Skip to main content
Top
Published in: Malaria Journal 1/2021

Open Access 01-12-2021 | Plasmodium Falciparum | Research

Prevalence of asymptomatic malaria, submicroscopic parasitaemia and anaemia in Korogwe District, north-eastern Tanzania

Authors: Paul M. Hayuma, Christian W. Wang, Edwin Liheluka, Vito Baraka, Rashid A. Madebe, Daniel T. R. Minja, Gerald Misinzo, Michael Alifrangis, John P. A. Lusingu

Published in: Malaria Journal | Issue 1/2021

Login to get access

Abstract

Background

Asymptomatic malaria infections largely remain undetected and act as a reservoir for continuous transmission. The study assessed the prevalence of submicroscopic asymptomatic malaria infections and anaemia in two rural low (300 m above sea level) and highland (700 m asl) settings of Korogwe District north-eastern Tanzania.

Methods

A cross-sectional malariometric survey involving individuals aged 0–19 years was conducted in June 2018 in the two rural villages. Venous blood was collected from eligible study participants for estimation of haemoglobin level, detection of malaria by rapid diagnostic test (RDT), quantification of malaria parasitaemia by microscopy, as well as dried blood spot (DBS) for determining submicroscopic infections by PCR targeting the small subunit of the ribosomal ribonucleic acid (ssrRNA) of human Plasmodium.

Results

Out of 565 individuals tested, 211 (37.3%) were malaria positive based on RDT, whereas only 81 (14.3%) were positive by microscopy. There was no significant difference in the prevalence between the highland and the lowland village, p = 0.19 and p = 0.78 microscopy and RDT, respectively. Three out of 206 (1.5%) RDT/microscopy negative samples were P. falciparum positive by PCR. Of the 211 RDT and 81 microscopy positive, 130 (61.6%) and 33 (40.7%), respectively, were defined as being asymptomatic. Of the 565 individuals, 135 (23.9%) were anaemic (haemoglobin < 11 g/dL) out of which 5.2% were severely anaemic. The risk of being anaemic was significantly higher among individuals with asymptomatic malaria as compared to those without malaria as confirmed by RDT (AOR = 2.06 (95% CI 1.32–3.20) while based on microscopic results there was no significant differences observed (AOR = 2.09, 95% CI 0.98–4.47). Age and altitude had no effect on the risk of anaemia even after adjusting for asymptomatic malaria.

