Subclinical Plasmodium spp. Infections in a Community Setting in Bangui, Central African Republic.

IF 3.1 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Research and Reports in Tropical Medicine Pub Date : 2025-01-21 eCollection Date: 2025-01-01 DOI:10.2147/RRTM.S495282
Romaric Nzoumbou-Boko, Mireille Cornelia Ingrid Denissio Morissi Nalingbo, Brice Martial Yambiyo, Roger Detol, Ermeland Rock Feller Moussa, Didita Nalinga, Lydie Joella-Venus de la Grace Namsenei-Dankpea, Alexandre Manirakiza, Lawrence Ayong, Yap Boum Ii
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引用次数: 0

Abstract

Background: Malaria is a major public health problem in the Central African Republic (CAR). Data on malaria epidemiology are often derived from confirmed cases of symptomatic malaria using passive detection approaches, with very limited knowledge of the extent of subclinical and submicroscopic infections.

Methods: A community-based cross-sectional study was conducted in Bangui, the capital of the CAR, to assess the prevalence of subclinical malaria parasitaemia. Proportions of positive tests for malaria parasites were determined by combining the results of antigen-based malaria rapid diagnostic test (mRDT), thick blood smear microscopy, and polymerase chain reaction (PCR).

Results: A total of 638 participants (mean age, 26.44 years (range, [1-75] years) with a sex ratio (M/F) of 1.22) were tested for malaria using all three detection methods. Proportions of positives were 32.45% by PCR, 27.59% by mRDT, and 23.51% by Giemsa-based thick blood smear microscopy, representing the burden of subclinical malaria. In addition, a 9.56% prevalence of submicroscopic infections was observed. Subclinical malaria was more common in individuals aged 15-49 years, and microspatial heterogeneity in positivity was observed, with the majority of cases occurring in semi-urban areas by mRDT and microscopy, respectively. Approximately, 80% of microscopy-positive subjects had a low parasite density (<1000 parasites/µL whole blood). Although P. falciparum was the most common species (98.55%), the transmission of P. ovale appears to be well-established in the area, occurring either as mono-infection (1.45%) or co-infection (1.93%) with P. falciparum.

Conclusion: This study of community malaria in Bangui highlights the high burden of subclinical malaria in the community and provides essential baseline data to guide future research on malaria parasites in the CAR, particularly regarding the circulating parasite species. The high prevalence of community malaria demonstrates its persistence as a major public health challenge in the country, highlighting the need to intensify its ongoing control using new tools such as the upcoming malaria vaccine.

中非共和国班吉社区环境中的亚临床疟原虫感染
背景:疟疾是中非共和国(CAR)的一个主要公共卫生问题。疟疾流行病学数据往往来自采用被动检测方法的有症状疟疾确诊病例,对亚临床和亚显微镜感染程度的了解非常有限。方法:在中非共和国首都班吉进行了一项以社区为基础的横断面研究,以评估亚临床疟疾寄生虫病的流行情况。通过结合基于抗原的疟疾快速诊断试验(mRDT)、厚血涂片镜检和聚合酶链反应(PCR)的结果,确定了疟疾寄生虫阳性检测的比例。结果:共有638名参与者(平均年龄26.44岁(范围[1-75]岁),性别比(M/F)为1.22)使用所有三种检测方法进行了疟疾检测。PCR阳性比例为32.45%,mRDT阳性比例为27.59%,giemsa血涂片镜检阳性比例为23.51%,为亚临床疟疾的负担。亚显微感染检出率为9.56%。亚临床疟疾在15-49岁人群中更为常见,并且观察到阳性的微空间异质性,分别通过mRDT和显微镜观察发现,大多数病例发生在半城市地区。镜检阳性人群中约80%的寄生虫密度较低,其中恶性疟原虫最为常见(98.55%),卵形疟原虫在该地区的传播情况较为稳定,以单一感染(1.45%)或与恶性疟原虫合并感染(1.93%)的形式存在。结论:班吉社区疟疾的这项研究突出了社区亚临床疟疾的高负担,并为指导中非共和国未来的疟疾寄生虫研究,特别是关于流行寄生虫物种的研究提供了必要的基线数据。社区疟疾的高流行率表明,它一直是该国的一项重大公共卫生挑战,突出表明需要利用诸如即将推出的疟疾疫苗等新工具加强目前的控制。
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来源期刊
Research and Reports in Tropical Medicine
Research and Reports in Tropical Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
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16 weeks
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