Rapid Diagnosis Of Malaria Research Articles

Locally Acquired (Autochthonous) Mosquito-Transmitted Plasmodium vivax Malaria - Saline County, Arkansas, September 2023.

A case of locally acquired (autochthonous) mosquito-transmitted Plasmodium vivax malaria was diagnosed in Arkansas in September 2023. This represents the 10th autochthonous case identified nationally in 2023, after 20 years without recorded local mosquitoborne malaria transmission in the United States. The public health response included case investigation, active case surveillance, mosquito surveillance and control, assessment of medical countermeasures, and clinical and public outreach. Prompt diagnosis and appropriate treatment of malaria can improve clinical outcomes and, in addition to vector control, minimize risk for local transmission. Clinicians should consider malaria among patients who have traveled to countries where malaria is endemic, or with unexplained fever regardless of travel history. Although the risk for autochthonous malaria in the United States remains very low, its reemergence highlights the importance of vectorborne disease preparedness and response. Examples of such efforts include improving awareness among clinicians, access to diagnostics and antimalarial medications, and capacity for mosquito surveillance and control. Collaboration and communication among CDC, health departments, local jurisdictions, clinicians, hospitals, laboratories, and the public can support rapid malaria diagnosis, prevention, and control. Before traveling internationally to areas where malaria is endemic, travelers should consult with their health care provider regarding recommended malaria prevention measures, including chemoprophylaxis and precautions to avoid mosquito bites, to reduce both personal and community risk.

EasyNAT Malaria: a simple, rapid method to detect Plasmodium species using cross-priming amplification technology.

This study established and validated EasyNAT Malaria Assay as a promising molecular detection tool for malaria screening of high-risk populations in clinical practice. This novel isothermal amplification method may effectively facilitate the rapid diagnosis of malaria and prevent its transmission.

Diagnosis of Malaria among Children in Sokoto: A Comparison of Microscopy and Rapid Diagnostic Tests

Study’s Novelty/Excerpt This study compares the utility, sensitivity, specificity, and predictive values of microscopy with that of Rapid Diagnostic Tests (RDTs) in diagnosing malaria among children in Specialist Hospital Sokoto. The novelty lies in its focus on a specific pediatric population in a resource-limited setting, providing valuable data on the comparative effectiveness of these diagnostic methods in real-world clinical practice. The findings highlight the higher positivity rate of microscopy, advocating for its continued use alongside RDTs to ensure accurate malaria diagnosis and optimal patient care in similar environments. Full Abstract Malaria is a life-threatening disease primarily found in tropical countries, and it is the leading cause of morbidity and mortality among children. Diagnosis of malaria depends largely on clinical presentations and laboratory diagnosis. Microscopy is the gold standard for laboratory malaria diagnosis but requires adequate training and time compared to Rapid Diagnostic Tests (RDTs). The study compared the utility, sensitivity, specificity, and predictive values between microscopy and RDTs in diagnosing malaria among children accessing care in Specialist Hospital Sokoto. A total of 367 blood samples of consented children who met the study inclusion criteria were examined. All samples were screened for malaria using RDT thin and thick blood films. Of the 367 samples assessed, RDT was positive for 202 (55.0%) and negative for 165 (45.0%), while microscopy was positive for 235 (64.1%) and negative for 132 (35.9%), a non-statistically significant (χ2 = 0.090, P = 0.922) difference was observed when both positive tests were compared. The Rapid diagnostic tests (RDTs) showed a sensitivity of 85.95% and a specificity of 83.33%. This study confirms the higher positivity rate of microscopy to RDTs in diagnosing malaria. As such, RDTs are useful for rapid malaria diagnosis, especially in resource-limited settings; microscopy should be encouraged as much as possible for children to avoid missing any positive cases.

Seasonal Trends with the Comparison of Venous and Capillary Blood for Diagnosis of Malaria among Children in Karachi, Pakistan.

