Skip to main content
Top
Published in: Malaria Journal 1/2013

Open Access 01-12-2013 | Research

Trends in multiplicity of Plasmodium falciparum infections among asymptomatic residents in the middle belt of Ghana

Authors: Akua Agyeman-Budu, Charles Brown, George Adjei, Mohammed Adams, David Dosoo, Dominic Dery, Michael Wilson, Kwaku P Asante, Brian Greenwood, Seth Owusu-Agyei

Published in: Malaria Journal | Issue 1/2013

Login to get access

Abstract

Background

Malaria is the most important cause of mortality and morbidity in children living in the Kintampo districts in the middle part of Ghana. This study has investigated the multiplicity of infection (MOI) within asymptomatic residents of the Kintampo districts, and the influence of age and seasonality on MOI, by studying the distribution of the polymorphic Plasmodium falciparum antigen merozoite surface protein 2 (MSP2).

Methods

DNA was extracted from an asymptomatic cohort of children and adults infected with P. falciparum during the period November 2003 to October 2004. Polymerase chain reaction was carried out and multiplicity of infection (MOI) was determined.

Results

Children under 10 years of age had an average MOI of 2.3 while adults 18 years and above had an average MOI of 1.4. Children below five years had high and low average MOIs of 2.8 in the March/April survey and 0.9 in the May/June survey respectively. A similar trend in the monthly distribution of MOI was observed for the entire cohort. IC/3D7 strains outnumbered the FC27 strains throughout the year by a ratio of about 4:1 with the difference between the prevalence of the two strains being least marked in the March/April survey, at the beginning of the rainy season. MOI was not linked to the level of malaria transmission as measured by the entomological inoculation rate.

