[en] Malaria remains a major public health problem in the Democratic Republic of Congo (DRC) with 14 million cases reported by the WHOMalaria Report in 2014. Asymptomaticmalaria cases are known to be prevalent in endemic areas and are generally untreated,resulting in a significant source of gametocytes that may serve as reservoir of disease transmission. Considering that microscopycertainly underestimates the prevalence of Plasmodium infections within symptomatic carriers and that PCR assays are currentlyrecognized as the most sensitive methods for Plasmodium identification, this study was conducted to weigh the asymptomatic
carriage in DRC by a molecular method. Six provinces were randomly selected for blood collection in which 80 to 100 individuals were included in the study. Five hundred and eighty blood sampleswere collected andmolecular diagnosiswas performed. Globally, almost half of the samples collected from asymptomatic individuals (280/580; 48.2%) had Plasmodium infections and the most species identified was P. falciparum alone in combination with P. malariae. The high prevalence reported here should interpellate the bodies involved in malaria control in DR Congo to take into account asymptomatic carriers in actions taken and consider asymptomatic malaria as a major hurdle for malaria elimination.
Disciplines :
Immunology & infectious disease
Author, co-author :
Mvumbi, Dieudonné; School of Medicine, University of Kinshasa, P.O. Box Kin XI > Biochemistry and Molecular Biology Unit, Department of Basic Sciences
Bobanga, Thierry; UNIKIN
Melin, Pierrette ; Université de Liège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie
De Mol, Patrick ; Université de Liège > Département des sciences biomédicales et précliniques > Département des sciences biomédicales et précliniques
Kayembe, Jean-Marie; Université de Kinshasa
Situakibanza, Hippolyte; UNIKIN > Department of Parasitology and Tropical Medicine,
Mvumbi, Georges; University of Kinshasa > 1Biochemistry and Molecular Biology Unit, Department of Basic Sciences, School of Medicine, University of Kinshasa
Nsibu, Célestin
Umesumbu, Solange
Hayette, Marie-Pierre ; Université de Liège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie
Language :
English
Title :
High Prevalence of Plasmodium falciparum Infection in Asymptomatic Individuals from the Democratic Republic of the Congo
Alternative titles :
[en] Forte prévalence de l'infection à Plasmodium falciparum en RDC [en] Forte prévalence de l'infection à Plasmodium falciparum chez des sujets asymptomatiques en RDC
N. J. White, S. Pukrittayakamee, T. T. Hien, M. A. Faiz, O. A. Mokuolu, and A. M. Dondorp, "Malaria," The Lancet, vol. 383, no. 9918, pp. 723-735, 2014.
D. L. Doolan, C. Dobaño, and J. K. Baird, "Acquired immunity to malaria," Clinical Microbiology Reviews, vol. 22, no. 1, pp. 13-36, 2009.
M. P. Grobusch and P. G. Kremsner, "Uncomplicated malaria," Current Topics in Microbiology and Immunology, vol. 295, pp. 83-104, 2005.
K. P. Day and K. Marsh, "Naturally acquired immunity to Plasmodium falciparum," Immunology Today, vol. 12, no. 3, pp. A68-A71, 1991.
R. W. Snow, J. A. Omumbo, B. Lowe et al., "Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa," The Lancet, vol. 349, no. 9066, pp. 1650-1654, 1997.
M. Vafa, M. Troye-Blomberg, J. Anchang, A. Garcia, and F. Migot-Nabias, "Multiplicity of Plasmodium falciparum infection in asymptomatic children in Senegal: relation to transmission, age and erythrocyte variants," Malaria Journal, vol. 7, article 17, 2008.
E. Bottius, A. Guanzirolli, J.-F. Trape, C. Rogier, L. Konate, and P. Druilhe, "Malaria: even more chronic in nature than previously thought: evidence for subpatentparasitemia detectable by PCR," Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 90, no. 1, pp. 15-19, 1996.
J. F. Trape, A. Zoulani, and M. C. Quinet, "Assessment of the incidence and prevalence of clinical malaria in semi-immune children exposed to intense and perennial transmission," American Journal of Epidemiology, vol. 126, no. 2, pp. 193-201, 1987.