Conclusions

Asymptomatic malaria is associated with an increased risk of having anaemia in the study communities. The findings highlight the need for targeted interventions focusing on asymptomatic infections which is an important risks factor for anaemia in the community and act as a source of continued transmission of malaria in the study area.
Literature
2.
go back to reference Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–11.CrossRef Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–11.CrossRef
4.
go back to reference Mahende C, Ngasala B, Lusingu J, Yong T-S, Lushino P, Lemnge M, et al. Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe District, Tanzania. Malar J. 2016;15:391.CrossRef Mahende C, Ngasala B, Lusingu J, Yong T-S, Lushino P, Lemnge M, et al. Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe District, Tanzania. Malar J. 2016;15:391.CrossRef
5.
go back to reference Drakeley C, Abdulla S, Agnandji ST, Fernandes JF, Kremsner P, Lell B, et al. Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries. Malar J. 2017;16:433.CrossRef Drakeley C, Abdulla S, Agnandji ST, Fernandes JF, Kremsner P, Lell B, et al. Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries. Malar J. 2017;16:433.CrossRef
6.
go back to reference Ishengoma DS, Mmbando BP, Segeja MD, Alifrangis M, Lemnge MM, Bygbjerg IC. Declining burden of malaria over two decades in a rural community of Muheza district, north-eastern Tanzania. Malar J. 2013;12:388.CrossRef Ishengoma DS, Mmbando BP, Segeja MD, Alifrangis M, Lemnge MM, Bygbjerg IC. Declining burden of malaria over two decades in a rural community of Muheza district, north-eastern Tanzania. Malar J. 2013;12:388.CrossRef
7.
go back to reference Mmbando BP, Vestergaard LS, Kitua AY, Lemnge MM, Theander TG, Lusingu JPA. A progressive declining in the burden of malaria in north-eastern Tanzania. Malar J. 2010;9:216.CrossRef Mmbando BP, Vestergaard LS, Kitua AY, Lemnge MM, Theander TG, Lusingu JPA. A progressive declining in the burden of malaria in north-eastern Tanzania. Malar J. 2010;9:216.CrossRef
8.
go back to reference Rek J, Katrak S, Obasi H, Nayebare P, Katureebe A, Kakande E, et al. Characterizing microscopic and submicroscopic malaria parasitaemia at three sites with varied transmission intensity in Uganda. Malar J. 2016;15:470.CrossRef Rek J, Katrak S, Obasi H, Nayebare P, Katureebe A, Kakande E, et al. Characterizing microscopic and submicroscopic malaria parasitaemia at three sites with varied transmission intensity in Uganda. Malar J. 2016;15:470.CrossRef
9.
go back to reference Roper C, Elhassan IM, Hviid L, Giha H, Richardson W, Babiker H, et al. 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. Am J Trop Med Hyg. 1996;54:325–31.CrossRef Roper C, Elhassan IM, Hviid L, Giha H, Richardson W, Babiker H, et al. 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. Am J Trop Med Hyg. 1996;54:325–31.CrossRef
10.
go back to reference Lusingu JPA, Vestergaard LS, Mmbando BP, Drakeley CJ, Jones C, Akida J, et al. Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in north-eastern Tanzania. Malar J. 2004;3:26.CrossRef Lusingu JPA, Vestergaard LS, Mmbando BP, Drakeley CJ, Jones C, Akida J, et al. Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in north-eastern Tanzania. Malar J. 2004;3:26.CrossRef
11.
go back to reference Gudo ES, Prista A, Jani IV. Impact of asymptomatic Plasmodium falciparum parasitemia on the imunohematological indices among school children and adolescents in a rural area highly endemic for malaria in southern Mozambique. BMC Infect Dis. 2013;13:244.CrossRef Gudo ES, Prista A, Jani IV. Impact of asymptomatic Plasmodium falciparum parasitemia on the imunohematological indices among school children and adolescents in a rural area highly endemic for malaria in southern Mozambique. BMC Infect Dis. 2013;13:244.CrossRef
12.
go back to reference Jones R, Roschnik N, Jukes MC, Clarke SE, Diarra S, Traore K, et al. Impact of a malaria intervention package in schools on Plasmodium infection, anaemia and cognitive function in schoolchildren in Mali: a pragmatic cluster-randomised trial. BMJ Glob Health. 2017;2:e000182.CrossRef Jones R, Roschnik N, Jukes MC, Clarke SE, Diarra S, Traore K, et al. Impact of a malaria intervention package in schools on Plasmodium infection, anaemia and cognitive function in schoolchildren in Mali: a pragmatic cluster-randomised trial. BMJ Glob Health. 2017;2:e000182.CrossRef