Discussion/conclusion

The impact of interventions, introduced since this baseline study was carried out on the parasite diversity of asymptomatic residents will be the subject of further investigations.
Appendix
Available only for authorised users
Literature
2.
go back to reference Afari EA, Appawu M, Dunyo S, Baffoe-Wilmot A, Nkrumah FK: Malaria infection, morbidity and transmission in two ecological zones Southern Ghana. Afr J Health Sci. 1995, 2: 312-315.PubMed Afari EA, Appawu M, Dunyo S, Baffoe-Wilmot A, Nkrumah FK: Malaria infection, morbidity and transmission in two ecological zones Southern Ghana. Afr J Health Sci. 1995, 2: 312-315.PubMed
3.
go back to reference Binka FN, Morris SS, Ross DA, Arthur P, Aryeetey ME: Patterns of malaria morbidity and mortality in children in northern Ghana. Trans R Soc Trop Med Hyg. 1994, 88: 381-385. 10.1016/0035-9203(94)90391-3.CrossRefPubMed Binka FN, Morris SS, Ross DA, Arthur P, Aryeetey ME: Patterns of malaria morbidity and mortality in children in northern Ghana. Trans R Soc Trop Med Hyg. 1994, 88: 381-385. 10.1016/0035-9203(94)90391-3.CrossRefPubMed
4.
go back to reference Owusu-Agyei S, Awini E, Anto F, Mensah-Afful T, Adjuik M, Hodgson A, Afari E, Binka F: Assessing malaria control in the Kassena-Nankana district of northern Ghana through repeated surveys using the RBM tools. Malar J. 2007, 6: 103-10.1186/1475-2875-6-103.PubMedCentralCrossRefPubMed Owusu-Agyei S, Awini E, Anto F, Mensah-Afful T, Adjuik M, Hodgson A, Afari E, Binka F: Assessing malaria control in the Kassena-Nankana district of northern Ghana through repeated surveys using the RBM tools. Malar J. 2007, 6: 103-10.1186/1475-2875-6-103.PubMedCentralCrossRefPubMed
5.
go back to reference Asante KP, Owusu R, Dosoo D, Awini E, Adjei G, Amenga Etego S, Chandramohan D, Owusu-Agyei S: Adherence to artesunate-amodiaquine therapy for uncomplicated malaria in Rural Ghana: a randomised trial of supervised versus unsupervised drug administration. J Trop Med 2009. 2009, 529583: 10.1155/2009/529583. Asante KP, Owusu R, Dosoo D, Awini E, Adjei G, Amenga Etego S, Chandramohan D, Owusu-Agyei S: Adherence to artesunate-amodiaquine therapy for uncomplicated malaria in Rural Ghana: a randomised trial of supervised versus unsupervised drug administration. J Trop Med 2009. 2009, 529583: 10.1155/2009/529583.
6.
go back to reference Owusu-Agyei S, Asante KP, Adjuik M, Adjei G, Awini E, Adams M, Newton S, Dosoo D, Dery D, Agyeman-Budu A, Gyapong J, Greenwood B, Chandramohan D: Epidemiology of malaria in the forest-savanna transitional zone of Ghana. Malar J. 2009, 8: 220-10.1186/1475-2875-8-220.PubMedCentralCrossRefPubMed Owusu-Agyei S, Asante KP, Adjuik M, Adjei G, Awini E, Adams M, Newton S, Dosoo D, Dery D, Agyeman-Budu A, Gyapong J, Greenwood B, Chandramohan D: Epidemiology of malaria in the forest-savanna transitional zone of Ghana. Malar J. 2009, 8: 220-10.1186/1475-2875-8-220.PubMedCentralCrossRefPubMed
7.
go back to reference Dery DB, Brown C, Asante KP, Adams M, Dosoo D, Amenga-Etego S, Wilson M, Chandramohan D, Greenwood B, Owusu-Agyei S: Patterns and seasonality of malaria transmission in the forest-savannah transitional zones of Ghana. Malar J. 2010, 9: 314-10.1186/1475-2875-9-314.PubMedCentralCrossRefPubMed Dery DB, Brown C, Asante KP, Adams M, Dosoo D, Amenga-Etego S, Wilson M, Chandramohan D, Greenwood B, Owusu-Agyei S: Patterns and seasonality of malaria transmission in the forest-savannah transitional zones of Ghana. Malar J. 2010, 9: 314-10.1186/1475-2875-9-314.PubMedCentralCrossRefPubMed
8.
go back to reference Arnot D: Unstable malaria in Sudan: the influence of the dry season. Clone multiplicity of Plasmodium falciparum infections in individuals exposed to variable levels of disease transmission. Trans R Soc Trop Med Hyg. 1998, 92: 580-585. 10.1016/S0035-9203(98)90773-8.CrossRefPubMed Arnot D: Unstable malaria in Sudan: the influence of the dry season. Clone multiplicity of Plasmodium falciparum infections in individuals exposed to variable levels of disease transmission. Trans R Soc Trop Med Hyg. 1998, 92: 580-585. 10.1016/S0035-9203(98)90773-8.CrossRefPubMed
9.
