title: Random distribution of mixed species malaria infections in Papua New Guinea.
abstract: Plasmodium falciparum (Pf), P. vivax (Pv), P. malariae (Pm), and P. ovale (Po) infections are endemic in coastal areas of Papua New Guinea. Here 2,162 individuals living near Dreikikir, East Sepik Province, have been analyzed for complexity of malaria infection by blood smear and polymerase chain reaction (PCR) diagnoses. According to blood smear, the overall prevalence of Plasmodium infection was 0.320. Most individuals (0.283) were infected with a single species only. The prevalence of mixed species infections was low (0.037). Further analysis of a 173-sample subset by nested PCR of small subunit ribosomal DNA resulted in an overall 3.0-fold increase in prevalence of infection, with a 17.5-fold increase in the frequency of mixed species infections. Among mixed species infections detected by PCR, the frequency of double species was 0.364, and that of triple species was 0.237. Nine individuals (0.052) were infected with all 4 species. To determine if infection status (uninfected, single, and multiple infections) deviates from an independent random distribution (null hypothesis), observed versus expected frequencies of all combinations of Plasmodium species infections, or assemblages (Pf-, Pv-, Pm-, Po-, to Pf+, Pv+, Pm+, Po+), were compared using a multiple-kind lottery model. All 4 species were randomly distributed whether diagnosed by blood smear or PCR in the overall population and when divided into age group categories. These findings suggest that mixed species malaria infections are common, and that Plasmodium species appear to establish infection independent of one another.
authors.affiliation: Division of Geographic Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-4983, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Mehlotra
authors.forename: K
authors.initials: K
authors.lastname: Lorry
authors.forename: W
authors.initials: W
authors.lastname: Kastens
authors.forename: S M
authors.initials: SM
authors.lastname: Miller
authors.forename: M P
authors.initials: MP
authors.lastname: Alpers
authors.forename: M
authors.initials: M
authors.lastname: Bockarie
authors.forename: J W
authors.initials: JW
authors.lastname: Kazura
authors.forename: P A
authors.initials: PA
authors.lastname: Zimmerman
mesh_terms: D000818:Animals; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D017931:DNA Primers / Q000737:chemistry; D016054:DNA, Protozoan / Q000737:chemistry / Q000302:isolation & purification; D004587:Electrophoresis, Agar Gel; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology*; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology; D016780:Malaria, Vivax / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology; D008969:Molecular Sequence Data; D010219:Papua New Guinea / Q000453:epidemiology; D018512:Parasitemia / Q000469:parasitology; D010961:Plasmodium / Q000235:genetics / Q000254:growth & development*; D010963:Plasmodium falciparum / Q000235:genetics / Q000254:growth & development; D010965:Plasmodium malariae / Q000235:genetics / Q000254:growth & development; D010966:Plasmodium vivax / Q000235:genetics / Q000254:growth & development; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D016036:Seroepidemiologic Studies
chemical_list: D017931:DNA Primers; D016054:DNA, Protozoan