More than 250 million people are infected by malaria parasites annually while around one million children less than 5 years of age die every year due to malaria. We aimed to assess the seasonal trends and usefulness of capillary and venous blood for rapid diagnosis of malaria. This cross-sectional study of 18 months duration was conducted at the National Institute of Child Health (NICH), Karachi. All patients reporting fever as chief complaint were recruited as study subjects. A semi-structured questionnaire was used to collect demographic information, presenting complaints, awareness of caregivers regarding malaria, preventive measures and history of malaria fever. Three ml Venous (2-3ml) as well as peripheral blood (3-4 drops) samples of all patients were collected for microscopy and rapid diagnostic tests (RDTs). Out of total 477 patients with fever Venous and Capillary Blood RDTs methods detected 33(6.9%) and 30(6.3%) as the malaria positive while Venous and Capillary Blood Microscopy detected 30(6.1%) and 32(6.7%) cases respectively. Plasmodium Vivax infection was the most prevalent (87.9%) and majority (39.39%) of the cases occurred in the quarter, July to September. July to September is the peak season for malaria and P. Vivax (87.9%) is the predominant strain in Karachi. Venous and capillary blood are equally useful for malaria diagnosis however, convenience and less invasiveness may justify the preference of capillary blood over venous blood for early diagnosis of malaria.

Development and evaluation of PlasmoPod: A cartridge-based nucleic acid amplification test for rapid malaria diagnosis and surveillance.

Malaria surveillance is hampered by the widespread use of diagnostic tests with low sensitivity. Adequate molecular malaria diagnostics are often only available in centralized laboratories. PlasmoPod is a novel cartridge-based nucleic acid amplification test for rapid, sensitive, and quantitative detection of malaria parasites. PlasmoPod is based on reverse-transcription quantitative polymerase chain reaction (RT-qPCR) of the highly abundant Plasmodium spp. 18S ribosomal RNA/DNA biomarker and is run on a portable qPCR instrument which allows diagnosis in less than 30 minutes. Our analytical performance evaluation indicates that a limit-of-detection as low as 0.02 parasites/μL can be achieved and no cross-reactivity with other pathogens common in malaria endemic regions was observed. In a cohort of 102 asymptomatic individuals from Bioko Island with low malaria parasite densities, PlasmoPod accurately detected 83 cases, resulting in an overall detection rate of 81.4%. Notably, there was a strong correlation between the Cq values obtained from the reference RT-qPCR assay and those obtained from PlasmoPod. In an independent cohort, using dried blood spots from malaria symptomatic children living in the Central African Republic, we demonstrated that PlasmoPod outperforms malaria rapid diagnostic tests based on the PfHRP2 and panLDH antigens as well as thick blood smear microscopy. Our data suggest that this 30-minute sample-to-result RT-qPCR procedure is likely to achieve a diagnostic performance comparable to a standard laboratory-based RT-qPCR setup. We believe that the PlasmoPod rapid NAAT could enable widespread accessibility of high-quality and cost-effective molecular malaria surveillance data through decentralization of testing and surveillance activities, especially in elimination settings.

A simple and purification-free nucleic acid extraction method for rapid diagnosis of malaria

A simple and purification-free nucleic acid extraction method for rapid diagnosis of malaria

Contribution of hematology analyzers (Sysmex XN-Series) in the rapid diagnosis of malaria: case reports