go back to reference Babiker HA, Ranford-Cartwright LC, Walliker D: Genetic structure and dynamics of Plasmodium falciparum infections in the Kilombero region of Tanzania. Trans R Soc Trop Med Hyg. 1999, 93: 11-14.CrossRefPubMed Babiker HA, Ranford-Cartwright LC, Walliker D: Genetic structure and dynamics of Plasmodium falciparum infections in the Kilombero region of Tanzania. Trans R Soc Trop Med Hyg. 1999, 93: 11-14.CrossRefPubMed
10.
go back to reference Ntoumi F, Contamin H, Rogier C, Bonnefoy S, Trape JF, Mercereau-Puijalon O: Age-dependent carriage of multiple Plasmodium falciparum merozoite surface antigen-2 alleles in asymptomatic malaria infections. AmJTrop Med Hyg. 1995, 52: 81-88. Ntoumi F, Contamin H, Rogier C, Bonnefoy S, Trape JF, Mercereau-Puijalon O: Age-dependent carriage of multiple Plasmodium falciparum merozoite surface antigen-2 alleles in asymptomatic malaria infections. AmJTrop Med Hyg. 1995, 52: 81-88.
11.
go back to reference Al-Yaman F, Genton B, Reeder JC, Anders RF, Smith T, Alpers MP: Reduced risk of clinical malaria in children infected with multiple clones of Plasmodium falciparum in a highly endemic area: a prospective community study. Trans R Soc Trop Med Hyg. 1997, 91: 602-605. 10.1016/S0035-9203(97)90046-8.CrossRefPubMed Al-Yaman F, Genton B, Reeder JC, Anders RF, Smith T, Alpers MP: Reduced risk of clinical malaria in children infected with multiple clones of Plasmodium falciparum in a highly endemic area: a prospective community study. Trans R Soc Trop Med Hyg. 1997, 91: 602-605. 10.1016/S0035-9203(97)90046-8.CrossRefPubMed
12.
go back to reference Beck HP, Felger I, Huber W, Steiger S, Smith T, Weiss N, Alonso P, Tanner M: Analysis of multiple Plasmodium falciparum infections in Tanzanian children during the phase III trial of the malaria vaccine SPf66. J Infect Dis. 1997, 175: 921-926. 10.1086/513991.CrossRefPubMed Beck HP, Felger I, Huber W, Steiger S, Smith T, Weiss N, Alonso P, Tanner M: Analysis of multiple Plasmodium falciparum infections in Tanzanian children during the phase III trial of the malaria vaccine SPf66. J Infect Dis. 1997, 175: 921-926. 10.1086/513991.CrossRefPubMed
13.
go back to reference Contamin H, Fandeur T, Rogier C, Bonnefoy S, Konate L, Trape JF, Mercereau-Puijalon O: Different genetic characteristics of Plasmodium falciparum isolates collected during successive clinical malaria episodes in Senegalese children. AmJTrop Med Hyg. 1996, 54: 632-643. Contamin H, Fandeur T, Rogier C, Bonnefoy S, Konate L, Trape JF, Mercereau-Puijalon O: Different genetic characteristics of Plasmodium falciparum isolates collected during successive clinical malaria episodes in Senegalese children. AmJTrop Med Hyg. 1996, 54: 632-643.
14.
go back to reference Ofosu-Okyere A, Mackinnon MJ, Sowa MP, Koram KA, Nkrumah F, Osei YD, Hill WG, Wilson MD, Arnot DE: Novel Plasmodium falciparum clones and rising clone multiplicities are associated with the increase in malaria morbidity in Ghanaian children during the transition into the high transmission season. Parasitology. 2001, 123: 113-123.CrossRefPubMed Ofosu-Okyere A, Mackinnon MJ, Sowa MP, Koram KA, Nkrumah F, Osei YD, Hill WG, Wilson MD, Arnot DE: Novel Plasmodium falciparum clones and rising clone multiplicities are associated with the increase in malaria morbidity in Ghanaian children during the transition into the high transmission season. Parasitology. 2001, 123: 113-123.CrossRefPubMed
15.
go back to reference Roper C, Elhassan IM, Hviid L, Giha H, Richardson W, Babiker H, Satti GM, Theander TG, Arnot DE: Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan. AmJTrop Med Hyg. 1996, 54: 325-331. Roper C, Elhassan IM, Hviid L, Giha H, Richardson W, Babiker H, Satti GM, Theander TG, Arnot DE: Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan. AmJTrop Med Hyg. 1996, 54: 325-331.
16.
go back to reference Zwetyenga J, Rogier C, Tall A, Fontenille D, Snounou G, Trape JF, Mercereau-Puijalon O: No influence of age on infection complexity and allelic distribution in Plasmodium falciparum infections in Ndiop, a Senegalese village with seasonal, mesoendemic malaria. AmJTrop Med Hyg. 1998, 59: 726-735. Zwetyenga J, Rogier C, Tall A, Fontenille D, Snounou G, Trape JF, Mercereau-Puijalon O: No influence of age on infection complexity and allelic distribution in Plasmodium falciparum infections in Ndiop, a Senegalese village with seasonal, mesoendemic malaria. AmJTrop Med Hyg. 1998, 59: 726-735.
