Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Contrasting Epidemiology and Genetic Variation of Plasmodium vivax Infecting Duffy Negatives across Africa

Version 1 : Received: 7 December 2020 / Approved: 8 December 2020 / Online: 8 December 2020 (20:30:36 CET)

How to cite: Lo, E.; Russo, G.; Pestana, K.; Kepple, D.; Abargero, B.R.; Dongho, G.B.D.; Gunalan, K.; Miller, L.H.; Hamid, M.M.A.; Yewhalaw, D.; Paganotti, G.M. Contrasting Epidemiology and Genetic Variation of Plasmodium vivax Infecting Duffy Negatives across Africa. Preprints 2020, 2020120209 (doi: 10.20944/preprints202012.0209.v1). Lo, E.; Russo, G.; Pestana, K.; Kepple, D.; Abargero, B.R.; Dongho, G.B.D.; Gunalan, K.; Miller, L.H.; Hamid, M.M.A.; Yewhalaw, D.; Paganotti, G.M. Contrasting Epidemiology and Genetic Variation of Plasmodium vivax Infecting Duffy Negatives across Africa. Preprints 2020, 2020120209 (doi: 10.20944/preprints202012.0209.v1).

Abstract

Recent studies indicated that Plasmodium vivax can infect Duffy-negative individuals, but the varied diagnostic and methodological approaches have limited our ability to characterize P. vivax across Africa. Here, we utilized a standardized approach to compare epidemiological and genetic attributes of P. vivax from Botswana, Ethiopia, and Sudan, where Duffy-positive and Duffy-negative individuals coexist. Among 1,215 febrile patients, the proportions of Duffy negativity range from 20-36% in East Africa to 84% in Southern Africa. Considerable differences were observed in P. vivax prevalence among Duffy-negative populations ranging from averaged 9.2% in Sudan to 86% in Botswana. P. vivax parasite density in Duffy-negative infections is significantly lower than in Duffy-positive infections. Phylogenetic analyses of 229 PvDBP sequences indicated that Duffy-negative P. vivax were not monophyletic but occurred in multiple well-supported clades, suggesting independent origins. Duffy-negative Africans are clearly not resistant to P. vivax and the public health significance should no longer be neglected.

Subject Areas

Plasmodium vivax; Duffy Negatives; Africa; Molecular epidemiology; Genetic relatedness

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