Malaria is a potentially severe disease, particularly in Africa. In Europe, the majority of malaria cases come from travelers returning from endemic areas. The non-specific symptomatology may not alert the clinician if this notion of travel is not addressed. However, diagnosis and rapid initiation of treatment prevent the evolution of severe forms of the disease, especially in the case of Plasmodium falciparum infection, which can be life-threatening within 24 hours. Thin and thick blood smears microscopy is the main tools for diagnosis, but some automated hematology analyzers have demonstrated their ability to participate in early diagnosis. We describe two cases illustrating the contribution of the Sysmex XN-9100 automated system for the diagnosis of malaria. The first clinical case described a young man infected with numerous Plasmodium falciparum gametocytes. WNR (white blood cell count) and WDF (white blood cell differenciation) scattergrams showed an additional population, corresponding to gametocytes. The second case focused on a man with neuromalaria and high Plasmodium falciparum parasitaemia. Parasitized red blood cells form an inconspicuous double population on the reticulocyte scattergram, located at the discrimination limit between mature red blood cells and reticulocytes. Scattergram abnormalities, which can be visualized in a few minutes, offer an anticipation of the diagnosis of malaria in comparison to thin and thick smears microscopy, that requiring considerable time and expertise.

Rapid diagnosis of malaria by chemometric peak-free LIBS of trace biometals in blood

Laser Induced Breakdown Spectroscopy (LIBS) trace atomic species of diseased biofluids are subtle (peak-free) in complex spectra. Trace analysis requires a considerable push in analytical strategy. Enabling LIBS with chemometrics can help identify, extract, analyze and interpret the trace species’ spectral signatures to give an insight on the biophysiological status of the bodies from which the biofluids originate. We report on the trace quantitative performance of peak-free LIBS enabled by chemometrics modelling using principal components analysis (PCA) for direct artificial neural network (ANN)–based analysis of Cu, Zn, Fe and Mg in Plasmodium falciparum-infected blood in the context of rapid spectral diagnosis of malaria utilizing the biometals as the disease biomarkers. Only one standard is required in this method—to delineate the analyte spectral regions (feature selection) and to test for accuracy. Based on the alteration of the biometal levels and their multivariate and correlational patterns in cultured blood, peripheral finger blood drops dried directly on Nucleopore membrane filters was accurately discriminated as either malaria-infected or healthy. Further the morphological evolution of Plasmodium was accurately predicted using spectral features of the biometals wherein high negative correlations between Fe (− 0.775) and Zn (− 0.881) and high positive correlations between Cu (0.892) and Mg (0.805) with parasitemia were observed. During the first 96 h of malaria infection Cu increases profoundly (from 328 to 1999 ppb) while Fe, Zn and Mg decrease (from 1206 to 674 ppb), (from 1523 to 499 ppb) and (from 23,880 to 19,573 ppb) respectively. Compared with healthy, Plasmodium falciparum-infected blood has high Cu but low levels of Fe, Zn and Mg. Cu and Zn are highly (≥ 0.9) positively correlated while Fe and Cu as well as Zn and Cu are highly (≥ 0.9) negatively correlated. Chemometric peak-free LIBS showed the potential for direct rapid malaria diagnostics in blood based on the levels, alterations and multivariate associations of the trace biometals which are used as biomarkers of the disease.

The Impact of Submicroscopic Parasitemia on Malaria Rapid Diagnosis in Northeastern Tanzania, an Area with Diverse Transmission Patterns.

Global malaria epidemiology has changed in the last decade with a substantial increase in cases and deaths being recorded. Tanzania accounts for about 4% of all cases and deaths reported in recent years. Several factors contribute to the resurgence of malaria, parasite resistance to antimalarials and mosquito resistance to insecticides being at the top of the list. The presence of sub-microscopic infections poses a significant challenge to malaria rapid diagnostic tests (mRDT). Our cross-sectional surveys in Handeni and Moshi, Tanzania assessed the effect of low parasite density on mRDT. Handeni had higher malaria prevalence by mRDT (39.6%), light microscopy (LM) (16.9%) and polymerase chain reaction (PCR) (18.5%), compared to Moshi with prevalence of 0.2%, 1.3% and 2.3%, respectively. A significant difference (p ˂ 0.001) in malaria prevalence by mRDT, LM and nested PCR was found among age groups. In comparison to all other groups, school-age children (5-15 years) had the highest prevalence of malaria. Our results show that mRDT may miss up to 6% of cases of malaria mainly due to low-density parasitemia when compared to LM and PCR. Routinely used mRDT will likely miss the sub-microscopic parasitemia which will ultimately contribute to the spread of malaria and hinder efforts of elimination.

