Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed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

A peer-reviewed article of this Preprint also exists.

Lo E, Russo G, Pestana K, Kepple D, Abagero BR, Dongho GBD, Gunalan K, Miller LH, Hamid MMA, Yewhalaw D, Paganotti GM. Contrasting epidemiology and genetic variation of Plasmodium vivax infecting Duffy-negative individuals across Africa. Int J Infect Dis. 2021;108:63-71. Lo E, Russo G, Pestana K, Kepple D, Abagero BR, Dongho GBD, Gunalan K, Miller LH, Hamid MMA, Yewhalaw D, Paganotti GM. Contrasting epidemiology and genetic variation of Plasmodium vivax infecting Duffy-negative individuals across Africa. Int J Infect Dis. 2021;108:63-71.

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.

Keywords

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

Subject

Biology and Life Sciences, Anatomy and Physiology

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