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Background: Malaria remains a major public health concern in The Gambia. The study assessed the trend of malaria admissions and outcome of adult patients admitted after the start of the COVID-19 pandemic in a tertiary hospital in The Gambia., Methods: This was a retrospective hospital-based study and data was collected from the 18th October 2020 to 28th February 2023. Demographic data, clinical features, investigations, treatment, and outcomes were recorded., Results: A total of 499 malaria cases were admitted to the hospital over the 29 months of the study period. Data from 320 (67.2% of the total cases) adult patients admitted into the internal medicine department were analysed. The median age was 22 years, range (15-90) and 189 (59.1%) cases were youth with a youth (15-24 years) to older adult (> 24 years) ratio of 1.4:1. The majority of the patients were male 199 (62.2) with a male to female ratio of 1.6:1. The total number of malaria cases admitted into the internal medicine department increased from 103 cases in 2021 to 182 cases in 2022and admission peaked in November in both years. The total number of admitted malaria cases during the peak of the malaria season also increased from 92 patients between September 2021 and December 2021 to 132 patients from September 2022 to December 2022.There was also an increase in both severe and uncomplicated malaria during the same period. The total mortality was 31 (9.7%) and the rate was similar in 2021 9 (8.7%) and 2022 15 (8.4%). Patients with impaired consciousness were more likely to die when compared to those without impaired consciousness [19 (23.6%) vs 12 (5%), p  ≤ 0.001]. Patients with acute kidney injury were also more likely to die when compared with those without acute kidney injury [10 (20.4%) vs 15 (7.7%), p = 0.009]., Conclusion: The findings show an emerging and consistent trend of malaria admissions and the outcome in the youth and older adult population after the start of the COVID-19 pandemic in The Gambia. This, therefore, suggests the need for the implementation of targeted malaria prevention interventions in this population to further prevent the spread of the disease to the more vulnerable population., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Behavioral inhibition (BI), a tendency to withdraw from or avoid novel social and non-social situations, is a personality trait which can confer risk for anxiety disorders. Like many personality traits, BI is often assessed via self-report questionnaires where respondents rate themselves for frequency of certain behaviors or feelings. However, questionnaires have inherent limitations, particularly in psychiatric populations where there may be unawareness of deficit. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, we report on initial development of such an assessment tool, involving several onscreen scenarios with choice points where the participant can select from response options corresponding to inhibited or uninhibited behaviors. In two experiments involving over 300 college students, scores on the computer-based task were strongly correlated with BI scores attained through self-report questionnaire (r>.780, p<.001); this relationship held regardless of participant gender and experience with computer games. The results suggest that virtual environments may hold promise as alternative formats for assessment of personality traits in populations unsuited to traditional paper-and-pencil questionnaire formats due to psychopathology, limited attention span, or poor vocabulary and/or literacy skills.