Prevalence of <i>Plasmodium</i> spp. in symptomatic BaAka Pygmies inhabiting the rural Dzanga Sangha region of the Central African Republic

Abstract

Introduction. Malaria remains a diagnostic and therapeutic challenge in many endemic regions of sub-Saharan Africa. It is one of the most important causes of morbidity and mortality, especially in children <5 years. Plasmodium falciparum is responsible for the majority of severe malaria cases in sub-Saharan Africa, but is not the exclusive one. Objective. The objective of the study was to assess the prevalence of Plasmodium spp. in BaAka Pygmies with clinical symptoms of malaria, and define the percentage distribution of infections caused by species other than P. falciparum in order to assess the need for diversification of malaria treatment protocols. Materials and method. The study was conducted during the dry and rainy seasons in 2018 and involved a group of 540 symptomatic BaAka Pygmies, patients of both genders, aged 1-75-years-old. Two diagnostic methods for detecting Plasmodium in the bloodstream were used: RDTs targeting HRP2-protein specific for P. falciparum, and PCR assays aimed at detecting P. falciparum, P. vivax, P. ovale, P. malariae species. Results. Only 40.5% of symptomatic patients tested with RDTs for P. falciparum infections were positive. Molecular tests (PCR) confirmed P. falciparum in 94.8% of the samples and also revealed the genetic material of P. malariae (11.1%), P. ovale (9.8%), and P. vivax (0.7%). BaAka Pygmies aged <5 years of age dominated in patients with positive results; the common clinical symptoms reported by the sick individuals were fever, shivers and fatigue. Conclusions. The study suggests the need for introducing accurate diagnostic methods for the diagnosis of malaria and the revision of malaria treatment protocols. Assessment of the Pfhrp2/Pfhrp3 deletions is necessary for evaluating malaria epidemiology in Central Africa.

Airport Malaria in Non-Endemic Areas: New Insights into Mosquito Vectors, Case Management and Major Challenges

“…Most of the time, they are used as confirmatory tests in cases where the interpretation of the thick drop is difficult [33,34]. Venous blood (300 µL) is applied to a filtered paper FTA (Flinders Technology Associates) microcard, which is then stored in an aluminum barrier bag until the PCR (Polymerase Chain Reaction) test is performed [93]. The structure and composition of the FTA blotting paper allows for automatic isolation of DNA from its surface; the DNA is ready to be purified and analyzed after 30 min [93].…”

“…Venous blood (300 µL) is applied to a filtered paper FTA (Flinders Technology Associates) microcard, which is then stored in an aluminum barrier bag until the PCR (Polymerase Chain Reaction) test is performed [93]. The structure and composition of the FTA blotting paper allows for automatic isolation of DNA from its surface; the DNA is ready to be purified and analyzed after 30 min [93]. However, due to their implementation constraints, these techniques can only be used in equipped centers and during regular working hours.…”

Factors Affecting the Performance of HRP2-Based Malaria Rapid Diagnostic Tests

“…The following supporting information can be downloaded at: , Table S1: Reports on pfhrp2/3 deletions between 2018 to 2022 from different countries. References [ 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 ] are cited in the supplementary materials.…”