WHO Uganda Country Office, Kampala, Uganda.
Malar J. 2024 Jul 12;23(1):207. doi: 10.1186/s12936-024-05023-9.
Plasmodium falciparum is the dominant malaria species in the sub-Saharan Africa and the main cause of severe disease and death. Notwithstanding, severe malaria and death due to non-falciparum infections have been reported, but at much lower rates than P. falciparum infections. Following increasing use of molecular detection techniques in epidemiological studies, a higher prevalence of non-falciparum species has been reported in the region than previously thought. This article reviews the literature on the prevalence of non-falciparum malaria species in Uganda and the clinical figures of their severe diseases. It aims to elucidate the extent to which mono non-falciparum malaria infections in a highly malaria-endemic country contribute to malaria mortality and outline its policy implications on malaria case management.
The available English-language published peer-reviewed literature up to March 2024 was sought via PubMed and Google Scholar. The keywords used were severe malaria, AND P. falciparum, P. malariae, P. vivax, P. ovale spp., mixed infections AND Uganda. The review encompassed 53 articles. Articles using molecular diagnosis methods were accounted for analysis.
The literature reported a substantial prevalence of non-falciparum infections in Uganda. Plasmodium malariae and Plasmodium ovale spp. were the second and third most prevalent reported malaria species respectively after P. falciparum as dominant species. Non-falciparum malaria infections often occur as mixed infections rather than mono-infections. Besides, molecular diagnostics revealed that 21% of initially reported mono-infections of P. falciparum were, in fact, mixed infections. No article was found on the prevalence of severe malaria or case fatality rate due to mixed or non-falciparum infections.
A critical knowledge gap exists regarding the impact of mixed and non-falciparum species on severe malaria and death in Uganda. Robust evidence on prevalence, recurrent parasitaemia, and severe clinical manifestations of mixed and non-falciparum malaria infections is crucial for evidence-based and effective policymaking regarding malaria case management.
恶性疟原虫是撒哈拉以南非洲地区的主要疟疾病原体，也是导致严重疾病和死亡的主要原因。尽管如此，也有报道称非恶性疟原虫感染会导致严重疟疾和死亡，但发病率远低于恶性疟原虫感染。随着分子检测技术在流行病学研究中的广泛应用，该地区报告的非恶性疟原虫种的流行率高于先前的估计。本文综述了乌干达非恶性疟原虫疟疾的流行情况以及其严重疾病的临床数据，旨在阐明在一个疟疾高度流行的国家，单一致疟原虫感染对疟疾死亡率的影响，并概述其对疟疾病例管理的政策意义。
通过 PubMed 和 Google Scholar 检索截至 2024 年 3 月的已发表的英文同行评议文献。使用的关键词为严重疟疾、恶性疟原虫、间日疟原虫、卵形疟原虫、三日疟原虫和混合感染以及乌干达。综述涵盖了 53 篇文章。对使用分子诊断方法的文章进行了分析。
文献报告称，乌干达的非恶性疟原虫感染率很高。间日疟原虫和卵形疟原虫是继恶性疟原虫之后报告的第二和第三大常见疟原虫，恶性疟原虫是主要病原体。非恶性疟原虫感染通常为混合感染，而非单一感染。此外，分子诊断显示，最初报告的 21%恶性疟原虫单一感染实际上是混合感染。没有找到关于混合或非恶性疟原虫感染导致严重疟疾或病死率的文章。
关于混合和非恶性疟原虫对乌干达严重疟疾和死亡的影响，存在一个关键的知识空白。关于混合和非恶性疟原虫感染的流行率、复发性寄生虫血症和严重临床表现的可靠证据，对于疟疾病例管理的循证和有效决策至关重要。
