title: Frequency and distribution of mixed Plasmodium falciparum-vivax infections in French Guiana between 2000 and 2008.
abstract: BACKGROUND
  The two main plasmodial species in French Guiana are Plasmodium vivax and Plasmodium falciparum whose respective prevalence influences the frequency of mixed plasmodial infections. The accuracy of their diagnosis is influenced by the sensitivity of the method used, whereas neither microscopy nor rapid diagnostic tests allow a satisfactory evaluation of mixed plasmodial infections.
  
  
  METHODS
  In the present study, the frequency of mixed infections in different part of French Guiana was determined using real time PCR, a sensitive and specific technique.
  
  
  RESULTS
  From 400 cases of malaria initially diagnosed by microscopy, real time PCR showed that 10.75 % of the cases were mixed infections. Their prevalence varied considerably between geographical areas. The presence, in equivalent proportions, of the two plasmodial species in eastern French Guiana was associated with a much higher prevalence of mixed plasmodial infections than in western French Guiana, where the majority of the population was Duffy negative and thus resistant to vivax malaria.
  
  
  CONCLUSIONS
  Clinicians must be more vigilant regarding mixed infections in co-endemic P. falciparum/P. vivax areas, in order to deliver optimal care for patients suffering from malaria. This may involve the use of rapid diagnostic tests capable of detecting mixed infections or low density single infections. This is important as French Guiana moves towards malaria elimination.
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. marine.ginouves@univ-guyane.fr.
authors.forename: Marine
authors.initials: M
authors.lastname: Ginouves
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. Vincent.Veron@st-pee.inra.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Veron
authors.affiliation: Laboratoire de Parasitologie, Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques, CNR du Paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana. lmusset@pasteur-cayenne.fr.
authors.forename: Lise
authors.initials: L
authors.lastname: Musset
authors.affiliation: Laboratoire de Parasitologie, Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques, CNR du Paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana. eric.legrand@pasteur.fr.|Research Unit of Genetics and Genomics of Insect Vectors, Institut Pasteur, Paris, France. eric.legrand@pasteur.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Legrand
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. aurelia.stefani@gmail.com.
authors.forename: Aurélia
authors.initials: A
authors.lastname: Stefani
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. fac.prevot@gmail.com.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Prevot
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. magalie.demar@ch-cayenne.fr.
authors.forename: Magalie
authors.initials: M
authors.lastname: Demar
authors.affiliation: Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana. felix.djossou@ch-cayenne.fr.
authors.forename: Félix
authors.initials: F
authors.lastname: Djossou
authors.affiliation: Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana. paul.brousse@ch-cayenne.fr.
authors.forename: Paul
authors.initials: P
authors.lastname: Brousse
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. mathieu.nacher@ch-cayenne.fr.|Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC EC 1424, Cayenne General Hospital, Cayenne, French Guiana. mathieu.nacher@ch-cayenne.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.affiliation: Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, French Guiana. carme.bernard@wanadoo.fr.
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
mesh_terms: D060085:Coinfection / Q000453:epidemiology / Q000469:parasitology; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D008853:Microscopy; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D010966:Plasmodium vivax / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction