news, need also review at Diagnosis_of_malaria#Molecular_methods)

In December 2013 a new diagnosis method was promoted as the faster, precise and inexpensive detection technology. For a patient is like a optical fingerprint detector, and can be operated by nonmedical personal, but internally it detects the iron crystal byproduct of parasitized hemoglobin (hemozoin).[3],[4]. --Krauss (talk) 00:53, 11 January 2014 (UTC)

Move to research section as 1) there does not appear to be evidence in humans 2) it is not being done yet as far as I can tell. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:29, 11 January 2014 (UTC)
No, was tested with humans and lab rats, and was demonstred that can “detect just a few infected cells in a million normal cells”[5]. The "evidence in humans" is the Hemozoin (!!). --Krauss (talk) 02:17, 11 January 2014 (UTC)
My reading of "Lopotko said the light beam used by this rapid, non-invasive technology is less powerful than the familiar laser pointer and has been shown to be safe in volunteers. The next step is clinical trials at a hospital in Houston that cares for patients infected with malaria, followed shortly thereafter by global clinical trials in 2014." Is that safety testing has been done in humans. But not humans with Malaria. That is coming soon. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:20, 11 January 2014 (UTC)
Ok, thanks explanation, I and readers must agree. Well, returning to the starting point: you decide to not show this information at article. I think we must say something, the malaria's article show a lot of "less relevant" information, and this is a very good news (!): in theory a massive detection will be possible, and, as effect of the contamination/diffusion cycle, is expected also a "massive reduction" when (detected) contaminated people receives treatment and not exposed to vectors.[21] Is not only a "technology for airports" (!), is a hope for Africa in near future (ex. 2 or 3 years for industry-scale adaptations) ... New text-proposal:

In December 2013 a new diagnosis method was promoted as a 2014's faster, precise and inexpensive malaria-detection technology. Was tested with lab rats and volunteers, the next step is clinical trials. For a patient is like a optical fingerprint detector, and can be operated by nonmedical personal. Internally, the device detects the iron crystal byproduct of parasitized hemoglobin (hemozoin).[6],[7], exciting the crystals with the energy of pulsed-laser ligth, to the point of exploding, and (synchronically) detecting the "nano-explosions" by its characteristical sound (just a few infected cells in a million normal cells). These little "explosions of hemozoin" are healthy, not need clinical trial, is also (when using more energy) a knowed terapeutic method.[8]

  1. ^ "Giving What We Can AMF overview of cost effectiveness and report on progress in Ntcheu, Malawi". 
  2. ^ "Givewell AMF review". 
  3. ^ "Vapor nanobubbles rapidly detect malaria through the skin",
  4. ^ "Hemozoin-generated vapor nanobubbles for transdermal reagent- and needle-free detection of malaria", Ekaterina Y. L., et. al. 2013-12-26, DOI:10.1073/pnas.1316253111 and PDF Supplemental
  5. ^
  6. ^ "Vapor nanobubbles rapidly detect malaria through the skin",
  7. ^ "Hemozoin-generated vapor nanobubbles for transdermal reagent- and needle-free detection of malaria", Ekaterina Y. L., et. al. 2013-12-26, DOI:10.1073/pnas.1316253111 and PDF Supplemental
  8. ^ Note. Clinically the "explosion of hemozoin" is healthy, and have therapeutic effec, as proved by studies of same-aim technologies, as this other one.

English and Medicine are not "my language", you can rewrite to something simpler and better, to add a paragraph in the article. --Krauss (talk) 23:44, 11 January 2014 (UTC)

I did not delete it but moved it here to the section on research. Agree it is a very exciting area of research and I hope it pans out.[22]Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:22, 12 January 2014 (UTC)

P. ovale is now a species complex (2 species)[edit]

P. ovale is now at least a species complex, or possible superspecies: P. ovale curtisi and P. ovale wallikeri. So we have not five, but six infectious species of Plasmodia. There are also at least 5 more species that are known to be capable of infecting humans, but natural transmission of them has not been recorded.Sbalfour (talk) 23:53, 19 March 2014 (UTC)