13.
go back to reference Lee JH, Jang JW, Cho CH, Kim JY, Han ET, Yun SG, et al. False-positive results for rapid diagnostic tests for malaria in patients with rheumatoid factor. J Clin Microbiol. 2014;52:3784–7.CrossRef Lee JH, Jang JW, Cho CH, Kim JY, Han ET, Yun SG, et al. False-positive results for rapid diagnostic tests for malaria in patients with rheumatoid factor. J Clin Microbiol. 2014;52:3784–7.CrossRef
15.
go back to reference Singh B, Bobogare A, Cox-Singh J, Snounou G, Abdullah MS, Rahman HA. A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies. Am J Trop Med Hyg. 1999;60:687–92.CrossRef Singh B, Bobogare A, Cox-Singh J, Snounou G, Abdullah MS, Rahman HA. A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies. Am J Trop Med Hyg. 1999;60:687–92.CrossRef
16.
go back to reference Bousema T, Okell L, Felger I, Drakeley C. Asymptomatic malaria infections: detectability, transmissibility and public health relevance. Nat Rev Microbiol. 2014;12:833–40.CrossRef Bousema T, Okell L, Felger I, Drakeley C. Asymptomatic malaria infections: detectability, transmissibility and public health relevance. Nat Rev Microbiol. 2014;12:833–40.CrossRef
18.
go back to reference Mboera LEG, Bwana VM, Rumisha SF, Malima RC, Mlozi MRS, Mayala BK, et al. Malaria, anaemia and nutritional status among schoolchildren in relation to ecosystems, livelihoods and health systems in Kilosa District in central Tanzania global health. BMC Public Health. 2015;15:553.CrossRef Mboera LEG, Bwana VM, Rumisha SF, Malima RC, Mlozi MRS, Mayala BK, et al. Malaria, anaemia and nutritional status among schoolchildren in relation to ecosystems, livelihoods and health systems in Kilosa District in central Tanzania global health. BMC Public Health. 2015;15:553.CrossRef
19.
go back to reference Nzobo BJ, Ngasala BE, Kihamia CM. Prevalence of asymptomatic malaria infection and use of different malaria control measures among primary school children in Morogoro Municipality, Tanzania. Malar J. 2015;14:491.CrossRef Nzobo BJ, Ngasala BE, Kihamia CM. Prevalence of asymptomatic malaria infection and use of different malaria control measures among primary school children in Morogoro Municipality, Tanzania. Malar J. 2015;14:491.CrossRef
20.
go back to reference Chacky F, Runge M, Rumisha SF, Machafuko P, Chaki P, Massaga JJ, et al. Nationwide school malaria parasitaemia survey in public primary schools, the United Republic of Tanzania. Malar J. 2018;17:452.CrossRef Chacky F, Runge M, Rumisha SF, Machafuko P, Chaki P, Massaga JJ, et al. Nationwide school malaria parasitaemia survey in public primary schools, the United Republic of Tanzania. Malar J. 2018;17:452.CrossRef
21.
go back to reference Bell DR, Martin LB, Wilson DW. False-positive results of a Plasmodium falciparum histidine-rich protein 2—detecting malaria rapid diagnostic test due to high sensitivity in a community with fluctuating low parasite density. Am J Trop Med Hyg. 2018;73:199–203.CrossRef Bell DR, Martin LB, Wilson DW. False-positive results of a Plasmodium falciparum histidine-rich protein 2—detecting malaria rapid diagnostic test due to high sensitivity in a community with fluctuating low parasite density. Am J Trop Med Hyg. 2018;73:199–203.CrossRef
22.
go back to reference Kim MJ, Jung BK, Chai JY, Eom KS, Yong TS, Min DY, et al. High malaria prevalence among schoolchildren on Kome Island, Tanzania. Korean J Parasitol. 2015;53:571–4.CrossRef Kim MJ, Jung BK, Chai JY, Eom KS, Yong TS, Min DY, et al. High malaria prevalence among schoolchildren on Kome Island, Tanzania. Korean J Parasitol. 2015;53:571–4.CrossRef
23.
go back to reference Humar A, Ohrt C, Harrington MA, Pillai D, Kain KC. ParaSight®F test compared with the polymerase chain reaction and microscopy for the diagnosis of Plasmodium falciparum malaria in travelers. Am J Trop Med Hyg. 1998;92:166–9.CrossRef Humar A, Ohrt C, Harrington MA, Pillai D, Kain KC. ParaSight®F test compared with the polymerase chain reaction and microscopy for the diagnosis of Plasmodium falciparum malaria in travelers. Am J Trop Med Hyg. 1998;92:166–9.CrossRef
24.