T. Smith, J. D. Charlwood, J. Kihonda et al., "Absence of seasonal variation in malaria parasitaemia in an area of intense seasonal transmission," Acta Tropica, vol. 54, no. 1, pp. 55-72, 1993.
F. P. Alves, L. H. S. Gil, M. T. Marrelli, P. E. M. Ribolla, E. P. Camargo, and L. H. P. Da Silva, "Asymptomatic carriers of Plasmodium spp. as infection source for malaria vector mosquitoes in the Brazilian Amazon," Journal of Medical Entomology, vol. 42, no. 5, pp. 777-779, 2005.
World Health Organization, World Malaria Report, WHO Press, Geneva, Switzerland, 2014, http://www.who.int/malaria/publications/world-malaria-report-2014/report/en/.
J. R. Matangila, J. Lufuluabo, A. L. Ibalanky, R. A. Inocêncio da Luz, P. Lutumba, and J.-P. Van Geertruyden, "Asymptomatic Plasmodium falciparum infection is associated with anaemia in pregnancy and can be more cost-effectively detected by rapid diagnostic test than by microscopy in Kinshasa, Democratic Republic of the Congo," Malaria Journal, vol. 13, article132, 2014.
V. Maketa, H. Mavoko, R. da Luz et al., "The relationship between Plasmodium infection, anaemia and nutritional status in asymptomatic children aged under five years living in stable transmission zones in Kinshasa, Democratic Republic of Congo," Malaria Journal, vol. 14, no. 1, p. 83, 2015.
Demographic and Health Survey, Democratic Republic of Congo, 2014, http://www.dhsprogram.com/pubs/pdf/FR300/FR300.pdf.
A. B. Tiono, A. Ouédraogo, A. Diarra et al., "Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso," Malaria Journal, vol. 13, no. 1, article 30, 2014.
G. Snounou, S. Viriyakosol, Xin Ping Zhu et al., "High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction," Molecular and Biochemical Parasitology, vol. 61, no. 2, pp. 315-320, 1993.
N. Steenkeste, S. Incardona, S. Chy et al., "Towards high-throughput molecular detection of Plasmodium: new approaches and molecular markers," Malaria Journal, vol. 8, no. 1, article 86, 2009.
W. Jarra and G. Snounou, "Only viable parasites are detected by PCR following clearance of rodent malarial infections by drug treatment or immune responses," Infection and Immunity, vol. 66, no. 8, pp. 3783-3787, 1998.
L. Cnops, J. Jacobs, and M. Van Esbroeck, "Validation of a four-primer real-time PCR as a diagnostic tool for single and mixed Plasmodium infections," Clinical Microbiology and Infection, vol. 17, no. 7, pp. 1101-1107, 2011.
F. N. Baliraine, Y. A. Afrane, D. A. Amenya et al., "High prevalence of asymptomatic Plasmodium falciparum Infections in a highland area of western Kenya: a cohort study," Journal of Infectious Diseases, vol. 200, no. 1, pp. 66-74, 2009.
M. P. Dal-Bianco, K. B. Köster, U. D. Kombila et al., "High prevalence of asymptomatic Plasmodium falciparum infection in Gabonese adults," American Journal of Tropical Medicine and Hygiene, vol. 77, no. 5, pp. 939-942, 2007.
J. May, F. P. Mockenhaupt, O. G. Ademowo et al., "High rate of mixed and subpatent malarial infections in southwest Nigeria," The American Journal of Tropical Medicine and Hygiene, vol. 61, no. 2, pp. 339-343, 1999.
G. H. Stresman, A. Kamanga, P. Moono et al., "A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia," Malaria Journal, vol. 9, no. 1, article 265, 2010.
B. Ogutu, A. B. Tiono, M. Makanga et al., "Treatment of asymptomatic carriers with artemether-lumefantrine: an opportunity to reduce the burden of malaria?" Malaria Journal, vol. 9, no. 1, article 30, 2010.
S. E. Kern, A. B. Tiono, M. Makanga et al., "Community screening and treatment of asymptomatic carriers of Plasmodium falciparum with artemether-lumefantrine to reduce malaria disease burden: a modelling and simulation analysis," Malaria Journal, vol. 10, article 210, 2011.