Genetic Sequence Variation in the Plasmodium falciparum Histidine-Rich Protein 2 Gene from Field Isolates in Tanzania: Impact on Malaria Rapid Diagnosis.

Malaria rapid diagnosis test (RDT) is crucial for managing the disease, and the effectiveness of detection depends on parameters such as sensitivity and specificity of the RDT. Several factors can affect the performance of RDT. In this study, we focused on the pfhrp2 sequence variation and its impact on RDTs targeted by antigens encoded by Plasmodium falciparum histidine-rich protein 2 (pfhrp2). Field samples collected during cross-sectional surveys in Tanzania were sequenced to investigate the pfhrp2 sequence diversity and evaluate the impact on HRP2-based RDT performance. We observed significant mean differences in amino acid repeats between current and previous studies. Several new amino acid repeats were found to occur at different frequencies, including types AAY, AHHAHHAAN, and AHHAA. Based on the abundance of types 2 and 7 amino acid repeats, the binary predictive model was able to predict RDT insensitivity by about 69% in the study area. About 85% of the major epitopes targeted by monoclonal antibodies (MAbs) in RDT were identified. Our study suggested that the extensive sequence variation in pfhrp2 can contribute to reduced RDT sensitivity. The correlation between the different combinations of amino acid repeats and the performance of RDT in different malaria transmission settings should be investigated further.

Prevalence and factors associated with anaemia in children aged 6-24 months living a high malaria transmission setting in Burundi.

In very young children, anaemia has been linked to increased morbidity, mortality and poor cognitive development. Although Burundi has a high burden of anaemia, which may be worsened by the high burden of malaria, little is known about the extent of the problem in very young children who are most at risk of severe disease. We estimated the prevalence, and assessed the factors associated with anaemia in children aged 6-24 months using baseline data collected as part of an on-going study evaluating the effect of Micronutrient supplementation on anaemia and cognition among children in high malaria transmission settings in Burundi. Between February and March 2020, surveys were conducted in 498 households within the catchment area of Mukenke Health Center. One child aged 6-24 months was selected per household to participate in the survey. Following written informed consent, we administered a questionnaire to the child's primary caregiver to capture information on child's demographics, nutritional status, food intake, health (status, and morbidity and treatment-seeking practices), as well as the household markers of wealth. A physical exam was conducted, and a blood sample was collected to: 1) assess for presence of plasmodium infection using a rapid diagnosis test; 2) estimate the haemoglobin levels using a portable haemocue machine. A stool sample was also collected to examine for the presence of helminth infections. The prevalence of anaemia was 74.3% (95% confidence interval [CI] 61.5%-84.0%), with most of the anaemic study participants classified as having moderate anaemia (59.2%). A total of 62 (12.5%) participants had positive malaria rapid diagnosis tests. Factors significantly associated with higher odds of developing anaemia included not receiving deworming medication (adjusted Odd ratio [aOR] = 3.54, 95% CI 1.79-6.99, p<0.001), the child's home location (Mukenke II: aOR = 2.22, 95% CI 1.89-2.62, p<0.001; Mukenke: aOR = 2.76, 95% CI 2.46-3.10, p<0.001 and Budahunga: aOR = 3.12, 95% CI 2. 94-3.31, p<0.001) and the child's age group (Children aged 6-11 months: aOR = 2.27, 95% CI 1.32-3.91, p<0.001). Education level was inversely associated with less odds of anaemia: child's primary care giver with a secondary (aOR = 0.67; 95% CI: 0.47-0.95, p = 0,024) and tertiary education level (aOR = 0.48; 95% CI: 0.38-0.61, p<0.001). Anaemia is highly prevalent among young children in high malaria transmission setting. Anaemia is more prevalent among children who not dewormed and those with malaria. To prevent the long-term adverse outcomes of the anaemia in children, policy makers should focus on improving uptake of the deworming and malaria prevention programs, promote preventive interventions and improve the education of women especially in families with very young children.

