High rate of mixed and subpatent malarial infections in southwest Nigeria.

J MayInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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F P MockenhauptInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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O G AdemowoInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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A G FalusiInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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P E OlumeseInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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U BienzleInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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C G MeyerInstitut für Tropenmedizin, Medizinische Fakultät Charité der Humboldt-Universität zu Berlin, Germany.

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The rate of malarial parasitemia in children and adults was assessed by microscopy and the polymerase chain reaction in a holoendemic area in Nigeria. A high rate of subpatent Plasmodium falciparum parasitemia (19.6%) was found. Plasmodium malariae and P. ovale infections were common in a rural area (26.1% and 14.8%) but were observed sporadically in individuals from an urban area. Simultaneous infections with P. falciparum, P. malariae, and P. ovale were frequent in the rural area (11.7% triple infections). The rate of triple infections was higher than expected from the prevalences of each species (P < 0.00001). Spleen enlargement was associated with mixed infections of P. falciparum and P. malariae (odds ratio [OR] = 5.9, 95% confidence interval [CI] 3.0-11.7) and less frequently observed in individuals without detectable parasitemia (OR = 0.06, 95% CI = 0.01-0.3). Spleen enlargement and titers of antibodies to schizonts were positively correlated with parasite densities. The results also suggest that in some individuals a long-lasting subpatent parasitemia might occur.

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