Shouldn't we mention smoke baths too ? KVDP (talk) 07:21, 4 August 2014 (UTC)

Do we have a high quality ref that does so. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:02, 4 August 2014 (UTC)

Current new News[edit]

Headline-1: The No. 1 Killer on This ‘Deadliest Animals’ Infographic Might Surprise You

QUOTE: "More than 700,000 people — that’s how many lives are taken each year thanks to a bite from small and seemingly innocuous animal.Bill Gates released this powerful infographic on his blog late last week to highlight a campaign against the deadly and debilitating diseases that are carried by mosquitoes. “Personally I’ve had a thing about sharks since the first time I saw ‘Jaws,’” Gates wrote on his blog. “But if you’re judging by how many people are killed by an animal every year, then the answer isn’t any of the above. It’s mosquitoes.” Gates pointed out that malaria, which is a parasite spread by the mosquito, kills more than 600,000 people per year, but it also is debilitating for an additional 200 million. And that’s just one of many mosquito-borne illnesses." [Bill Gates brings attention to malaria.] -- AstroU (talk) 12:14, 30 April 2014 (UTC) -- PS: FYI for future editing.

Here's the Bill Gates 'blog' url: [23] AstroU (talk) 12:19, 30 April 2014 (UTC)
Yes other humans and mosquitoes vying for number one. Not really surprising for those in medicine. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:42, 30 April 2014 (UTC)
Bill Gates and his wife want to help others and cement their 'legacy'in their old age. As you probably know, others like Buffett(sp) are doing the same. Charles Edwin Shipp (talk) 21:19, 2 May 2014 (UTC)
Doctor James; I looked on my talk page and then your talk page which is certainly impressive, to say the least. If you have lost count of your impressive Wikipedia editing, there are 26 commendations at the top of your TALK page. I liked your 'dragon' icon award. Congratulations on going over 100,000 edits .!. AstroU (talk) 21:35, 2 May 2014 (UTC)
We each do our little bit to battle disease. Thanks AstroU Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:37, 2 May 2014 (UTC)

Semi-protected edit request on 28 August 2014[edit]

In first paragraph, "latter" should be "later."

Thank you or spotting this. I missed it earlier when I was reading the latest edits. Graham Colm (talk) 23:30, 28 August 2014 (UTC) (talk) 23:26, 28 August 2014 (UTC)

Semi-protected edit request on 10 September 2014[edit]

Link PfSPZ vaccine. Yeniczek (talk) 22:00, 10 September 2014 (UTC)

Should be dealt with on the article on malaria vaccine thus does not need linking Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:59, 11 September 2014 (UTC)

More about sickle-cell disease[edit]

There should be more added about how sickle-cell disease is lowering the mortality due to malaria. People heterozygous for the sickle-cell gene can still get malaria, but they are far less serious than someone who is not a carrier of the sickle-cell trait. For instance, the article cited shows a study of children who were between 2-16 months old, had a significantly low mortality rate if they carried the sickle-cell gene. [1] Wulf.174 (talk) 00:23, 2 October 2014 (UTC)


As we are translating the lead of this article into other languages it is useful if we could leave the full refs in the lead rather than moving them all to the end of the article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:50, 5 October 2014 (UTC)