An efficient model of residual based convolutional neural network with Bayesian optimization for the classification of malarial cell images

BackgroundMalaria is a disease caused by the Plasmodium parasite, which results in millions of deaths in the human population worldwide each year. It is therefore considered a major global health issue with a massive disease burden. Accurate and rapid diagnosis of malaria is important for treatment. Rapid diagnosis of this disease will be very valuable for patients, as traditional methods require tedious work for its detection. The aim of the study is to classify malaria cell images using machine learning and deep learning methods. Material & methodsThe National Institutes of Health (NIH) database was used for malaria cell images classification as infected and uninfected, with a total of 27,558 malaria cell images used in the experimental study. Additionally, the training option parameters (initial learning rate, L2 regularization, and momentum values) of the Residual Convolutional Neural Network (CNN) were optimized using the Bayesian method. In the study, Residual CNN, k-Nearest Neighbors (k-NN), and Support Vector Machine (SVM) classifiers were used to classify the malaria cell images. Neighborhood Components Analysis (NCA) were observed to increase the performance of classifiers used in the classification of malaria cell images. Results and conclusionThe Accuracy (Acc), Sensitivity (Se), Specificity (Spe), and F-score were used as the performance metrics for the classifier performances. The best classification results were achieved with SVM (Acc 99.90%, Se 99.98%, Spe 87.50%, and F-Score 99.90%). As a result, a high level of classification performance was achieved from creating a hybrid model with Bayesian optimization and Deep Residual CNN features.

Diagnosis of Indigenous Non-Malarial Vector-Borne Infections from Malaria Negative Samples from Community and Rural Hospital Surveillance in Dhalai District, Tripura, North-East India.

The aetiology of non-malaria vector-borne diseases in malaria-endemic, forested, rural, and tribal-dominated areas of Dhalai, Tripura, in north-east India, was studied for the first time in the samples collected from malaria Rapid Diagnostic Kit negative febrile patients by door-to-door visits in the villages and primary health centres. Two hundred and sixty serum samples were tested for the Dengue NS1 antigen and the IgM antibodies of Dengue, Chikungunya, Scrub Typhus (ST), and Japanese Encephalitis (JE) during April 2019–March 2020. Fifteen Dengue, six JE, twelve Chikungunya, nine ST and three Leptospirosis, and mixed infections of three JE + Chikungunya, four Dengue + Chikungunya, three Dengue + JE + Chikungunya, one Dengue + Chikungunya + ST, and one Dengue + ST were found positive by IgM ELISA tests, and four for the Dengue NS1 antigen, all without any travel history. True prevalence values estimated for infections detected by Dengue IgM were 0.134 (95% CI: 0.08–0.2), Chikungunya were 0.084 (95% CI: 0.05–0.13), Scrub were 0.043 (95% CI: 0.01–0.09), and Japanese Encephalitis were 0.045 (95% CI: 0.02–0.09). Dengue and Chikungunya were associated significantly more with a younger age. There was a lack of a defined set of symptoms for any of the Dengue, Chikungunya, JE or ST infections, as indicated by the k-modes cluster analysis. Interestingly, most of these symptoms have an overlapping set with malaria; thereby, it becomes imperative that malaria and these non-malaria vector-borne disease diagnoses are made in a coordinated manner. Findings from this study call for advances in routine diagnostic procedures and the development of a protocol that can accommodate, currently, in practicing the rapid diagnosis of malaria and other vector-borne diseases, which is doable even in the resource-poor settings of rural hospitals and during community fever surveillance.

