Kouevi Amélé Fifi Chantal, Bayala Ipéné Mylène Carenne, Sondo Paul, Kaboré Bérenger, Millogo Kié Solange, Kambou Sié A Elisée, Compaore Eulalie W, Nikiema Moustapha, Kazienga Adama, Rouamba Toussaint, Gnémé Awa, Tinto Halidou
Institut de Recherche en Sciences de la Santé (IRSS)/ Clinical Research Unit of Nanoro (CRUN), Nanoro, Burkina Faso.
Laboratoire de Biologie et Ecologie Animales/ Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
Malariaworld J. 2025 Jul 16;16:15. doi: 10.5281/zenodo.15965746. eCollection 2025.
The widespread use of histidine-rich protein 2 (HPR2)-based rapid diagnostic tests (RDTs), specific to in endemic areas may underestimate the weight of minor species such as and in malaria transmission. This study aimed to determine the extent of undetected and infections in children with positive diagnosis of uncomplicated malaria based on HRP2 RDT in the Nanoro health district, Burkina Faso.
Children <5 yrs with uncomplicated malaria confirmed by HRP2 RDT were recruited from July 2021 to June 2022 in five peripheral health facilities of the Nanoro health district. Blood samples were collected from finger prick for malaria species identification by microscopy and nested PCR. The prevalence of , , and mixed infections was estimated as the ratio of positive cases over the total samples analysed. Binomial generalised linear models were used to assess the effect of age and sex on the positivity rate of mixed infections.
Over the study period, 207 children with uncomplicated malaria who tested positive for the HRP2 antigen were included. Microscopy detected 4 non- cases: 3 and 1 . In addition to these patent cases, sub-patent infection with and were detected in 6 and 5 cases, respectively. Mixed infections with non- species exhibited lower parasite densities than mono-infections with alone. There was no effect of gender or age on the mixed infection positivity rate (X=0.16, p=0.683).
The widespread use of HPR2-based RDTs underestimate the burden of non- species. In the context of eliminating malaria, new diagnostic tools allowing the detection of species other than must be deployed.
在疟疾流行地区，基于富含组氨酸蛋白2（HPR2）的快速诊断检测（RDT）广泛使用，可能会低估诸如卵形疟原虫和三日疟原虫等次要疟原虫种类在疟疾传播中的比重。本研究旨在确定在布基纳法索纳诺罗卫生区，基于HPR2 RDT确诊为非重症疟疾的儿童中未检测到的卵形疟原虫和三日疟原虫感染的程度。
2021年7月至2022年6月，在纳诺罗卫生区的五个基层卫生机构招募了经HPR2 RDT确诊为非重症疟疾的5岁以下儿童。通过手指采血收集血样，用于显微镜检查和巢式PCR法进行疟原虫种类鉴定。卵形疟原虫、三日疟原虫及混合感染的患病率以阳性病例数与分析的总样本数之比来估算。采用二项广义线性模型评估年龄和性别对混合感染阳性率的影响。
在研究期间，纳入了207例HPR2抗原检测呈阳性的非重症疟疾儿童。显微镜检查发现4例非恶性疟原虫病例：3例卵形疟原虫和1例三日疟原虫。除了这些显性病例外，还分别在6例和5例中检测到卵形疟原虫和三日疟原虫的隐性感染。与仅感染恶性疟原虫的单一感染相比，非恶性疟原虫种类的混合感染寄生虫密度较低。性别或年龄对混合感染阳性率没有影响（X=0.16，p=0.683）。
基于HPR2的RDT广泛使用会低估非恶性疟原虫种类的负担。在消除疟疾的背景下，必须部署能够检测除恶性疟原虫以外其他疟原虫种类的新诊断工具。
