Plasmodium vivax Infections over 3 Years in Duffy Blood Group Negative Malians in Bandiagara, Mali

Abstract

<i>Plasmodium vivax</i> was thought to infect only the erythrocytes of Duffy blood group positive people. In the last decade, <i>P. vivax</i> has appeared throughout Africa, both in areas where Duffy positive and negative people live side by side as in Madagascar and Ethiopia and in areas where people are primarily Duffy negative, such as in western Kenya. We performed quantitative polymerase chain reaction on blood samples dried onto filter paper to determine the prevalence of <i>P. vivax</i> and <i>Plasmodium falciparum</i> in a cohort of 300 children (newborn to 6 years of age) in Bandiagara, a Sahelian area of Mali, west Africa, where the people are Duffy negative. We report 1-3 occurrences of <i>P. vivax</i> in each of 25 Duffy-negative children at six time points over two rainy seasons and the beginning of the third season. The prevalence of <i>P. vivax</i> infection was 2.0-2.5% at every time point (June 2009 to June 2010). All children with <i>P. vivax</i> infections were asymptomatic and afebrile, and parasite densities were extremely low. Anemia, however, was the main burden of infection. <i>Plasmodium vivax</i> could become a burden to sub-Saharan Africa, and the evidence of <i>P. vivax</i> existence needs to be taken into consideration in designing malaria control and elimination strategies in Africa.