article · The Journal of Infectious Diseases
Malaria control in sub-Saharan Africa primarily targets Plasmodium falciparum, but Plasmodium ovale species are increasingly reported in East Africa. Screening of 7,173 asymptomatic individuals over five years of age in coastal Tanzania between 2018 and 2022 revealed distinct patterns between the species. Plasmodium falciparum had an overall prevalence of 27.4 percent and was linked to younger age, male sex, and higher recent rainfall. By contrast, Plasmodium ovale showed an 11.5 percent prevalence without these demographic or environmental links. Plasmodium ovale infections peaked when Plasmodium falciparum rates dropped, particularly during the long wet season where single ovale infections predominated. However, during the short wet season, co-infections between falciparum and ovale were enriched. Furthermore, mixed infections of the subspecies Plasmodium ovale curtisi and Plasmodium ovale wallikeri occurred frequently across all seasons, making up nearly a quarter of speciation-resolved ovale cases.
Understanding how different malaria parasites circulate and interact is essential for regional disease control. Because non-falciparum species behave differently across seasons and demographic groups, interventions focused solely on Plasmodium falciparum might miss a significant burden of asymptomatic infections. Recognising the seasonal shifts and high rates of mixed species infections helps public health programmes adapt surveillance and management strategies.
The abstract does not indicate a direct commercial application pathway, as it reports early-stage epidemiological surveillance rather than product development. However, the findings provide baseline biological data that diagnostic developers and public health planners could use when designing multi-species malaria detection tests and intervention schedules targeting non-falciparum infections in East Africa.
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BACKGROUND: Malaria control in sub-Saharan Africa is typically focused on Plasmodium falciparum (Pf), but non-falciparum species like P. ovale curtisi (Poc) and P. ovale wallikeri (Pow) appear to be rising in prevalence, especially in parts of East Africa. METHODS: We conducted polymerase chain reaction (PCR)-based screening of 7173 asymptomatic individuals over 5 years of age in coastal Tanzania from 2018-2022, employing real-time 18S rRNA PCR assays for P. falciparum and P. ovale, followed by Poc/Pow detection. Plasmodium positivity was compared across seasons and demographic groups, and interactions between species were analyzed via binomial regression. RESULTS: Plasmodium falciparum infection (prevalence 27.4%) was associated with younger age, male sex, and higher recent cumulative rainfall, whereas these associations were not apparent for P. ovale (Po, prevalence 11.5%). P. ovale infections appeared to peak during months with lower Pf prevalence, especially during the long wet season, when Po mono-infections predominated and fewer Pf-Po co-infections were detected than expected by independent assortment. This apparent antagonism was reversed during the short wet season: Pf-Po co-infections were comparatively enriched despite low overall Po prevalence. In contrast, excess mixed Poc/Pow infections were detected across all seasons, composing 23% of the Po-positive isolates in which a specific Po species could be detected. CONCLUSIONS: The epidemiology of P. ovale species in coastal Tanzania suggests they are frequently present when P. falciparum recedes, but also co-infect the same hosts during the short wet season. Meanwhile, the individual Poc and Pow species often co-exist within individuals, perhaps due to co-transmission or concurrent relapse.
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DOI: 10.1093/infdis/jiaf498
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