Institute of International Health, Center for Global Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
John Curtin School of Medical Research, Australian National University, Canberra, Australia.
Am J Trop Med Hyg. 2023 Aug 7;109(3):621-623. doi: 10.4269/ajtmh.23-0143. Print 2023 Sep 6.
Plasmodium vivax is the second-most common malaria pathogen globally, but is considered very rare in the predominantly Duffy-negative sub-Saharan African population. In 259 malaria patients from highland southern Rwanda, we assessed Plasmodium species and Duffy blood group status by polymerase chain reaction (PCR). Plasmodium falciparum, P. vivax, Plasmodium malariae, and Plasmodium ovale were seen in 90.7%, 8.1%, 11.6%, and 5.0%, respectively. Plasmodium vivax occurred more frequently as a monoinfection than in combination with P. falciparum. All P. vivax-infected individuals showed heterozygous Duffy positivity, whereas this was the case for only 3.1% of patients with P. falciparum monoinfection and malaria-negative control subjects (P < 0.01). Based on PCR diagnosis, P. vivax is not rare in southern Rwanda. All episodes of P. vivax were observed in heterozygous Duffy-positive patients, whereas elsewhere in Africa, P. vivax is also reported in Duffy-negative individuals. Refined mapping of Plasmodium species is required to establish control and elimination strategies including all malaria species.
间日疟原虫是全球第二常见的疟原虫病原体，但在主要为 Duffy 阴性的撒哈拉以南非洲人群中被认为非常罕见。在卢旺达南部高地的 259 名疟疾患者中，我们通过聚合酶链反应 (PCR) 评估了疟原虫种类和 Duffy 血型状况。分别在 90.7%、8.1%、11.6%和 5.0%的患者中观察到恶性疟原虫、间日疟原虫、卵形疟原虫和三日疟原虫。间日疟原虫更常以单一感染的形式出现，而不是与恶性疟原虫混合感染。所有感染间日疟原虫的个体均表现为杂合 Duffy 阳性，而单纯感染恶性疟原虫的患者和疟疾阴性对照者中仅 3.1%为这种情况（P < 0.01）。基于 PCR 诊断，间日疟原虫在卢旺达南部并不罕见。所有间日疟原虫感染均发生在杂合 Duffy 阳性患者中，而在非洲其他地区，也有报道称 Duffy 阴性个体也感染间日疟原虫。需要进行更精细的疟原虫种类绘图，以制定包括所有疟原虫在内的控制和消除策略。