Factors Affecting Adherence to National Malaria Treatment Guidelines in the Diagnosis, Treatment and Prevention of Malaria in Pregnancy among Healthcare Workers in Public Health Facilities in Jowhar District, Somalia

Introduction: Early diagnosis and effective treatment remain critical elements of a malaria control strategy in preventing mortality and reducing the incidence of severe malaria illness in Somalia. In Sub-Saharan African countries showed different levels of adherence to their national malaria guidelines for malaria treatment and prevention in pregnancy, while experiences from many countries indicated several challenges and constraints that may make the implementation of the guidelines difficult. Objective: The study aimed to assess factors affecting adherence to revised national malaria treatment guidelines in the diagnosis, treatment and prevention of malaria in pregnancy among health care workers in public health facilities in Jowhar District, Somalia. Methodology: A cross-sectional health facility-based study conducted in Jowhar district. A structured interview questionnaire was used for data collection from (n = 150). Healthcare workers selected from ten health facilities using proportionate stratified sampling technique and an observational checklist was used to assess patient’s medical prescriptions to review their conformity to the guideline and the availability of antimalarial, malaria diagnostic tests (mRDTs and microscopy) and job aids, such as the national malaria treatment guideline, clinical algorithm (flow chart), malaria rapid diagnosis tests mRDTs’ use of wall charts, and drug dose wall charts at the facilities. Data was analyzed through the application of descriptive statistical analysis that includes frequency, and percentages by using Statistical Package for Social Sciences (SPSS) Version 25. Results: Healthcare workers interviewed were 89 (59.3%) aware of the existence of the revised malaria treatment guidelines. However, 61 (40.7%) were not aware of the guidelines and only 46 (30.7%) had been trained for the guidelines. Overall, 33 (22%) of the workers reported to adhere to guidelines, with 117 (78.0%) reported non-adherence. A statistically significance was observed between training and health worker’s adherence to national malaria guideline with (p-value of 0.022). Conclusion and Recommendation: In conclusion, the study showed that adherence to the national malaria guidelines for Malaria diagnosis, treatment and prevention in pregnancy among health care workers are associated with inadequate awareness of the revised national malaria guideline, inadequate supply of diagnostic tests (mRDTs and microscopy) and lack of access to revised national guidelines for malaria diagnosis and treatment 2016, a lack of regular supervision and monitoring and lack of in-service training respectively. The national malaria control program should intensify efforts to strengthen the readiness of the public health facilities in the district to handle malaria in pregnancy cases, diagnosis, treatment and prevention, improve the availability of antimalarial drugs and malaria diagnostic tests (mRDTs and microscopy), job aids and undertake regular monitoring and on job training to ensure the proper use of the guideline at all levels of health care service delivery points across the country.

A purview into highly sensitive magnetic SERS detection of hemozoin biomarker for rapid malaria diagnosis

Here, we report detection of hemozoin, a metabolic byproduct of malaria parasite exhibiting paramagnetic properties using magnetic surface enhanced Raman spectroscopy (M-SERS). The SERS active silver nanorods were deposited over neodymium magnetic substrates (0.3 T) kept at 120 K temperature using glancing angle deposition technique. Magnetic field augmented SERS measurements were performed for hemozoin on these M-SERS substrates and AgNRs deposited over glass (conventional SERS) substrates in presence of an external magnetic field (0.3 T). The SERS signal intensity was found to be enhanced by ten-fold compared to the measurements performed on the conventional SERS substrates in the absence of any magnetic field. The presence of high spin trivalent iron in hemozoin structure led the magnetic field induced agglomeration of these molecules in vicinity of the electromagnetic ‘hotspots’ available on the SERS substrates which was confirmed by running RCWA based simulations. These interactions lead to higher enhancement of vibrational modes of the porphine group directly linked to iron. The limit of detection of hemozoin for M-SERS was obtained as low as 10−11 M (< 10 parasites/µl) which can be employed for early stage malaria detection.

