Co-circulation of Plasmodium and Bacterial DNAs in Blood of Febrile and Afebrile Children from Urban and Rural Areas in Gabon.
Malaria is considered to be the most common etiology of fever in sub-Saharan Africa while bacteremias exist but are under assessed. This study aimed to assess bacteremias and malaria in children from urban and rural areas in Gabon. DNA extracts from blood samples of 410 febrile and 60 afebrile children were analyzed using quantitative polymerase chain reaction. Plasmodium spp. was the microorganism most frequently detected in febrile (78.8%, 323/410) and afebrile (13.3%, 8/60) children, (P < 0.001). DNA from one or several bacteria were detected in 15 febrile patients (3.7%) but not in the controls (P = 0.1). This DNA was more frequently detected as co-infections among febrile children tested positive for Plasmodium (4.6%, 15/323) than in those tested negative for Plasmodium (0%, 0/87; P = 0.04). The bacteria detected were Streptococcus pneumoniae 2.4% (10/410), Staphylococcus aureus 1.7% (7/410), Salmonella spp. 0.7% (3/410), Streptococcus pyogenes 0.2% (1/410) and Tropheryma whipplei 0.2% (1/410) only in febrile children. Coxiella burnetii, Borrelia spp., Bartonella spp., Leptospira spp., and Mycobacterium tuberculosis were not observed. This paper reports the first detection of bacteremia related to T. whipplei in Gabon and shows that malaria decreases in urban areas but not in rural areas. Co-infections in febrile patients are common, highlighting the need to improve fever management strategies in Gabon.
Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France. Ecole Doctorale Régionale d'Afrique Centrale, Franceville, Gabon.
Gaël
G
Mourembou
Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
Sydney Maghendji
SM
Nzondo
Département de Microbiologie, Laboratoire National de Référence IST/sida, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon.
Angélique
A
Ndjoyi-Mbiguino
Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon. Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Sciences de la Santé, Libreville, Gabon.
Jean Bernard
JB
Lekana-Douki
Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
Lady Charlène
LC
Kouna
Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon.
Pierre Blaise
PB
Matsiegui
Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon.
Rella Zoleko
RZ
Manego
Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
Irene Pegha
IP
Moukandja
Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France.
Alpha Kabinet
AK
Keïta
Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France.
Hervé
H
Tissot-Dupont
Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France.
Florence
F
Fenollar
Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France. didier.raoult@gmail.com.
Didier
D
Raoult
D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000382:microbiology / Q000469:parasitology; D004269:DNA, Bacterial / Q000097:blood* / Q000302:isolation & purification; D016054:DNA, Protozoan / Q000097:blood* / Q000302:isolation & purification; D005260:Female; D005334:Fever / Q000097:blood* / Q000382:microbiology / Q000469:parasitology; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D010961:Plasmodium / Q000302:isolation & purification*; D015995:Prevalence; D012424:Rural Population; D012475:Salmonella / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D054851:Tropheryma / Q000302:isolation & purification; D014505:Urban Population
D004269:DNA, Bacterial; D016054:DNA, Protozoan