Abstract
Malaria is a worldwide public health problem; parasites from the genus Plasmodium are the aetiological agent for this disease. The parasites are mostly diagnosed by conventional microscopy-based techniques; however, their limitations have led to under-registering the reported prevalence of Plasmodium species. This study has thus been aimed at evaluating the infection and coinfection prevalence of 3 species of Plasmodium spp., in an area of the Colombian Amazon region. Blood samples were taken from 671 symptomatic patients by skin puncture; a nested PCR amplifying the 18S ssRNA region was used on all samples to determine the presence of P. vivax, P. malariae and P. falciparum. Statistical analysis determined infection and coinfection frequency; the association between infection and different factors was established. The results showed that P. vivax was the species having the greatest frequency in the study population (61.4%), followed by P. malariae (43.8%) and P. falciparum (11.8%). The study revealed that 35.8% of the population had coinfection, the P. vivax/P. malariae combination occurring most frequently (28.3%); factors such as age, geographical origin and clinical manifestations were found to be associated with triple-infection. The prevalence reported in this study differed from previous studies in Colombia; the results suggest that diagnosis using conventional techniques could be giving rise to underestimating some Plasmodium spp. species having high circulation rates in Colombia (particularly in the Colombian Amazon region). The present study’s results revealed a high prevalence of P. malariae and mixed infections in the population being studied. The results provide relevant information which should facilitate updating the epidemiological panorama and species’ distribution so as to include control, prevention and follow-up measures.
Highlights
Malaria represents a public health problem for many countries around the world, being the main cause of morbidity and mortality for many of them
The inclusion criteria for obtaining samples took the following into account: patients who were symptomatic for malaria, inhabitants living in the south of the Colombian Amazon region
This has been the first study in Colombia which has sought to establish circulating Plasmodium spp. species’ prevalence in an endemic region of the Amazon by means of molecular diagnostic methods
Summary
Malaria represents a public health problem for many countries around the world, being the main cause of morbidity and mortality for many of them. Transmission by becoming exposed to infected blood (blood transfusion) or congenital transmission have been described, though occurring less frequently; most cases of malaria in industrialised nations involve travellers, immigrants or military personnel coming from endemic areas of the countries they have visited or lived in [4]. Most cases of malaria observed around the world are caused by P. falciparum and P. vivax [3,5]. A fourth (~26%) of the malaria-endemic areas worldwide are exposed to P. falciparum transmission, involving about one thousand million people [6]. P. vivax has a broader geographical reach than P. falciparum, covering at least 95 countries and involving tropical, subtropical and temperate regions, meaning that more people are exposed to infection by this parasite [5]
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