Reconsidering rebound malaria: Zanzibari voices on acquired immunity, risk, and history

Zanzibaris' lack of familiarity with the concepts of acquired immunity and rebound malaria raises several serious questions. Ethical malaria interventions must honestly and clearly share relevant information. Failure to disclose risks such as fading/lost acquired immunity and rebound epidemics does not respect persons or autonomy. These findings indicate the need to shift to more robust consent practices, greater disclosure of potential risks, and more public education about these concepts. Informing Zanzibaris about the benefits and risks of malaria interventions empowers communities to participate in global health activities and recognizes the autonomy of individuals and communities.