Nationwide molecular surveillance of three Plasmodium species harboured by symptomatic malaria patients living in Ghana

Abstract

Background Clinical presentations of malaria in Ghana are primarily caused by infections containing microscopic densities of Plasmodium falciparum, with a minor contribution from Plasmodium malariae and Plasmodium ovale. However, infections containing submicroscopic parasite densities can result in clinical disease. In this study, we used PCR to determine the prevalence of three human malaria parasite species harboured by suspected malaria patients attending healthcare facilities across the country. Methods Archived dried blood spots on filter paper that had been prepared from whole blood collected from 5260 patients with suspected malaria attending healthcare facilities across the country in 2018 were used as experimental material. Plasmodium species-specific PCR was performed on DNA extracted from the dried blood spots. Demographic data and microscopy data for the subset of samples tested were available from the original study on these specimens. Results The overall frequency of P. falciparum, P. malariae and P. ovale detected by PCR was 74.9, 1.4 and 0.9%, respectively. Of the suspected symptomatic P. falciparum malaria cases, 33.5% contained submicroscopic densities of parasites. For all regions, molecular diagnosis of P. falciparum, P. malariae and P. ovale was significantly higher than diagnosis using microscopy: up to 98.7% (75/76) of P. malariae and 97.8% (45/46) of P. ovale infections detected by PCR were missed by microscopy. Conclusion Plasmodium malariae and P. ovale contributed to clinical malaria infections, with children aged between 5 and 15 years harbouring a higher frequency of P. falciparum and P. ovale, whilst P. malariae was more predominant in individuals aged between 10 and 20 years. More sensitive point-of-care tools are needed to detect the presence of low-density (submicroscopic) Plasmodium infections, which may be responsible for symptomatic infections. Graphical Abstract

The burden of Vector-Borne and Soil-Transmitted Polyparasitism in a Nigerian Rural Community: A cross-sectional study

“…The high prevalence of asymptomatic malaria recorded in the study confirms previous reports that malaria is hyperendemic in Osun State [23]. It was previously observed that the majority of individuals infected with malaria parasites living in endemic regions do not show symptoms of this disease [24]. The high prevalence of malaria parasites could be a reflection of the poor socioeconomic condition of the study area, which promotes the transmission of malaria, especially during the rainy season.…”

Late Parasitological Failure and Subsequent Isolated Gametocytemia of Uncomplicated Plasmodium falciparum Malaria in a Returned Traveler From Ghana, 2023

“…In Ghana, approximately 75% of malaria cases are caused by P. falciparum , and some are caused by P. malariae and P. ovale . 9 For our patient, PCR was positive only for P. falciparum during both admissions. Clear distinction between isolated gametocytemia and treatment failure is necessary for effective treatment.…”

Molecular speciation of Plasmodium and multiplicity of P. falciparum infection in the Central region of Ghana

“…Another finding worth nothing was that, all the other non-falciparum species identified, co-infected with the falciparum species. However, this is not new in Ghana, since a previous study has recorded almost the same prevalence (0.7%) of Pf/Po in a nationwide study that analysed 5260 samples [ 28 ]. The other mixed-infection that was found in this study was Pf/Pv/Pm .…”