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Molecular Evidence of Malaria and Zoonotic Diseases Among Rapid Diagnostic Test–Negative Febrile Patients in Low-Transmission Season, Mali
From November to December 2012 in Sélingué-Mali, blood samples from 88 febrile patients who tested negative by malaria Paracheck® rapid diagnostic tests (RDTs) were used to assess the presence of sub-RDT Plasmodium falciparum as well as Borrelia, Coxiella burnetii, and Babesia applying molecular tools. Plasmodium sp. was present among 57 (60.2%) of the 88 malaria RDT–negative patients, whereas the prevalence of Borrelia, C. burnetii, and Babesia were 3.4% (N = 3), 1.1% (N = 1), and 0.0%, respectively. The additional diagnostic use of polymerase chain reaction (PCR) identified a high proportion of Plasmodium sp.-positive samples and although this may be a concern for malaria control, the respective PCR-identified malaria infections were less likely responsible for the observed fevers given the low parasite density. Also, the low infection levels of Borrelia and C. burnetii and lack of Babesia among the febrile patients call for further studies to assess the causes of fever among malaria RDT–negative patients in Sélingué.
Author Notes
Authors' addresses: Mahamoudou Touré, Sidy N'D. Bathily, Daouda Sanogo, and Seydou Doumbia, Faculte de Medecine et d'Odontostomatologie, Universite des Sciences, Techniques et Technologies, Bamako, Mali, E-mails: mah.toure@gmail.com, sidbath9@gmail.com, sanogodd@gmail.com, and sdoumbi@icermali.org. Pelle T. Petersen, Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark, E-mail: qmv317@alumni.ku.dk. Christian W. Wang and Michael Alifrangis, Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark, E-mails: cwang@sund.ku.dk and micali@sund.ku.dk. Karin L. Schiøler and Flemming Konradsen, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark, E-mails: ksch@sund.ku.dk and flko@sund.ku.dk.