Evaluating the dual reactivity on SD bioline malaria rapid diagnosis tests as a potential indicator of high parasitemia due to Plasmodium falciparum

ABSTRACT The co-reactivity of the Plasmodium histidine-rich protein 2 (HRP2) and lactate dehydrogenase (pLDH) in malaria rapid diagnosis tests (mRDTs) as a potential indicator of high parasitemia linked to Plasmodium falciparum was evaluated in the reported study from Cameroon. The samples were screened for malaria using both mRDTs (SD bioline HRP2/pLDH), light microscopy and further confirmed by Plasmodium species-specific PCR assay. Of the 483 patients enrolled, 161 (33.3%) showed a reactive mRDTs amongst which 70 patients were positive by both microscopy and mRDTs with 30.0% (21/70) positive for HRP2 alone, while 70.0% (49/70) showed a dual reaction to HRP2 and pLDH parasite antigens. P. falciparum parasitemia was found to be significantly high among patients with both reactive antigens, (p < 0.0001) suggesting that mRDTs reactivity is influenced by parasite load which could be used as a diagnostic marker for therapeutic management of patients with high parasitemia in field conditions.

Performance of Rapid Diagnosis Technique (RDT) in Screening Malaria Among Patients of Selected Health Facilities in Ardo-Kola Local Government Area, Taraba State

Malaria infection is one of the most common disease of public health importance afflicting millions of people in sub-Saharan Africa. Malaria diagnosis and surveillance rely predominantly on rapid diagnostic tests (RDTs). This study investigated the performance of Rapid Diagnostic Test (RDT) against microscopy of stained blood for Plasmodium falciparum of patients attending some Primary Health Centres in Ardo-Kola LGA, Taraba State. Five hundred and eighty five (585) blood samples were collected and examined for Plasmodium falciparum on the microscope. Rapid Diagnostic Tests were also used for examination. The overall result showed a prevalence of 446 (76.23%). The infection found female, 199 (82.23%) to be more exposed to malaria than male, 247 (72.01%) with no significant difference (χ2=4.381; P≥0.05). With regards to age, females aged ≥51 years were more infected than other age groups, while male aged 21-30 years were more infected with malaria than the other age groups. There was no significant difference with malaria infection between the age groups (χ2=2.207; P≥0.05). The performance of RDTs against microscopy showed that RDT used had a sensitivity of 66.91% and specificity of 58.52%. The positive predictive value of 33.45% and negative predictive value of 85.02% were found for the RDT used. The present study demonstrated that RDTs can act as diagnostic tool to manage malaria in resource poor settings with limited, access to expert microscopy as they are easy to use and perform better than microscopy. It is recommended that malaria Rapid Diagnosis Tests can be used in endemic areas in Nigeria.

Where have all the parasites gone? Unusual Plasmodium falciparum monoparasitaemia in a cross-sectional malariometric survey in northern Nigeria

Background: Malaria is caused by one of five currently known Plasmodium parasite species causing disease in humans. While modelling has provided information of the vector, the same is not entirely the case for the parasite. The World Malaria reports of 2014 to 2016 reported 100% of confirmed cases from Nigeria being due to Plasmodium falciparum. Generally, about 98% of cases of uncomplicated malaria in most regions surveyed in Nigeria recently is due to P. falciparum, with the remainder being due to P. malariae. This study aimed to determine the proportions of Plasmodium parasites causing uncomplicated malaria in Wamakko Local Government Area of Sokoto State, north-western Nigeria. Methods: The study was a descriptive, cross-sectional study conducted during the rainy season and dry season in north-western Nigeria. The area has a ‘local steppe’ climate and Sudanian Savannah vegetation. Sampling was via multistage cluster sampling. Selected participants were examined for pallor, palpable splenomegaly and signs of complicated malaria. Blood samples were also taken for rapid diagnosis of malaria and thick and thin films to identify parasitaemia and the parasite species. Participants found to have malaria were treated with Artemether/Lumefantrine and those with complicated malaria were referred to the nearest hospital. Results: We found a parasite prevalence of 34.8% overall, which was higher in the rainy season (49.3%) than in the dry season (20.2%). There was monoparasitaemia of Plasmodium falciparum throughout the study area, irrespective of the clinical status of the participant. Mapping of the parasite was extended throughout the Local Government Area and the State. Conclusions: Despite the intermediate endemicity in the area. P. falciparum monoparasitaemia affirms theories of disappearance of other parasite species, either due to faltering control of P. falciparum or more efficient control of other species.

