Abstract

Plasmodium malariae is often reported as a benign malaria parasite. There are limited data on its biology and disease burden in sub-Saharan Africa (sSA) possibly due to the unavailability of specific and affordable tools for routine diagnosis and large epidemiology studies. In addition, P. malariae occurs at low parasite densities and in co-infections with other species, predominately P. falciparum. The paucity of data on P. malariae infections limits the capacity to accurately determine its contribution to malaria and the effect of control interventions against P. falciparum on its prevalence. Here, we summarise the current knowledge on P. malariae epidemiology in sSA - overall prevalence ranging from 0-32%, as detected by different diagnostic methods; seroprevalence ranging from 0–56% in three countries (Mozambique, Benin and Zimbabwe), and explore the future application of next-generation sequencing technologies as a tool for enriching P. malariae genomic epidemiology. This will provide insights into important adaptive mechanisms of this neglected non-falciparum species, including antimalarial drug resistance, local and regional parasite transmission patterns and genomic signatures of selection. Improved diagnosis and genomic surveillance of non-falciparum malaria parasites in Africa would be helpful in evaluating progress towards elimination of all human Plasmodium species.

摘要

疟原虫疟疾通常被报告为良性疟原虫。撒哈拉以南非洲（sSA）关于其生物学和疾病负担的数据有限，这可能是由于无法获得用于常规诊断和大规模流行病学研究的特定且负担得起的工具。另外，疟疾疟原虫以低的寄生虫密度发生并且与其他物种（主要是恶性疟原虫）共感染。疟原虫感染数据的缺乏限制了准确确定其对疟疾的影响的能力以及控制恶性疟原虫流行率的干预措施的能力。在这里，我们总结了有关疟疾的最新知识sSA中的流行病学-通过不同的诊断方法检测，总体患病率为0-32％；在三个国家（莫桑比克，贝宁和津巴布韦）的血清阳性率范围为0-56％，并探索了下一代测序技术作为丰富疟原虫基因组流行病学工具的未来应用。这将提供对这种被忽视的非恶性疟原虫物种重要适应机制的见解，包括抗疟药耐药性，局部和区域寄生虫传播模式以及选择的基因组特征。非洲非恶性疟疾寄生虫的诊断和基因组监测的改进将有助于评估消除所有人类疟原虫物种的进展。