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Background  In an effort to improve surveillance for epidemiological and clinical outcomes, rapid diagnostic tests (RDTs) have become increasingly widespread as cost-effective and field-ready methods of malaria diagnosis. However, there are concerns that using RDTs specific to  Plasmodium falciparum  may lead to missed detection of other malaria species such as  Plasmodium malariae  and  Plasmodium ovale .    Methods  Four hundred and sixty six samples were selected from children under 5 years old in the Democratic Republic of the Congo (DRC) who took part in a Demographic and Health Survey (DHS) in 2013–14. These samples were first tested for all  Plasmodium  species using an 18S ribosomal RNA-targeted real-time PCR; malaria-positive samples were then tested for  P. falciparum, P. malariae  and  P.  ovale  using a highly sensitive nested PCR.    Results  The prevalence of  P. falciparum, P. malariae  and  P. ovale  were 46.6, 12.9 and 8.3 %, respectively. Most  P. malariae  and  P. ovale  infections were co-infected with  P. falciparum —the prevalence of mono-infections of these species were only 1.0 and 0.6 %, respectively. Six out of these eight mono-infections were negative by RDT. The prevalence of  P. falciparum  by the more sensitive nested PCR was higher than that found previously by real-time PCR.    Conclusions   Plasmodium malariae  and  P. ovale  remain endemic at a low rate in the DRC, but the risk of missing malarial infections of these species due to falciparum-specific RDT use is low. The observed prevalence of  P. falciparum  is higher with a more sensitive PCR method.    Electronic supplementary material  The online version of this article (doi:10.1186/s12936-016-1409-0) contains supplementary material, which is available to authorized users.

malaria journal

Low prevalence of Plasmodium malariae and Plasmodium ovale mono-infections among children in the Democratic Republic of the Congo: a population-based, cross-sectional study