Abstract
BackgroundMalaria remains a very important public health problem in Ethiopia. Currently, only Plasmodium falciparum and Plasmodium vivax are considered in the malaria diagnostic and treatment policies. However, the existence and prevalence of Plasmodium ovale spp. and Plasmodium malariae in Ethiopia have not been extensively investigated. The objective of this study was to use a multiplex IgG antibody detection assay to evaluate evidence for exposure to any of these four human malaria parasites among asymptomatic individuals.MethodsDried blood spots (DBS) were collected from 180 healthy study participants during a 2016 onchocerciasis survey in the Jimma Zone, southwest Ethiopia. IgG antibody reactivity was detected using a multiplex bead assay for seven Plasmodium antigens: P. falciparum circumsporozoite protein (CSP), P. falciparum apical membrane antigen-1 (AMA1), P. falciparum liver stage antigen-1 (LSA1), and homologs of the merozoite surface protein-1 (MSP1)-19kD antigens that are specific for P. falciparum, P. vivax, P. ovale spp. and P. malariae.ResultsOne hundred six participants (59%) were IgG seropositive for at least one of the Plasmodium antigens tested. The most frequent responses were against P. falciparum AMA1 (59, 33%) and P. vivax (55, 28%). However, IgG antibodies against P. ovale spp. and P. malariae were detected in 19 (11%) and 13 (7%) of the participants, respectively, providing serological evidence that P. malariae and P. ovale spp., which are rarely reported, may also be endemic in Jimma.ConclusionThe findings highlight the informative value of multiplex serology and the need to confirm whether P. malariae and P. ovale spp. are aetiologies of malaria in Ethiopia, which is critical for proper diagnosis and treatment.
Highlights
Malaria remains a very important public health problem in Ethiopia
Plasmodium species causing malaria in Ethiopia are Plasmodium falciparum, accounting for about 60% of cases, and Plasmodium vivax, which accounts for about 40% of cases, with the former being the cause of most severe clinical manifestations and deaths [4, 6]
Antibodies reactive with P. falciparum were detected most frequently, with 59 (33%) seropositive persons to P. falciparum apical membrane antigen-1 (AMA1), 52 (29%), to P. falciparum MSP 1-19kD, 16 (9%) to, P. falciparum circumsporozoite protein (CSP) and 4 (2%) to P. falciparum liver stage antigen-1 (LSA1) (Table 2 and Fig. 1)
Summary
Only Plasmodium falciparum and Plasmodium vivax are considered in the malaria diagnostic and treatment policies. The existence and prevalence of Plasmodium ovale spp. and Plasmodium malariae in Ethiopia have not been extensively investigated. Plasmodium species causing malaria in Ethiopia are Plasmodium falciparum, accounting for about 60% of cases, and Plasmodium vivax, which accounts for about 40% of cases, with the former being the cause of most severe clinical manifestations and deaths [4, 6]. [7, 8] and Plasmodium malariae [6] have been reported from limited areas in Ethiopia. The FMoH has historical records that include reports of sizeable number of cases of both P. malariae and P. ovale spp. during the 1980s and 1990s [6,7,8]. Current information about populationlevel exposure estimates to these species is limited
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