Where have all the parasites gone? Unusual Plasmodium falciparum monoparasitaemia in a cross-sectional malariometric survey in northern Nigeria

Background: Malaria is caused by one of five currently known Plasmodium parasite species causing disease in humans. While modelling has provided information of the vector, the same is not entirely the case for the parasite. The World Malaria reports of 2014 to 2016 reported 100% of confirmed cases from Nigeria being due to Plasmodium falciparum. Generally, about 98% of cases of uncomplicated malaria in most regions surveyed in Nigeria recently is due to P. falciparum, with the remainder being due to P. malariae. This study aimed to determine the proportions of Plasmodium parasites causing uncomplicated malaria in Wamakko Local Government Area of Sokoto State, north-western Nigeria. Methods: The study was a descriptive, cross-sectional study conducted during the rainy season and dry season in north-western Nigeria. The area has a ‘local steppe’ climate and Sudanian Savannah vegetation. Sampling was via multistage cluster sampling. Selected participants were examined for pallor, palpable splenomegaly and signs of complicated malaria. Blood samples were also taken for rapid diagnosis of malaria and thick and thin films to identify parasitaemia and the parasite species. Participants found to have malaria were treated with Artemether/Lumefantrine and those with complicated malaria were referred to the nearest hospital. Results: We found a parasite prevalence of 34.8% overall, which was higher in the rainy season (49.3%) than in the dry season (20.2%). There was monoparasitaemia of Plasmodium falciparum throughout the study area, irrespective of the clinical status of the participant. Mapping of the parasite was extended throughout the Local Government Area and the State. Conclusions: Despite the intermediate endemicity in the area. P. falciparum monoparasitaemia affirms theories of disappearance of other parasite species, either due to faltering control of P. falciparum or more efficient control of other species.

Where have all the parasites gone? Unusual Plasmodium falciparum monoparasitaemia in a cross-sectional malariometric survey in northern Nigeria.

Background: Malaria is caused by one of five currently known Plasmodium parasite species causing disease in humans. While modelling has provided information of the vector, the same is not entirely the case for the parasite. The World Malaria reports of 2014 to 2016 reported 100% of confirmed cases from Nigeria being due to Plasmodium falciparum. Generally, about 98% of cases of uncomplicated malaria in most regions surveyed in Nigeria recently is due to P. falciparum, with the remainder being due to P. malariae. This study aimed to determine the proportions of Plasmodium parasites causing uncomplicated malaria in Wamakko Local Government Area of Sokoto State, north-western Nigeria. Methods: The study was a descriptive, cross-sectional study conducted during the rainy season and dry season in north-western Nigeria. The area has a 'local steppe' climate and Sudanian Savannah vegetation. Sampling was via multistage cluster sampling. Selected participants were examined for pallor, palpable splenomegaly and signs of complicated malaria. Blood samples were also taken for rapid diagnosis of malaria and thick and thin films to identify parasitaemia and the parasite species. Participants found to have malaria were treated with Artemether/Lumefantrine and those with complicated malaria were referred to the nearest hospital. Results: We found a parasite prevalence of 34.8% overall, which was higher in the rainy season (49.3%) than in the dry season (20.2%). There was monoparasitaemia of Plasmodium falciparum throughout the study area, irrespective of the clinical status of the participant. Mapping of the parasite was extended throughout the Local Government Area and the State. Conclusions: Despite the intermediate endemicity in the area. P. falciparum monoparasitaemia affirms theories of disappearance of other parasite species, either due to faltering control of P. falciparum or more efficient control of other species.