Gaither Claudia, Morgan Camille, Kirby Rebecca, Karema Corine, Gashema Pierre, Zuromski Jenna, White Samuel J, Topazian Hillary M, Giesbrecht David, Thwai Kyaw, Young Neeva Wernsman, Goel Varun, Boyter Koby, Munyaneza Tharcisse, Muvunyi Claude Mambo, Butera Jean De Dieu, Bailey Jeffrey A, Mazarati Jean-Baptiste, Juliano Jonathan J
Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America.
PLoS One. 2025 Sep 11;20(9):e0330480. doi: 10.1371/journal.pone.0330480. eCollection 2025.
Recent molecular surveillance suggests an unexpectedly high prevalence of non-falciparum malaria in Africa. Malaria control is also challenged by undetected asymptomatic P. falciparum malaria resulting in an undetectable reservoir for potential transmission. Context-specific surveillance of asymptomatic P. falciparum and non-falciparum species is needed to properly inform malaria control programs.
We performed quantitative real time PCR for four malaria species in 5,050 primarily adult individuals in Rwanda using the 2014-2015 Demographic Health Survey. We assessed correlates of infection by species to explore attributes associated with each species. Asymptomatic P. ovale spp., P. malariae, and P. falciparum malaria infection had broad spatial distribution across Rwanda. P. vivax infection was rare.
Overall infection prevalence was 22.3% (95%CI [20.3, 24.3]), with P. falciparum and non-falciparum at 16.3% [14.5, 18.1] and 8.0% [6.6, 9.3], respectively. Parasitemias tended to be low and mixed species infections were common, especially where malaria transmission and overall prevalence was the highest. P. falciparum infection was associated with lower wealth, rural residence and low elevation. Fewer factors were significantly associated with non-falciparum malaria.
Asymptomatic non-falciparum malaria and P. falciparum malaria are common and widely distributed across Rwanda in adults. Continued molecular monitoring, preferably done by the national malaria control program, of Plasmodium diversity using routine survey samples is needed to strengthen malaria control.
近期的分子监测表明，非洲非恶性疟原虫疟疾的流行率出人意料地高。未被检测到的无症状恶性疟原虫疟疾也给疟疾控制带来了挑战，导致存在一个潜在传播的未被检测到的传染源。需要针对特定情况对无症状恶性疟原虫和非恶性疟原虫物种进行监测，以便为疟疾控制项目提供恰当信息。
我们利用2014 - 2015年人口与健康调查，对卢旺达5050名主要为成年人的个体进行了四种疟原虫的定量实时PCR检测。我们评估了按物种分类的感染相关因素，以探索与每种物种相关的特征。卵形疟原虫、三日疟原虫和恶性疟原虫的无症状感染在卢旺达各地具有广泛的空间分布。间日疟原虫感染很少见。
总体感染率为22.3%（95%置信区间[20.3, 24.3]），其中恶性疟原虫和非恶性疟原虫的感染率分别为16.3% [14.5, 18.1]和8.0% [6.6, 9.3]。疟原虫血症往往较低，混合物种感染很常见，尤其是在疟疾传播和总体流行率最高的地区。恶性疟原虫感染与较低的财富水平、农村居住和低海拔有关。与非恶性疟原虫疟疾显著相关的因素较少。
无症状非恶性疟原虫疟疾和恶性疟原虫疟疾在卢旺达成年人中很常见且分布广泛。需要利用常规调查样本，通过国家疟疾控制项目持续进行疟原虫多样性的分子监测，以加强疟疾控制。
