title: Prevalence and distribution of human Plasmodium infection in Pakistan.
abstract: BACKGROUND
  Both Plasmodium vivax and Plasmodium falciparum are prevalent in Pakistan, yet up-to-date data on the epidemiology of malaria in Pakistan are not available. This study was undertaken to determine the current prevalence and distribution of Plasmodium species across the country.
  
  
  METHODS
  A malariometric population survey was conducted in 2011 using blood samples collected from 801 febrile patients of all ages in four provinces and the capital city of Islamabad. Microscopically confirmed Plasmodium-positive blood samples were reconfirmed by polymerase chain reaction (PCR). Confirmed parasite-positive samples were subjected to species-specific PCR capable of detecting four species of human malaria.
  
  
  RESULTS
  Of the 707 PCR-positive samples, 128 (18%) were P. falciparum, 536 (76%) were P. vivax, and 43 (6%) were mixed P. falciparum and P. vivax. Ninety-four microscopy-positive samples were PCR-negative, and Plasmodium malariae and Plasmodium ovale were not detected. Prevalence of P. vivax ranged from 2.4% in Punjab Province to 10.8% in Sindh Province and prevalence of P. falciparum ranged from 0.1% in Islamabad to 3.8% in Balochistan.
  
  
  CONCLUSIONS
  Plasmodium infections in Pakistan are largely attributed to P. vivax but P. falciparum and mixed species infections are also prevalent. In addition, regional variation in the prevalence and species composition of malaria is high.
authors.affiliation: Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA. cplowe@medicine.umaryland.edu.
authors.forename: Aamer A
authors.initials: AA
authors.lastname: Khattak
authors.forename: Meera
authors.initials: M
authors.lastname: Venkatesan
authors.forename: Muhammad F
authors.initials: MF
authors.lastname: Nadeem
authors.forename: Humayoon S
authors.initials: HS
authors.lastname: Satti
authors.forename: Adnan
authors.initials: A
authors.lastname: Yaqoob
authors.forename: Kathy
authors.initials: K
authors.lastname: Strauss
authors.forename: Lubna
authors.initials: L
authors.lastname: Khatoon
authors.forename: Salman A
authors.initials: SA
authors.lastname: Malik
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Plowe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001769:Blood / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010961:Plasmodium / Q000145:classification* / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D055815:Young Adult