The epidemiology of Plasmodium vivax among adults in the Democratic Republic of the Congo

Nicholas F. Brazeau (), Cedar L. Mitchell, Andrew P. Morgan, Molly Deutsch-Feldman, Oliver John Watson, Kyaw L. Thwai, Pere Gelabert, Lucy Dorp, Corinna Y. Keeler, Andreea Waltmann, Michael Emch, Valerie Gartner, Ben Redelings, Gregory A. Wray, Melchior K. Mwandagalirwa, Antoinette K. Tshefu, Joris L. Likwela, Jessie K. Edwards, Robert Verity, Jonathan B. Parr, Steven R. Meshnick and Jonathan J. Juliano
Additional contact information
Nicholas F. Brazeau: University of North Carolina
Cedar L. Mitchell: University of North Carolina
Andrew P. Morgan: University of North Carolina
Molly Deutsch-Feldman: University of North Carolina
Oliver John Watson: Imperial College London
Kyaw L. Thwai: University of North Carolina
Pere Gelabert: University College London
Lucy Dorp: University College London
Corinna Y. Keeler: University of North Carolina
Andreea Waltmann: University of North Carolina
Michael Emch: University of North Carolina
Valerie Gartner: Duke University
Ben Redelings: Duke University
Gregory A. Wray: Duke University
Melchior K. Mwandagalirwa: Kinshasa School of Public Health
Antoinette K. Tshefu: Kinshasa School of Public Health
Joris L. Likwela: Programme National de la Lutte Contre le Paludisme
Jessie K. Edwards: University of North Carolina
Robert Verity: Imperial College London
Jonathan B. Parr: University of North Carolina
Steven R. Meshnick: University of North Carolina
Jonathan J. Juliano: University of North Carolina

Nature Communications, 2021, vol. 12, issue 1, 1-10

Abstract: Abstract Reports of P. vivax infections among Duffy-negative hosts have accumulated throughout sub-Saharan Africa. Despite this growing body of evidence, no nationally representative epidemiological surveys of P. vivax in sub-Saharan Africa have been performed. To overcome this gap in knowledge, we screened over 17,000 adults in the Democratic Republic of the Congo (DRC) for P. vivax using samples from the 2013-2014 Demographic Health Survey. Overall, we found a 2.97% (95% CI: 2.28%, 3.65%) prevalence of P. vivax infections across the DRC. Infections were associated with few risk-factors and demonstrated a relatively flat distribution of prevalence across space with focal regions of relatively higher prevalence in the north and northeast. Mitochondrial genomes suggested that DRC P. vivax were distinct from circulating non-human ape strains and an ancestral European P. vivax strain, and instead may be part of a separate contemporary clade. Our findings suggest P. vivax is diffusely spread across the DRC at a low prevalence, which may be associated with long-term carriage of low parasitemia, frequent relapses, or a general pool of infections with limited forward propagation.

Date: 2021
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DOI: 10.1038/s41467-021-24216-3

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