Abstract
Background Monitoring changes in the composition of the Plasmodium species circulating within the population over a period can inform appropriate treatment recommendations. This study monitored variations in the prevalence of four common human Plasmodium species carried by children with asymptomatic malaria infections over a two-year period. Methods Two cross-sectional studies were conducted in November 2017 and December 2019. A total of 210 children aged between 4 and 13 years were recruited in 2017, and 164 similarly aged children were recruited in 2019. Approximately 150 μl of finger-pricked blood was used to prepare thick and thin blood smears as well as spot Whatman® #3 filter paper. Genomic DNA was extracted from the dried blood spots and used in PCR to amplify the 18S rRNA gene from four different human Plasmodium parasites. Results Parasite prevalence by microscopy and the prevalence of P. falciparum detected by PCR was relatively similar at the two time points (Pearson chi-square = 0.405, p=0.525, and Pearson chi-square = 0.452, p=0.501, respectively). However, the prevalence of PCR detectable P. malariae increased by 8.5-fold, whilst P. ovale increased from 0 to 9% in the children sampled in 2019 relative to the children sampled in 2017. The only parasite species identified by microscopy in this study was P. falciparum, and no P. vivax was identified by either microscopy or PCR in the study population during the study period. Conclusion There is the need to implement molecular diagnostic tools for malaria parasite surveillance in Ghana. This will enable the identification and treatment of all circulating malaria parasites including P. malariae and P. ovale, whose population is expanding in parts of Ghana including Simiw.
Highlights
All human malaria parasite species are capable of causing symptomatic as well as asymptomatic infections [1]
Discussion e National Malaria Control Program of Ghana has implemented numerous vector control interventions including enhanced distribution of insecticide-treated materials and adulticiding and larviciding of mosquitoes in addition to parasite control interventions including adapting the T3: Test, Treat, Track Initiative. ese interventions have resulted in a reduction in the incidence and prevalence of severe manifestations of malaria and uncomplicated malaria but not asymptomatic malaria [20]. e escalation of global efforts to eliminate malaria [21, 22] requires improved rapid and effective diagnosis of symptomatic as well as asymptomatic infections caused by all human malaria parasites [23, 24]
Is study determined the prevalence of children harboring P. falciparum in asymptomatic infections to have remained stable over the two-year study period. is supports an earlier report that malaria control in several parts of sub-Saharan Africa, including Ghana, remains a substantial challenge [10]
Summary
All human malaria parasite species are capable of causing symptomatic as well as asymptomatic infections [1]. The inability of microscopy to detect low-density infections [5,6,7] does not make it ideal for the detection of Plasmodium parasites contained in asymptomatic infections [8]. Infections containing P. malariae and P. ovale most often present as low-density asymptomatic infections that require molecular tools for accurate detection [11, 12]. Is study monitored variations in the prevalence of four common human Plasmodium species carried by children with asymptomatic malaria infections over a two-year period. Genomic DNA was extracted from the dried blood spots and used in PCR to amplify the 18S rRNA gene from four different human Plasmodium parasites. Conclusion. ere is the need to implement molecular diagnostic tools for malaria parasite surveillance in Ghana. is will enable the identification and treatment of all circulating malaria parasites including P. malariae and P. ovale, whose population is expanding in parts of Ghana including Simiw
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