Indigenous Plasmodium malariae Infection in an Endemic Population at the Thai–Myanmar Border

Ritthideach Yorsaeng Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;
Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;

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Teerawat Saeseu Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;

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Kesinee Chotivanich Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;

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Ingrid Felger Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;

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Rahel Wampfler Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;

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Liwang Cui Department of Entomology, Pennsylvania State University, University Park, Pennsylvania;

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Ivo Mueller Population-Based Biology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia;
Department of Medical Biology, University of Melbourne, Parkville, Australia;
Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France;

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Jetsumon Sattabongkot Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;

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Wang Nguitragool Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

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Plasmodium malariae is a neglected malaria parasite. It has wide geographic distribution and, although often associated with mild malaria, is linked to a high burden of anemia and nephrotic syndromes. Here, we report a cohort study conducted in the Kanchanaburi Province of Thailand during May 2013–June 2014 in which P. malariae infection was detected. Of the 812 study participants, two were found to be infected with P. malariae. One had an infection that led to acute malaria, but the other was positive for P. malariae at multiple visits during the study and apparently had chronic asymptomatic infection. Such persistent infection may explain how P. malariae has been able to thrive at very low prevalence and represents a challenge for malaria elimination.

Author Notes

Address correspondence to Wang Nguitragool, Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. E-mail: wang.ngu@mahidol.edu

Authors’ addresses: Ritthideach Yorsaeng, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, and Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: ritthideach.yor@gmail.com. Teerawat Saeseu and Jetsumon Sattabongkot, Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mails: teerawatsaeseu@gmail.com and jetsumon.pra@mahidol.ac.th. Kesinee Chotivanich, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: nok@tropmedres.ac. Ingrid Felger and Rahel Wampfler, Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Swiss Tropical and Public Health Institute, Basel, Switzerland, E-mails: ingrid.felger@swisstph.ch and rahel.wampfler@swisstph.ch. Liwang Cui, Department of Entomology, Pennsylvania State University, University Park, PA, E-mail: luc2@psu.edu. Ivo Mueller, Population-Based Biology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia, Department of Medical Biology, University of Melbourne, Parkville, Australia, and Malaria: Parasites and Hosts Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France, E-mail: mueller@wehi.edu.au. Wang Nguitragool, Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: wang.ngu@mahidol.edu.

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