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. 2015 Feb 19:14:84.
doi: 10.1186/s12936-015-0596-4.

Molecular epidemiology of Plasmodium vivax and Plasmodium falciparum malaria among Duffy-positive and Duffy-negative populations in Ethiopia

Eugenia Lo  1 , Delenasaw Yewhalaw  2 , Daibin Zhong  3 , Endalew Zemene  4 , Teshome Degefa  5 , Kora Tushune  6 , Margaret Ha  7 , Ming-Chieh Lee  8 , Anthony A James  9 , Guiyun Yan  10
Affiliations

Molecular epidemiology of Plasmodium vivax and Plasmodium falciparum malaria among Duffy-positive and Duffy-negative populations in Ethiopia

Eugenia Lo et al. Malar J. .

Abstract

Background: Malaria is the most prevalent communicable disease in Ethiopia, with 75% of the country's landmass classified as endemic for malaria. Accurate information on the distribution and clinical prevalence of Plasmodium vivax and Plasmodium falciparum malaria in endemic areas, as well as in Duffy-negative populations, is essential to develop integrated control strategies.

Methods: A total of 390 and 416 community and clinical samples, respectively, representing different localities and age groups across Ethiopia were examined. Malaria prevalence was estimated using nested PCR of the 18S rRNA region. Parasite gene copy number was measured by quantitative real-time PCR and compared between symptomatic and asymptomatic samples, as well as between children/adolescents and adults from the local community. An approximately 500-bp segment of the human DARC gene was amplified and sequenced to identify Duffy genotype at the -33rd nucleotide position for all the clinical and community samples.

Results: Plasmodium vivax prevalence was higher in the south while P. falciparum was higher in the north. The prevalence of P. vivax and P. falciparum malaria is the highest in children compared to adolescents and adults. Four P. vivax infections were detected among the Duffy-negative samples. Samples from asymptomatic individuals show a significantly lower parasite gene copy number than those from symptomatic infections for P. vivax and P. falciparum.

Conclusions: Geographical and age differences influence the distribution of P. vivax and P. falciparum malaria in Ethiopia. These findings offer evidence-based guidelines in targeting malaria control efforts in the country.

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Figures

Figure 1
Figure 1
Map showing the geographical distribution of the sample sites in Ethiopia. Community samples were collected in Asendabo and clinical samples were collected in the other six sites.
Figure 2
Figure 2
Box plots of the log-transformed parasite gene copy number of the community and clinical samples. (A) Box plot of the log-transformed parasite gene copy number of Plasmodium vivax and Plasmodium falciparum measured by qPCR in children/adolescents of age under 18 and adults of age 18 and above. These samples represent the local community of Asendabo, Ethiopia. (B) Box plot showing the log-transformed parasite gene copy number of clinical Plasmodium vivax and Plasmodium falciparum cases in children/adolescents and adults from the six health centre/hospital sites in Ethiopia. The central box represents the interquartile range and the vertical lines represent the first and fourth quartiles of the data. The median is shown as a line through the centre of the box. Outlier samples are represented by open circles. P-values (above) are provided for the comparison of gene copy number between the two age groups with respect to P. vivax and P. falciparum. Numbers (bottom) indicate the number of individuals included.
Figure 3
Figure 3
Box plot of the log-transformed parasite gene copy number of Plasmodium vivax and Plasmodium falciparum measured by qPCR in asymptomatic and symptomatic samples from Asendabo (community) and Jimma (hospital), respectively. The central box represents the interquartile range and the vertical lines represent the first and fourth quartiles of the data. The median is shown as a line through the centre of the box. Outlier samples are represented by open circles. The gene copy number of P. vivax detected in the four Duffy-negative individuals are indicated by crosses in red. Numbers (top) indicate the number of individuals included. P-values (below) are provided for the comparison of gene copy number between asymptomatic and symptomatic samples with respect to P. vivax and P. falciparum.
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