Molecular detection and species identification of Plasmodium spp. infection in adults in the Democratic Republic of Congo: A population-based study

Abstract

Background In efforts to control malaria infection, the Democratic Republic of Congo has implemented several strategies. Studies assessing their efficiency mainly involved at-risk groups, especially children under five years of age. This study aimed to determine the prevalence and identify the risk factors associated with Plasmodium spp. infection. Methods From October 2014 to March 2015, individuals aged at least 15 years were selected randomly and enrolled in a cross-sectional study conducted throughout the country. Microscopy and polymerase chain reaction (PCR) analysis were used for the detection of Plasmodium ssp. Results From 2286 individuals recruited, 1870 with valid laboratory results were included in the study for further analysis. The prevalence of Plasmodium spp. infection assessed by microscopy (355/ 1870 (19%) was lower than that estimated by PCR (580/1870 (31%). In addition, the difference between the two results was statistically significant (P < 0.0001). The most prevalent Plasmodium species was P. falciparum, either as mono-infection (96.3%; 95% C.I. 93.9–98.1) or combined with P. malariae (3.7%; 95% C.I. 2.8–5.9). The mean parasite density was 3272739 trophozoites/μL of blood. Women had higher risks of being infected than men (OR 2.03, 95% C.I.: 1.96. 2.62, P = 0.041)]. Conclusion In this study, the molecular detection and species identification of Plasmodium spp. showed that, despite all efforts for malaria control, malaria remains a public health problem in the Democratic Republic of Congo. The high prevalence and parasite density of Plasmodium spp. in adults make this age group a potential parasitic infectious reservoir for the at-risk groups and supports the need to include this age group in further programs for malaria control.

Epidemiology ofPlasmodium malariaeandPlasmodium ovalespp. in a highly malaria-endemic country: a longitudinal cohort study in Kinshasa Province, Democratic Republic of Congo

“…Similar prevalences were observed among symptomatic individuals. Prevalences generally align with previous estimates of non-falciparum infections in the DRC derived from cross-sectional studies 14,[16][17][18][19][20][21][22]41 . Infection prevalences were stable across the 34-month follow-up, differing from recent studies in neighboring countries which have detected increases in P. malariae and P. ovale infection prevalence over time, particularly as P. falciparum prevalences have started to decline 3,4,6 .…”

“…have been documented at low-level prevalences in the DRC 8,[14][15][16] ; however, their epidemiology and clinical impact remains poorly understood. Existing non-falciparum prevalence estimates were largely derived from cross-sectional studies, limiting risk assessment, or focused on a singular age group or symptomatic status, which restricts broader generalizability 14,[16][17][18][19][20][21][22] . The absence of reliable field diagnostics for these less-common infections complicates surveillance efforts and case management.…”

Prevalence and Molecular Detection of Plasmodium falciparum among Pregnant Women Attending Selected Hospitals in Kaduna North Local Government Area, Kaduna State

“…Kiyonga et al, 2020), and might be from degradation of extracted DNA due to poor storage conditions and the activity of DNase that digests DNA molecules. This observation contradicts those ofMbuyi et al (2014) who reported that P. falciparum DNA was amplified in all the samples shown to be infected by microscopy examination.…”