Abstract
Multiplicity of infection (MOI) and genetic diversity of P. falciparum infections are important surrogate indicators for assessing malaria transmission intensity in different regions of endemicity. Determination of MOI and diversity of P. falciparum among asymptomatic carriers will enhance our understanding of parasite biology and transmission to mosquito vectors. This study examined the MOI and genetic diversity of P. falciparum parasite populations circulating in Mbita, a region characterized as one of the malaria hotspots in Kenya. The genetic diversity and multiplicity of P. falciparum infections in 95 asymptomatic school children (age 5–15 yrs.) residing in Mbita, western Kenya were assessed using 10 polymorphic microsatellite markers. An average of 79.69% (Range: 54.84–95.74%) of the isolates analysed in this study were polyclonal infections as detected in at least one locus. A high mean MOI of 3.39 (Range: 2.24–4.72) and expected heterozygosity (He) of 0.81 (Range: 0.57–0.95) was reported in the study population. The analysed samples were extensively polyclonal infections leading to circulation of highly genetically diverse parasite populations in the study area. These findings correlated with the expectations of high malaria transmission intensity despite scaling up malaria interventions in the area thereby indicating the need for a robust malaria interventions particularly against asymptomatic carriers in order to attain elimination in the region.
Highlights
Malaria continues to be a major public health problem in many parts of the world despite numerous national and international efforts in combatting the ongoing disease transmission
The use of molecular genotyping of polymorphic antigenic markers like merozoite surface protein (MSP) 1 and 2, glutamate rich protein (Glurp) for parasite diversity studies are faced with some criticisms due to the fact that these genes are implicated to be under strong immune selection[44,50,51,52]
Based on the Rapid Diagnostic Test (RDT) and microscopy results, 77 (81.1%) of the participants were infected with only P. falciparum while 18 (18.9%) of the subjects were infected with P. falciparum plus another Plasmodium species (P. ovale and P. malariae) and 50.5% carried the sexual stage of the parasite
Summary
Malaria continues to be a major public health problem in many parts of the world despite numerous national and international efforts in combatting the ongoing disease transmission. The high prevalence of asymptomatic carriers especially among older children[19,24,25,26,27,28], high recombination rates among distinct P. falciparum clones in endemic settings leading to emergence of highly diverse parasite isolates, rapid emergence and distribution of drug resistant P. falciparum parasite strains[29,30,31,32,33], and prevalence of infections characterized by multiple genetically distinct parasite strains are some of the major contributing factors hindering the global malaria control and elimination[31,34,35]. These criteria have made them an ideal tool for the estimation of parasite genetic diversity and MOI36,46,48
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