Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Geography, University of North Carolina, Chapel Hill, North Carolina, USA.
J Infect Dis. 2021 Mar 29;223(6):1005-1014. doi: 10.1093/infdis/jiaa478.
Plasmodium ovale is an understudied malaria species prevalent throughout much of sub-Saharan Africa. Little is known about the distribution of ovale malaria and risk factors for infection in areas of high malaria endemicity.
Using the 2013 Democratic Republic of the Congo (DRC) Demographic and Health Survey, we conducted a risk factor analysis for P. ovale infections. We evaluated geographic clustering of infections and speciated to P. ovale curtisi and P. ovale wallikeri through deep sequencing.
Of 18 149 adults tested, we detected 143 prevalent P. ovale infections (prevalence estimate 0.8%; 95% confidence interval [CI], .59%-.98%). Prevalence ratios (PR) for significant risk factors were: male sex PR = 2.12 (95% CI, 1.38-3.26), coprevalent P. falciparum PR = 3.52 (95% CI, 2.06-5.99), and rural residence PR = 2.19 (95% CI, 1.31-3.66). P. ovale was broadly distributed throughout the DRC; an elevated cluster of infections was detected in the south-central region. Speciation revealed P. ovale curtisi and P. ovale wallikeri circulating throughout the country.
P. ovale persists broadly in the DRC, a high malaria burden country. For successful elimination of all malaria species, P. ovale needs to be on the radar of malaria control programs.
卵形疟原虫是一种研究较少的疟疾物种，在撒哈拉以南非洲的大部分地区流行。对于卵形疟的分布以及在疟疾高度流行地区感染的危险因素知之甚少。
利用 2013 年刚果民主共和国（DRC）的人口与健康调查，我们对卵形疟感染的危险因素进行了风险因素分析。我们通过深度测序评估了感染的地理聚集性，并将其分类为卵形疟原虫 curtisi 和卵形疟原虫 wallikeri。
在 18149 名成年人中，我们检测到 143 例现患卵形疟感染（患病率估计为 0.8%；95%置信区间[CI]，0.59%-0.98%）。显著危险因素的患病率比（PR）为：男性 PR=2.12（95%CI，1.38-3.26），共感染恶性疟原虫 PR=3.52（95%CI，2.06-5.99），以及居住在农村 PR=2.19（95%CI，1.31-3.66）。卵形疟在刚果民主共和国广泛分布；在中南部地区检测到感染的高发集群。分类学发现卵形疟原虫 curtisi 和卵形疟原虫 wallikeri 在全国范围内传播。
卵形疟在疟疾负担高的刚果民主共和国广泛存在。为了成功消除所有疟疾，需要将卵形疟纳入疟疾控制规划的考虑范围。
