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Plasmodium falciparum infection in febrile Congolese children: prevalence of clinical malaria 10 years after introduction of artemisinin‐combination therapies
Author(s) -
EtokaBeka Mandingha Kosso,
Ntoumi Francine,
Kombo Michael,
Deibert Julia,
Poulain Pierre,
Vouvoungui Christevy,
Kobawila Simon Charles,
KoukouikilaKoussounda Felix
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12786
Subject(s) - malaria , plasmodium falciparum , sickle cell trait , medicine , immunology , nested polymerase chain reaction , parasitemia , pediatrics , biology , polymerase chain reaction , disease , biochemistry , gene
Objectives To investigate the proportion of malaria infection in febrile children consulting a paediatric hospital in Brazzaville, to determine the prevalence of submicroscopic malaria infection, to characterise Plasmodium falciparum infection and compare the prevalence of uncomplicated P. falciparum malaria according to haemoglobin profiles. Methods Blood samples were collected from children aged <10 years with an axillary temperature ≥37.5 °C consulting the paediatric ward of Marien Ngouabi Hospital in Brazzaville. Parasite density was determined and all samples were screened for P. falciparum by nested polymerase chain reaction ( PCR ) using the P. falciparum msp‐2 marker to detect submicroscopic infections and characterise P. falciparum infection. Sickle cell trait was screened by PCR . Results A total of 229 children with fever were recruited, of whom 10% were diagnosed with uncomplicated malaria and 21% with submicroscopic infection. The mean parasite density in children with uncomplicated malaria was 42 824 parasites/μl of blood. The multiplicity of infection ( MOI ) was 1.59 in children with uncomplicated malaria and 1.69 in children with submicroscopic infection. The mean haemoglobin level was 10.1 ± 1.7 for children with uncomplicated malaria and 12.0 ± 8.6 for children with submicroscopic infection. About 13% of the children harboured the sickle cell trait (Hb AS ); the rest had normal haemoglobin (Hb AA ). No difference in prevalence of uncomplicated malaria and submicroscopic infection, parasite density, haemoglobin level, MOI and P. falciparum genetic diversity was observed according to haemoglobin type. Conclusion The low prevalence of uncomplicated malaria in febrile Congolese children indicates the necessity to investigate carefully other causes of fever.