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Background   Plasmodium vivax  is very rarely seen in West Africa, although specific detection methods are not widely applied in the region, and it is now considered to be absent from North Africa. However, this parasite species has recently been reported to account for most malaria cases in Nouakchott, the capital of Mauritania, which is a large country at the interface of sub-Saharan West Africa and the Maghreb region in northwest Africa.    Methods  To determine the distribution of malaria parasite species throughout Mauritania, malaria cases were sampled in 2012 and 2013 from health facilities in 12 different areas. These sampling sites were located in eight major administrative regions of the country, within different parts of the Sahara and Sahel zones. Blood spots from finger-prick samples of malaria cases were processed to identify parasite DNA by species-specific PCR.    Results  Out of 472 malaria cases examined, 163 (34.5 %) had  P. vivax  alone, 296 (62.7 %)  Plasmodium falciparum  alone, and 13 (2.8 %) had mixed  P. falciparum  and  P. vivax  infection. All cases were negative for  Plasmodium malariae  and  Plasmodium ovale . The parasite species distribution showed a broad spectrum,  P. vivax  being detected at six of the different sites, in five of the country’s major administrative regions (Tiris Zemmour, Tagant, Brakna, Assaba, and the capital Nouakchott). Most cases in Nouakchott were due to  P. vivax , although proportions vary significantly among different health facilities in the city. In the northern town of Zouérat, all cases were due to  P. vivax , whereas almost all cases in the south of the country were due to  P. falciparum . All  P. vivax  cases tested were Duffy blood group positive.    Conclusions  It is important that  P. vivax  is recognized to be a widespread cause of malaria in Mauritania, occurring in diverse regions. This should be noted by the World Health Organization, as it has significant implications for diagnosis, treatment and control of malaria in the northwestern part of Africa.

Widespread distribution of Plasmodium vivax malaria in Mauritania on the interface of the Maghreb and West Africa