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

BACKGROUND: The 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 as...

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Autores principales: Moussa, Rahma Abdi, Papa Mze, Nasserdine, Arreh, Houssein Yonis, Hamoud, Aicha Abdillahi, Alaleh, Kahiya Mohamed, Omar, Abdoul-Razak Yonis, Abdi, Warsama Osman, Guelleh, Samatar Kayad, Abdi, Abdoul-Ilah Ahmed, Aboubaker, Mohamed Houmed, Basco, Leonardo K., Khaireh, Bouh Abdi, Bogreau, Hervé
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154177/
https://www.ncbi.nlm.nih.gov/pubmed/37131225
http://dx.doi.org/10.1186/s12936-023-04546-x
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author Moussa, Rahma Abdi
Papa Mze, Nasserdine
Arreh, Houssein Yonis
Hamoud, Aicha Abdillahi
Alaleh, Kahiya Mohamed
Omar, Abdoul-Razak Yonis
Abdi, Warsama Osman
Guelleh, Samatar Kayad
Abdi, Abdoul-Ilah Ahmed
Aboubaker, Mohamed Houmed
Basco, Leonardo K.
Khaireh, Bouh Abdi
Bogreau, Hervé
author_facet Moussa, Rahma Abdi
Papa Mze, Nasserdine
Arreh, Houssein Yonis
Hamoud, Aicha Abdillahi
Alaleh, Kahiya Mohamed
Omar, Abdoul-Razak Yonis
Abdi, Warsama Osman
Guelleh, Samatar Kayad
Abdi, Abdoul-Ilah Ahmed
Aboubaker, Mohamed Houmed
Basco, Leonardo K.
Khaireh, Bouh Abdi
Bogreau, Hervé
author_sort Moussa, Rahma Abdi
collection PubMed
description BACKGROUND: The 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. METHODS: All 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. RESULTS: In 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). CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04546-x.
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spelling pubmed-101541772023-05-04 Molecular investigation of malaria-infected patients in Djibouti city (2018–2021) Moussa, Rahma Abdi Papa Mze, Nasserdine Arreh, Houssein Yonis Hamoud, Aicha Abdillahi Alaleh, Kahiya Mohamed Omar, Abdoul-Razak Yonis Abdi, Warsama Osman Guelleh, Samatar Kayad Abdi, Abdoul-Ilah Ahmed Aboubaker, Mohamed Houmed Basco, Leonardo K. Khaireh, Bouh Abdi Bogreau, Hervé Malar J Research BACKGROUND: The 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. METHODS: All 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. RESULTS: In 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). CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04546-x. BioMed Central 2023-05-03 /pmc/articles/PMC10154177/ /pubmed/37131225 http://dx.doi.org/10.1186/s12936-023-04546-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Moussa, Rahma Abdi
Papa Mze, Nasserdine
Arreh, Houssein Yonis
Hamoud, Aicha Abdillahi
Alaleh, Kahiya Mohamed
Omar, Abdoul-Razak Yonis
Abdi, Warsama Osman
Guelleh, Samatar Kayad
Abdi, Abdoul-Ilah Ahmed
Aboubaker, Mohamed Houmed
Basco, Leonardo K.
Khaireh, Bouh Abdi
Bogreau, Hervé
Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title_full Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title_fullStr Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title_full_unstemmed Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title_short Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)
title_sort molecular investigation of malaria-infected patients in djibouti city (2018–2021)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154177/
https://www.ncbi.nlm.nih.gov/pubmed/37131225
http://dx.doi.org/10.1186/s12936-023-04546-x
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