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High Prevalence of Asymptomatic Plasmodium falciparum Infection in Gabonese Adults

Plasmodium falciparum, the most common malarial parasite in sub-Saharan Africa, accounts for a high number of deaths in children less than five years of age. In malaria-endemic countries with stable transmission, semi-immunity is usually acquired after childhood. For adults, severe malaria is rare. Infected adults have either uncomplicated malaria or asymptomatic parasitemia. During a period of one year, we screened 497 afebrile males to investigate the prevalence of asymptomatic P. falciparum parasitemia in villages near Lambaréné, Gabon by use of three different methods. A total of 52% of the individuals had parasites detected by a subtelomeric variable open reading frame polymerase chain reaction (stevor-PCR), 27% of the rapid diagnostic test results were positive, and 12% of the thick blood smears with low parasitemias had P. falciparum. Most positive cases were only detected by the stevor-PCR. Asymptomatic P. falciparum parasitemia in adults living in a malaria-endemic country is frequent.

Received October 22, 2006. Accepted for publication February 28, 2007.

Acknowledgments: We thank all persons from villages near Lambaréné for participating in the study; Philemon Koumba-Koumba and Leonce Massoussa Mbadinga for assistance during sample collection; Judith Kammer, Marcel Nkeyi, Anselme Ndzengue, Brigitte Migombet, and Ariane Ntseyi for microscopic examination of the thick blood smears; and Andrea Weierich for conducting the stevor-PCR analysis.

^* Address correspondence to Matthias P. Dal-Bianco, Medical Research Unit, Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon and Department of Parasitology, Institute of Tropical Medicine University of Tübingen, Wilhelmstrasse 27, 72074, Tübingen, Germany. E-mail:matthiasdalbianco{at}yahoo.com

Authors’ addresses: Matthias P. Dal-Bianco, Pierre B. Matsiegui, Michel A. Missinou, Saadou Issifou, Bertrand Lell, and Peter Kremsner, Medical Research Unit, Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon and Department of Parasitology, Institute of Tropical Medicine University of Tübingen, Wilhelmstrasse 27, 72074, Tübingen, Germany. Kai B. Köster, Ulrich D. Kombila, Ghyslain Mombo Ngoma, Christian Supan, and Carmen L. Ospina Salazar, Medical Research Unit, Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon. Jürgen F. J. Kun, Department of Parasitology, Institute of Tropical Medicine University of Tübingen, Wilhelmstrasse 27, 72074, Tübingen, Germany. Martin P. Grobusch, Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences University of the Witwatersrand, 7 York Road, Parktown 2196, Johannesburg, South Africa and Medical Research Unit, Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon.

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