Circulation of Non- Species in Niger: Implications for Malaria Diagnosis.

BACKGROUND

Niger's National Malaria Control Programme and its partners use histidine-rich protein 2-based RDTs, which are specific to diagnosis. This study aimed to screen for the circulation of non- species in Zinder, a region of Niger, West Africa.

METHODS

A cross-sectional study was carried out from July to December 2022 at the district hospital of the Zinder region of Niger. histidine-rich protein 2-based rapid diagnostic tests were performed, and dried blood spot samples were collected for further laboratory multiplexed photo-induced electron transfer-polymerase chain reaction (PET-PCR) analysis on positive light microscopy from all patients with fever who attended the Zinder district hospital during the study period.

RESULTS

In total, 340 dried blood spots were collected and analyzed by PET-PCR. Overall, 73.2% (95% CI, 68.2%-77.9%; 249/340) were positive for genus and species and represented the study population. species proportions were 89.5% (95% CI, 85.1%-93.1%; 223/249) for , 38.5% (95% CI, 32.5%-44.9%; 96/249) for , 10.8% (95% CI, 7.3%-15.4%; 27/249) for , and 1.6% (95% CI, .4%-4.1%; 4/249) for . Single infection with species counted for 61.8% (95% CI, 55.5%-67.9%; 154/249), and the mixed infections rate, with at least 2 species, was 38.1% (95% CI, 32.1%-44.5%; 95/249). Single non- infections represented a rate of 10.0% (95% CI, 6.6%-14.5%; 25/249).

CONCLUSION

This study confirms the first evidence of by PET-PCR in Niger in addition to the other 3 species. These findings underline the need to adapt malaria diagnostic tools and therapeutic management, as well as the training of microscopists, for recognition of non- plasmodial species circulating in the country. This will better inform the strategies toward malaria control and elimination, as well as the decision making of the health authorities of Niger.