This is unnecessary, all the refs are in alphabetical order in a section at the end. Sasata (talk) 00:07, 6 October 2014 (UTC)
You have reverted User:Boghog as he has changed the referencing formatting and now I have reverted you for changing it aswell. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:08, 6 October 2014 (UTC)
This is unnecessary, all the refs are in alphabetical order in a section at the end. Your reversion undid all of my intervening work. When you are ready to supply a translated version, you can also add the refs easily in the version you give to your translator, there's no need to bloat this article with duplicated refs for that purpose. You are incorrect about me reverting Boghog's edit; I have removed the deprecated cite doi template already and replaced it (which you might have noticed by perusing the edit history). Sasata (talk) 00:07, 6 October 2014 (UTC)
You are over 3 reverts. Was just keeping the ones in the lead as a compromise. You have not edited here in months and now are trying to impose your prefered ref style.
Back in April 2012 all the refs were within the text [24]. There was no consensus to move them all to the end. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:20, 6 October 2014 (UTC)
If you would like to impose your preferred citation style, please establish a consensus for it. I am a main editor of this article, and prefer the list-defined refs. If you can establish a consensus for changing the reference formatting, I'll be happy to oblige. Sasata (talk) 00:34, 6 October 2014 (UTC)
There was no consensus to move to your style. Here was the last discussion [25] which you appear to have backed out of. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:47, 6 October 2014 (UTC)
Well, if you really want to look at citation formatting long before the article became a GA, there were no refs in the lead, so by your argument we shouldn't have refs in the lead either (no consensus has been established to do this). Also, this style was discussed here [26]; of three editors that cared enough to comment (you, me, Colin), two out of the three liked the list-defined refs.Sasata (talk) 00:55, 6 October 2014 (UTC)

The Use of Methoprene to Combat Malaria[edit]

Because the development of resistance to DDT and other insecticides is a major issue, principles of Darwinian medicine can be applied in order to combat malaria by controlling mosquito populations. Darwinian medicine involves the application of evolutionary principles as means of understanding and combating diseases and promoting health. Recent studies have shown promise in some cutting-edge methods of controlling mosquito populations while also curtailing the evolution of resistance. One recent study involves hormone manipulation to manage mosquito populations by interfering with the insects’ fundamental physiology. Methoprene, a Juvenile Hormone analog, disrupts mosquito metamorphosis. As a result, these mosquitos never reach adult form and eventually die in the larval stage. Studies have suggested that methoprene can be used to control mosquito populations by disrupting the intrinsic physiology and can thus lead to a reduction in the transmission of malaria. [2]

This is not sourced to a WP:MEDRS-compliant source (recent reviews are preferred), and is therefore not a suitable addition. Sasata (talk) 19:32, 16 November 2014 (UTC)
I have found a more recent source that supports this information and believe that this information is important for the article. [3] --Murtha.22 (talk) 23:12, 5 December 2014 (UTC)
Any secondary source say it is useful for preventing malaria? Doc James (talk · contribs · email) 23:47, 5 December 2014 (UTC)


This link has been removed: CRISPR] either reinstate or place on a more suitable subarticle

Why? We should use medical sources not the NYTs. Doc James (talk · contribs · email) 13:34, 24 November 2014 (UTC)

Fluid management[edit]

... in severe malaria doi:10.1186/s13054-014-0642-6 JFW | T@lk 00:41, 27 November 2014 (UTC)

Just out of curiosity[edit]

It seems that this article has been un-editable for over a year? Doesn't that seem a bit excessive? And in the "history" section, there is no mention of the fact that malaria was largely eradicated during the 1960s, but then came roaring back after the suppression of DDT use. That would seem to be a rather crucial piece of information about the disease. — Preceding unsigned comment added by Mr Bee Pod (talkcontribs) 16:34, 12 December 2014 (UTC)

  1. ^ Aidoo, Michael, Dianne J Terlouw, Margarette S Kolczak, Peter D McElroy, Feiko O ter Kuile, Simon Kariuki, Bernard L Nahlen, Altaf A Lal, and Venkatachalam Udhayakumar. "Protective Effects of the Sickle-cell Gene Against Malaria Morbidity and Mortality." The Lancelet. 359.9314 (2002): 1311-1312. Web. 12 September 2014.
  2. ^ Nishiura J.T., Ho P., Ray K. 2003. Methoprene interferes with mosquito midgut remodeling during metamorphosis. J Med Entomol. 40(4):498-507.
  3. ^ Bai H, DB Gelman, and SR Palli. 2010. Mode of action of methoprene in affecting female reproduction in the African malaria mosquito, Anopheles gambiae. Pest Management Science. 66 (9): 936-43.