Malar J

BackgroundExpanded malaria control efforts in S\ue9n\ue9gal have resulted in increased use of rapid diagnostic tests (RDT) to identify the primary disease-causing Plasmodium species, Plasmodium falciparum. However, the type of RDT utilized in S\ue9n\ue9gal does not detect other malaria-causing species such as Plasmodium ovale spp., Plasmodium malariae, or Plasmodium vivax. Consequently, there is a lack of information about the frequency and types of malaria infections occurring in S\ue9n\ue9gal. This study set out to better determine whether species other than P. falciparum were evident among patients evaluated for possible malaria infection in K\ue9dougou, S\ue9n\ue9gal.MethodsReal-time polymerase chain reaction speciation assays for P. vivax, P. ovale spp., and P. malariae were developed and validated by sequencing and DNA extracted from 475 Plasmodium falciparum-specific HRP2-based RDT collected between 2013 and 2014 from a facility-based sample of symptomatic patients from two health clinics in K\ue9dougou, a hyper-endemic region in southeastern S\ue9n\ue9gal, were analysed.ResultsPlasmodium malariae (n\ua0=\ua03) and P. ovale wallikeri (n\ua0=\ua02) were observed as co-infections with P. falciparum among patients with positive RDT results (n\ua0=\ua0187), including one patient positive for all three species. Among 288 negative RDT samples, samples positive for P. falciparum (n\ua0=\ua024), P. ovale curtisi (n\ua0=\ua03), P. ovale wallikeri (n\ua0=\ua01), and P. malariae (n\ua0=\ua03) were identified, corresponding to a non-falciparum positivity rate of 2.5%.ConclusionsThese findings emphasize the limitations of the RDT used for malaria diagnosis and demonstrate that non-P. falciparum malaria infections occur in S\ue9n\ue9gal. Current RDT used for routine clinical diagnosis do not necessarily provide an accurate reflection of malaria transmission in K\ue9dougou, S\ue9n\ue9gal, and more sensitive and specific methods are required for diagnosis and patient care, as well as surveillance and elimination activities. These findings have implications for other malaria endemic settings where species besides P. falciparum may be transmitted and overlooked by control or elimination activities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1661-3) contains supplementary material, which is available to authorized users.20172017-01-03T00:00:00Z28049489PMC520981