The Evolving Landscape of Malaria Prevention Strategies: A Review of Recent Developments.

Malaria continues to impose a devastating disease burden globally despite control efforts spanning decades. Its elimination has been hindered by parasite and vector complexity and emerging drug and insecticide resistance, along with unremitting barriers to uptake of preventative strategies largely driven by social inequities, cost constraints, and logistical challenges in implementation. This review synthesises current and emerging prevention strategies, including vector control, chemoprevention and immunoprophylaxis. Insecticide-treated nets and indoor residual spraying remain cornerstones of vector control, although their effectiveness is increasingly compromised by widespread insecticide resistance. Chemoprevention, including intermittent preventive treatment in pregnancy and seasonal malaria chemoprevention in children, has proven highly efficacious, yet uptake remains below WHO targets and concerns about drug resistance remain. Recent advances in vaccines, notably RTS,S/AS01 and R21/Matrix-M, represent landmark achievements, with large-scale rollouts demonstrating reductions in severe disease and mortality. Novel approaches, such as monoclonal antibodies and genetically modified mosquitoes, offer promising avenues for future prevention. However, challenges remain in ensuring equitable access, sustaining efficacy in the face of evolving parasite and vector biology, and integrating interventions into diverse health systems. This review highlights the need for adaptive, multifaceted approaches to achieve malaria elimination goals.