STUDY WARNS OF CHALLENGES IN TREATING MALARIA IN INFANTS UNDER SIX MONTHS IN MOZAMBIQUE

Jéssica Dalsuco, researcher at CISM, physician, and first author of the article.

Malaria in infants under six months of age remains an under-recognized challenge in health systems, despite the high vulnerability of this age group to the disease. The warning comes from a recent scientific review that brings together evidence on the diagnosis, treatment, and clinical management of neonatal malaria and malaria in young infants. The study is particularly relevant for Mozambique, where malaria remains one of the leading causes of illness and child mortality, especially affecting children under five years of age and pregnant women.

According to Jéssica Dalsuco, physician and researcher at the Centro de Investigação em Saúde de Manhiça (CISM), one of the main conclusions of the article is that significant limitations still exist in the treatment of malaria in very young infants. “The most important finding is that the optimal treatment for malaria in infants under six months of age remains limited, and therapeutic protocols are still not well defined. This gap has resulted in the absence of robust, evidence-based recommendations for children in this age group,” explained the researcher.

The study differs from previous research.

Jéssica Dalsuco added that, historically, this population has been largely excluded from scientific studies on malaria, making it difficult to define specific and safe treatments. “This study differs from previous research because it comprehensively gathers and synthesizes the available evidence on malaria in children under six months of age, a population that is often underrepresented in scientific research,” she stated.

The scientific review highlights that the perception still persists that newborns and young infants have some natural protection against malaria, mainly due to maternal immunity and breastfeeding. However, the researchers warn that these babies remain vulnerable to infection, especially in endemic countries such as Mozambique. Clinical signs in this age group may include fever, irritability, breathing difficulties, refusal to feed, and weakness — symptoms that are often confused with other common childhood illnesses, making early diagnosis more difficult.

The study was funded by Novartis

Another challenge identified is related to the lack of evidence regarding the safety and efficacy of antimalarial medicines for very young infants. Until recently, there were no officially approved treatments for children weighing less than 4.5 kilograms, creating significant gaps in the therapeutic recommendations currently in use.

According to Jessica Dalsuco, the article could have a significant impact on science and public health, particularly by drawing attention to a frequently neglected group. “This study contributes to a better understanding of the epidemiology, risk factors, clinical manifestations, and therapeutic challenges in this age group. In addition, it reinforces the need for further clinical research to develop safe, effective, and evidence-based treatments for these infants,” she emphasized.

There is a need to strengthen the systematic collection of data on malaria in infants under six months of age

The authors argue that the next steps should include strengthening the systematic collection of data on malaria in infants under six months of age, increasing the participation of this population in clinical trials, and improving the coverage of preventive measures, such as the use of insecticide-treated mosquito nets and preventive therapies for pregnant women. “The study also highlights the importance of raising awareness among health professionals working in endemic regions, promoting a reassessment of current approaches in order to improve diagnosis, treatment, and reduce the morbidity and mortality associated with malaria in this vulnerable age group,” added Jessica Dalsuco.

The researcher from the Centro de Investigação em Saúde de Manhiça (CISM) describes her scientific journey as an enriching experience marked by collaboration with leading experts in the fields of malaria and tuberculosis.

“My career as a researcher has been extremely rewarding. I have had the opportunity to work with and benefit from the mentorship of leading professionals, whose knowledge and guidance have contributed significantly to my growth in scientific research,” she stated.

In a context where Mozambique remains among the countries most affected by malaria in the world, researchers argue that strengthening scientific research in vulnerable groups, such as newborns and infants, could be crucial to reducing severe complications and saving children’s lives.

Reference

Dalsuco J, Bassat Q, Ahmed H, Pfeffer S, Winnips C, Boulton C, Otsyula N, D'Alessandro U. Malaria in children aged <6 months: a narrative review of current evidence, recommendations and practice gaps. Trop Med Health. 2026 Apr 24;54(1):94. doi: 10.1186/s41182-026-00935-5. PMID: 42032704; PMCID: PMC13195890.

Saiba mais sobre o contributo do CISM na área da Malária

https://www.youtube.com/watch?v=WfaoIWzzoII&t=2s