Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)

Malaria Journal

Research

Warsama Osman Abdi¹  Houssein Yonis Arreh²  Mohamed Houmed Aboubaker³  Kahiya Mohamed Alaleh³  Aicha Abdillahi Hamoud³  Abdoul-Razak Yonis Omar⁴  Samatar Kayad Guelleh⁵  Abdoul-Ilah Ahmed Abdi⁶  Bouh Abdi Khaireh⁷  Leonardo K. Basco⁸  Nasserdine Papa Mze⁸  Rahma Abdi Moussa⁹  Hervé Bogreau^1,10 

[1]Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti

[2]Laboratoire National de Référence, Hôpital Général Peltier, Ministère de La Santé, Djibouti, Republic of Djibouti

[3]Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti

[4]Laboratoire de Diagnostic, Centre de Santé Communautaire d’Einguela, Ministère de La Santé, Djibouti, Republic of Djibouti

[5]Programme National de Lutte Contre Le Paludisme, Direction des Programmes de Santé Prioritaires, Ministère de La Santé, Djibouti, Republic of Djibouti

[6]Service de Santé des Armées, Présidence de la République, Djibouti, Republic of Djibouti

[7]UNDP Djibouti, Global Fund to Fight AIDS-TB-Malaria, Djibouti, Republic of Djibouti

[8]Université d’Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France

[9]IHU-Méditerranée Infection, Marseille, France

[10]Université d’Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France

[11]IHU-Méditerranée Infection, Marseille, France

[12]Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti

[13]Université d’Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France

[14]IHU-Méditerranée Infection, Marseille, France

[15]Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France

关键词: Malaria;    Plasmodium falciparum;    Plasmodium vivax;    Djibouti;    Epidemiology;    PCR;    Rapid diagnostic test;   

DOI  :  10.1186/s12936-023-04546-x

 received in 2022-08-26, accepted in 2023-03-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe Republic of Djibouti is a malaria endemic country that was in pre-elimination phase in 2006–2012. From 2013, however, malaria has re-emerged in the country, and its prevalence has been increasing every year. Given the co-circulation of several infectious agents in the country, the assessment of malaria infection based on microscopy or histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDT) has shown its limitations. This study, therefore, aimed to assess the prevalence of malaria among febrile patients in Djibouti city using more robust molecular tools.MethodsAll suspected malaria cases reported to be microscopy-positive were randomly sampled (n = 1113) and included in four health structures in Djibouti city over a 4-year period (2018–2021), mainly during the malaria transmission season (January–May). Socio-demographic information was collected, and RDT was performed in most of the included patients. The diagnosis was confirmed by species-specific nested polymerase chain reaction (PCR). Data were analysed using Fisher’s exact test and kappa statistics.ResultsIn total, 1113 patients with suspected malaria and available blood samples were included. PCR confirmed that 788/1113 (70.8%) were positive for malaria. Among PCR-positive samples, 656 (83.2%) were due to Plasmodium falciparum, 88 (11.2%) Plasmodium vivax, and 44 (5.6%) P. falciparum/P. vivax mixed infections. In 2020, P. falciparum infections were confirmed by PCR in 50% (144/288) of negative RDTs. After the change of RDT in 2021, this percentage decreased to 17%. False negative RDT results were found more frequently (P < 0.05) in four districts of Djibouti city (Balbala, Quartier 7, Quartier 6, and Arhiba). Malaria occurred less frequently in regular bed net users than in non-users (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.42–0.92).ConclusionsThe present study confirmed the high prevalence of falciparum malaria and, to a lesser extent, vivax malaria. Nevertheless, 29% of suspected malaria cases were misdiagnosed by microscopy and/or RDT. There is a need to strengthen the capacity for diagnosis by microscopy and to evaluate the possible role of P. falciparum hrp2 gene deletion, which leads to false negative cases of P. falciparum.

【 授权许可】

CC BY   
© The Author(s) 2023

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