According to the latest World Health Organization malaria report, 95% of 241 million global malaria cases and 96% of 627,000 malaria deaths that were recorded in 2020 occurred in Africa. Compared to 2019, 14 million more cases and 69,000 more malaria deaths were recorded, mainly because of disruptions to medical services during the COVID-19 pandemic. The aim of this study was to assess the prevalence of asymptomatic malaria cases in children and adults living in the Dzanga Sangha region in the Central African Republic (CAR) during the COVID-19 pandemic. Rapid immunochromatographic assays for the qualitative detection of Plasmodium species (P. falciparum, P. vivax, P. ovale/P. malariae) circulating in whole blood samples were used. A screening was performed in the group of 515 patients, 162 seemingly healthy children (aged 1–15) and 353 adults, all inhabiting the villages in the Dzanga Sangha region (southwest CAR) between August and September 2021. As much as 51.2% of asymptomatic children and 12.2% of adults had a positive result in malaria rapid diagnostic tests (mRDTs). Our findings demonstrated a very high prevalence of asymptomatic malaria infections in the child population. Limited access to diagnostics, treatment and prevention of malaria during the global COVID-19 pandemic and less medical assistance from developed countries may be one of the factors contributing to the increase in the prevalence of disease in Africa.

According to the World Health Organization 94% of global malaria cases and 94% of global malaria deaths have been reported from Africa. Unfortunately, it is difficult to determine the exact prevalence of disease in some African countries due to a large number of asymptomatic cases. The aim of this study was to assess the prevalence of malaria infections in seemingly healthy children living in the Central African Republic (CAR). CareStartTM Malaria HRP2 rapid diagnostic test (RDT) targeting Plasmodium falciparum was used to test a group of 500 asymptomatic children aged 1-15 years old (330 settled Bantu and 170 semi-nomadic BaAka Pygmies) inhabiting the villages in the Dzanga Sangha region (south-west CAR) in March 2020. In total, 32.4% of asymptomatic Bantu and 40.6% of asymptomatic Pygmy children had a positive result of malaria RDT. Our findings allowed us to demonstrate the high prevalence of asymptomatic malaria infections in south-west CAR. RDTs seem to be a useful tool for the detection of Plasmodium falciparum in areas with limited possibilities of using other diagnostic methods, such as light microscopy and molecular biology.

Introduction. Malaria remains a diagnostic and therapeutic challenge in many endemic regions of sub-Saharan Africa. It is one of the most important causes of morbidity and mortality, especially in children <5 years. Plasmodium falciparum is responsible for the majority of severe malaria cases in sub-Saharan Africa, but is not the exclusive one. Objective. The objective of the study was to assess the prevalence of Plasmodium spp. in BaAka Pygmies with clinical symptoms of malaria, and define the percentage distribution of infections caused by species other than P. falciparum in order to assess the need for diversification of malaria treatment protocols. Materials and method. The study was conducted during the dry and rainy seasons in 2018 and involved a group of 540 symptomatic BaAka Pygmies, patients of both genders, aged 1-75-years-old. Two diagnostic methods for detecting Plasmodium in the bloodstream were used: RDTs targeting HRP2-protein specific for P. falciparum, and PCR assays aimed at detecting P. falciparum, P. vivax, P. ovale, P. malariae species. Results. Only 40.5% of symptomatic patients tested with RDTs for P. falciparum infections were positive. Molecular tests (PCR) confirmed P. falciparum in 94.8% of the samples and also revealed the genetic material of P. malariae (11.1%), P. ovale (9.8%), and P. vivax (0.7%). BaAka Pygmies aged <5 years of age dominated in patients with positive results; the common clinical symptoms reported by the sick individuals were fever, shivers and fatigue. Conclusions. The study suggests the need for introducing accurate diagnostic methods for the diagnosis of malaria and the revision of malaria treatment protocols. Assessment of the Pfhrp2/Pfhrp3 deletions is necessary for evaluating malaria epidemiology in Central Africa.

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According to the World Health Organization 94% of global malaria cases and 94% of global malaria deaths have been reported from Africa. Unfortunately, it is difficult to determine the exact prevalence of disease in some African countries due to a large number of asymptomatic cases. The aim of this study was to assess the prevalence of malaria infections in seemingly healthy children living in the Central African Republic (CAR). CareStartTM Malaria HRP2 Pf Ag RDT targeting Plasmodium falciparum was used to test a group of 500 asymptomatic children aged 1-15 years old (330 settled Bantu and 170 semi-nomadic BaAka Pygmies) inhabiting the villages in the Dzanga Sangha region (south-west CAR) in March 2020. 32.4% of asymptomatic Bantu and 40.6% of asymptomatic Pygmy children had a positive result of malaria RDT. The mean age of the study participants with RDT (+) was 8.7 in Bantu and 7.0 years in Pygmies; the mean body temperature was 36.8oC in both groups; the mean haemoglobin level was 10.6 g/dL and 10.1 g/dL, respectively. Our findings allowed us to demonstrate the high prevalence of asymptomatic malaria infections in south-west CAR. RDTs seem to be a useful tool for the detection of Plasmodium falciparum in areas with limited possibilities of using other diagnostic methods, such as light microscopy and molecular biology.