1. Asymptomatic falciparum and Non-falciparum Malarial Parasitemia in Adult Volunteers with and without HIV-1 Coinfection in a Cohort Study in Western Kenya
- Author
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David M. Rockabrand, Janet Oyieko, Brandi K. Torrevillas, John N. Waitumbi, Robin H. Miller, Stephen Ocholla, Deborah M Stiffler, V. Ann Stewart, Shirley Luckhart, Carolyne M. Kifude, Nathaniel I. Dizon, and Emily Parsons
- Subjects
Adult ,Male ,Adolescent ,Population ,Plasmodium falciparum ,Plasmodium malariae ,Parasitemia ,Asymptomatic ,Cohort Studies ,Young Adult ,Virology ,parasitic diseases ,Prevalence ,Medicine ,Humans ,Malaria, Falciparum ,education ,Asymptomatic Infections ,education.field_of_study ,biology ,business.industry ,Coinfection ,Articles ,Middle Aged ,Plasmodium ovale ,biology.organism_classification ,medicine.disease ,Kenya ,Healthy Volunteers ,Malaria ,Infectious Diseases ,Cross-Sectional Studies ,HIV-1 ,Parasitology ,Female ,medicine.symptom ,business - Abstract
Asymptomatic malarial parasitemia represents the largest reservoir of infection and transmission, and the impact of coinfection with HIV-1 on this reservoir remains incompletely described. Accordingly, we sought to determine the prevalence of asymptomatic malarial parasitemia in Kombewa, Western Kenya, a region that is endemic for both malaria and HIV-1. A total of 1,762 dried blood spots were collected from asymptomatic adults in a cross-sectional study. The presence of parasitemia was first determined by a sensitive Plasmodium genus–specific 18S assay, followed by less sensitive species-specific DNA-based quantitative polymerase chain reaction (PCR) assays. The prevalence of asymptomatic malarial parasitemia by 18S genus-specific PCR assay was 64.4% (1,134/1,762). Of the 1,134 malaria positive samples, Plasmodium falciparum was the most prevalent species (57.4%), followed by Plasmodium malariae (3.8%) and Plasmodium ovale (2.6%) as single or mixed infections. As expected, the majority of infections were below the detection limit of microscopy and rapid diagnostic tests. HIV-1 prevalence was 10.6%, and we observed a significant association with malarial parasitemia by χ2 analysis (P = 0.0475). Seventy-one percent of HIV-1 infected volunteers were positive for Plasmodium 18S (132/186), with only 29% negative (54/186). In HIV-1-negative volunteers, the proportion was lower; 64% were found to be positive for 18S (998/1,569) and 36% were negative (571/1,569). Overall, the prevalence of asymptomatic malarial parasitemia in Western Kenya is high, and knowledge of these associations with HIV-1 infection are critically important for malaria elimination and eradication efforts focused on this important reservoir population.
- Published
- 2021