go back to reference Keating J, Miller JM, Bennett A, Moonga HB, Eisele TP. Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: implications for monitoring and evaluation. Acta Trop. 2009;112:277–82.CrossRef Keating J, Miller JM, Bennett A, Moonga HB, Eisele TP. Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: implications for monitoring and evaluation. Acta Trop. 2009;112:277–82.CrossRef
25.
go back to reference Harris I, Sharrock W, Bain L, Gray KA, Bobogare A, Lilley K, et al. A large proportion of asymptomatic malaria infections with low parasite densities in Temotu Province, Solomon Islands: challenges for malaria diagnostics in an elimination setting. Malar J. 2010;9:254.CrossRef Harris I, Sharrock W, Bain L, Gray KA, Bobogare A, Lilley K, et al. A large proportion of asymptomatic malaria infections with low parasite densities in Temotu Province, Solomon Islands: challenges for malaria diagnostics in an elimination setting. Malar J. 2010;9:254.CrossRef
26.
go back to reference Yanda PZ, Kangalawe RY, Sigalla RJ. Climatic and socio-economic influences on malaria and cholera risks in the Lake Victoria region of Tanzania. AIACC Working Papers; 2005. Yanda PZ, Kangalawe RY, Sigalla RJ. Climatic and socio-economic influences on malaria and cholera risks in the Lake Victoria region of Tanzania. AIACC Working Papers; 2005.
27.
go back to reference Himeidan YE-S, Kweka E. Malaria in East African highlands during the past 30 years: impact of environmental changes. Front Physiol. 2012;3:315.CrossRef Himeidan YE-S, Kweka E. Malaria in East African highlands during the past 30 years: impact of environmental changes. Front Physiol. 2012;3:315.CrossRef
28.
go back to reference Wandiga SO, Opondo M, Olago D, Githeko A, Githui F, Marshall M, et al. Vulnerability to epidemic malaria in the highlands of Lake Victoria basin: the role of climate change/variability, hydrology and socio-economic factors. Clim Change. 2010;99:473–97.CrossRef Wandiga SO, Opondo M, Olago D, Githeko A, Githui F, Marshall M, et al. Vulnerability to epidemic malaria in the highlands of Lake Victoria basin: the role of climate change/variability, hydrology and socio-economic factors. Clim Change. 2010;99:473–97.CrossRef
29.
go back to reference Schellenberg D, Schellenberg JRMA, Mushi A, De Savigny D, Mgalula L, Mbuya C, et al. The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Organ. 2003;81:581–90.PubMedPubMedCentral Schellenberg D, Schellenberg JRMA, Mushi A, De Savigny D, Mgalula L, Mbuya C, et al. The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Organ. 2003;81:581–90.PubMedPubMedCentral
30.
go back to reference Vantaux A, Samreth R, Piv E, Khim N, Kim S, Berne L, et al. Contribution to malaria transmission of symptomatic and asymptomatic parasite carriers in Cambodia. J Infect Dis. 2018;217:1561–8.CrossRef Vantaux A, Samreth R, Piv E, Khim N, Kim S, Berne L, et al. Contribution to malaria transmission of symptomatic and asymptomatic parasite carriers in Cambodia. J Infect Dis. 2018;217:1561–8.CrossRef
31.
go back to reference Nankabirwa JI, Wandera B, Amuge P, Kiwanuka N, Dorsey G, Rosenthal PJ, et al. Impact of intermittent preventive treatment with dihydroartemisinin–piperaquine on malaria in Ugandan schoolchildren: a randomized, placebo-controlled trial. Clin Infect Dis. 2014;58:1404–12.CrossRef Nankabirwa JI, Wandera B, Amuge P, Kiwanuka N, Dorsey G, Rosenthal PJ, et al. Impact of intermittent preventive treatment with dihydroartemisinin–piperaquine on malaria in Ugandan schoolchildren: a randomized, placebo-controlled trial. Clin Infect Dis. 2014;58:1404–12.CrossRef
32.
go back to reference Bakari C, Jones S, Subramaniam G, Mandara CI, Chiduo MG, Rumisha S, et al. Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania. Malar J. 2020;19:391.CrossRef Bakari C, Jones S, Subramaniam G, Mandara CI, Chiduo MG, Rumisha S, et al. Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania. Malar J. 2020;19:391.CrossRef
Metadata
Title
Prevalence of asymptomatic malaria, submicroscopic parasitaemia and anaemia in Korogwe District, north-eastern Tanzania
Authors
Paul M. Hayuma
Christian W. Wang
Edwin Liheluka
Vito Baraka
Rashid A. Madebe
Daniel T. R. Minja
Gerald Misinzo
Michael Alifrangis
John P. A. Lusingu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2021
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-021-03952-3

Other articles of this Issue 1/2021

Malaria Journal 1/2021 Go to the issue
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.