17.
go back to reference Wooden J, Kyes S, Sibley CH: PCR and strain identification in Plasmodium falciparum. Parasitol Today. 1993, 9: 303-305. 10.1016/0169-4758(93)90131-X.CrossRefPubMed Wooden J, Kyes S, Sibley CH: PCR and strain identification in Plasmodium falciparum. Parasitol Today. 1993, 9: 303-305. 10.1016/0169-4758(93)90131-X.CrossRefPubMed
18.
go back to reference Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE: Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. AmJTrop Med Hyg. 1995, 52: 565-568. Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE: Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. AmJTrop Med Hyg. 1995, 52: 565-568.
19.
go back to reference Snounou G, Zhu X, Siripoon N, Jarra W, Thaithong S, Brown KN, Viriyakosol S: Biased distribution of msp1 and msp2 allelic variants in Plasmodium falciparum populations in Thailand. Trans R Soc Trop Med Hyg. 1999, 93: 369-374. 10.1016/S0035-9203(99)90120-7.CrossRefPubMed Snounou G, Zhu X, Siripoon N, Jarra W, Thaithong S, Brown KN, Viriyakosol S: Biased distribution of msp1 and msp2 allelic variants in Plasmodium falciparum populations in Thailand. Trans R Soc Trop Med Hyg. 1999, 93: 369-374. 10.1016/S0035-9203(99)90120-7.CrossRefPubMed
20.
go back to reference Felger I, Smith T, Edoh D, Kitua A, Alonso P, Tanner M, Beck HP: Multiple Plasmodium falciparum infections in Tanzanian infants. Trans R Soc Trop Med Hyg. 1999, 93: 29-34.CrossRefPubMed Felger I, Smith T, Edoh D, Kitua A, Alonso P, Tanner M, Beck HP: Multiple Plasmodium falciparum infections in Tanzanian infants. Trans R Soc Trop Med Hyg. 1999, 93: 29-34.CrossRefPubMed
21.
go back to reference Smith T, Beck HP, Kitua A, Mwankusye S, Felger I, Fraser-Hurt N, Irion A, Alonso P, Teuscher T, Tanner M: Age dependence of the multiplicity of Plasmodium falciparum infections and of other malariological indices in an area of high endemicity. Trans R Soc Trop Med Hyg. 1999, 93: 15-20.CrossRefPubMed Smith T, Beck HP, Kitua A, Mwankusye S, Felger I, Fraser-Hurt N, Irion A, Alonso P, Teuscher T, Tanner M: Age dependence of the multiplicity of Plasmodium falciparum infections and of other malariological indices in an area of high endemicity. Trans R Soc Trop Med Hyg. 1999, 93: 15-20.CrossRefPubMed
22.
go back to reference Smith T, Felger I, Tanner M, Beck HP: Premunition in Plasmodium falciparum infection: insights from the epidemiology of multiple infections. Trans R Soc Trop Med Hyg. 1999, 93: 59-64.CrossRefPubMed Smith T, Felger I, Tanner M, Beck HP: Premunition in Plasmodium falciparum infection: insights from the epidemiology of multiple infections. Trans R Soc Trop Med Hyg. 1999, 93: 59-64.CrossRefPubMed
23.
go back to reference Smith T, Felger I, Kitua A, Tanner M, Beck HP: Dynamics of multiple Plasmodium falciparum infections in infants in a highly endemic area of Tanzania. Trans R Soc Trop Med Hyg. 1999, 93: 35-39.CrossRefPubMed Smith T, Felger I, Kitua A, Tanner M, Beck HP: Dynamics of multiple Plasmodium falciparum infections in infants in a highly endemic area of Tanzania. Trans R Soc Trop Med Hyg. 1999, 93: 35-39.CrossRefPubMed
24.
go back to reference Engelbrecht F, Togel E, Beck HP, Enwezor F, Oettli A, Felger I: Analysis of Plasmodium falciparum infections in a village community in Northern Nigeria: determination of msp2 genotypes and parasite-specific IgG responses. Acta Trop. 2000, 74: 63-71. 10.1016/S0001-706X(99)00044-3.CrossRefPubMed Engelbrecht F, Togel E, Beck HP, Enwezor F, Oettli A, Felger I: Analysis of Plasmodium falciparum infections in a village community in Northern Nigeria: determination of msp2 genotypes and parasite-specific IgG responses. Acta Trop. 2000, 74: 63-71. 10.1016/S0001-706X(99)00044-3.CrossRefPubMed
Metadata
Title
Trends in multiplicity of Plasmodium falciparum infections among asymptomatic residents in the middle belt of Ghana
Authors
Akua Agyeman-Budu
Charles Brown
George Adjei
Mohammed Adams
David Dosoo
Dominic Dery
Michael Wilson
Kwaku P Asante
Brian Greenwood
Seth Owusu-Agyei
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2013
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-12-22

Other articles of this Issue 1/2013

Malaria Journal 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.