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Volume 29, Number 6—June 2023
Research

Similar Prevalence of Plasmodium falciparum and Non–P. falciparum Malaria Infections among Schoolchildren, Tanzania1

Rachel Sendor2, Cedar L. Mitchell2, Frank Chacky, Ally Mohamed, Lwidiko E. Mhamilawa, Fabrizio Molteni, Ssanyu Nyinondi, Bilali Kabula, Humphrey Mkali, Erik J. Reaves, Naomi Serbantez, Chonge Kitojo, Twilumba Makene, Thwai Kyaw, Meredith Muller, Alexis Mwanza, Erin L. Eckert, Jonathan B. Parr, Jessica T. Lin3, Jonathan J. Juliano3Comments to Author , and Billy Ngasala3
Author affiliations: University of North Carolina, Chapel Hill, North Carolina, USA (R. Sendor, C.L. Mitchell, T. Kyaw, M. Muller, A. Mwanza, J.B. Parr, J.T. Lin, J.J. Juliano); National Malaria Control Programme, Dodoma, Tanzania (F. Chacky, A. Mohamed); Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (L.E. Mhamilawa, T. Makene, B. Ngasala); Swiss Tropical and Public Health Institute, Basel, Switzerland (F. Molteni); RTI International, Dar es Salaam (S. Nyinondi, B. Kabula, H. Mkali); US Centers for Disease Control and Prevention, Dar es Salaam (E.J. Reaves); US Agency for International Development, Dar es Salaam (N. Serbantez, C. Kitojo); RTI International, Washington, DC, USA (E.L. Eckert); Uppsala University, Uppsala, Sweden (B. Ngasala)

Main Article

Table 1

Characteristics of students infected by different Plasmodium spp. in study of similar prevalence of Plasmodium falciparum and non–P. falciparum malaria infections among schoolchildren, Tanzania*

Characteristics Single species infections
 P. falciparum co-infections
 Other§ Total
Pf Po p value† Pm p value‡ Pv Po+Pf Pm+Pf Po+Pm+Pf Pv+Pf
No. students
 429 (12.4)
 519 (15.0)
24 (0.7)
224 (6.5)
 44 (1.3)
 55 (1,6)
 2 (0.1)
 NA
 3,456
Median age, y (IQR)
 12 (10–13)
 11 (9–12)
 <0.001
 11 (10–13)
 0.821
 11 (10–11)
12 (9–14)
 11 (9–12)
 12 (10–13)
 12 (12–13)
 12 (10–12)
 11 (9, 13)
Sex
M 236 (55.0) 240 (46.2) 0.009 15 (62.5) 0.612 3 (75.0) 120 (53.6) 27 (61.4) 34 (61.8) 2 (100.0) 9 (52.9) 1,761 (51.0)
F
 193 (45.0)
 279 (53.8)
9 (37.5)
1 (25.0)
104 (46.4)
 17 (38.6)
 21 (38.2)
 0 (0.0)
 8 (47.1)
 1,695 (49.0)
Fever¶ 40 (10.8) 8 (2.1) <0.001 3 (15.8) 0.455 0 (0.0) 12 (6.1) 6 (16.7) 2 (4.7) 0 (0.0) 1 (6.2) 99 (3.5)
Missing data
 60
 134
5
1
28
 8
 12
 0
 1
 618
Malaria RDT+ 295 (68.8) 40 (7.7) <0.001 8 (33.3) 0.001 1 (25.0) 170 (76.9) 36 (83.7) 45 (81.8) 2 (100.0) 9 (52.9) 686 (19.9)
Missing tests
 0
 0
0
0
3
 1
 0
 0
 0
 15
Epidemiologic risk strata#
High 367 (85.5) 293 (56.5) <0.001 19 (79.2) 0.484 3 (75.0) 204 (91.1) 41 (93.2) 53 (96.4) 2 (100.0) 16 (94.1) 1,768 (51.2)
Moderate 49 (11.4) 45 (8.7) 5 (20.8) 1 (25.0) 16 (7.1) 3 (6.8) 1 (1.8) 0 1 (5.9) 448 (13.0)
Low 9 (2.1) 155 (29.9) 0 0 4 (1.8) 0 1 (1.8) 0 0 602 (17.4)
Very low 4 (0.9) 26 (5.0) 0 0 0 0 0 (0.0) 0 0 638 (18.5)

*Values are no. (%) students unless otherwise indicated. Percentages were calculated according to the species-specific totals for nonmissing data. Species were determined by using real-time PCR. Continuous variables were compared by using Kruskal-Wallis test; categorical variables were compared by using χ2 test; and Fisher exact test was applied when cell counts were <5 cells/μL. IQR, interquartile range; Pf, Plasmodium falciparum; Pm, P. malariae; Po, P. ovale spp.; Pv, P. vivax; RDT, rapid diagnostic test; +, positive. †p value for Pf versus Po. ‡p value for Pf versus Pm. §Other mixed infections included Po + Pm (n = 12), Po + Pv (n = 3), Pm + Pv (n = 1), and Po + Pv + Pf (n = 1). Cases of Po + Pm + Pv, Pm + Pv + Pf, or Po + Pm + Pv + Pf co-infections were not detected. ¶Fever was defined as temperature >38°C at time of survey. Body temperature was missing for 618 (17.9%) students. #Epidemiologic risk strata are defined according to P. falciparum prevalences in children from the 2014–15 School Malaria Parasitological Survey, Tanzania: very low if prevalence <5%, low if 5% to <10%, moderate if 10% to <50%, and high if >50%.

Main Article

1Data from this study were presented as a virtual poster at the American Society of Tropical Medicine and Hygiene conference, November 17–21, 2021.

2These first authors contributed equally to this article.

3These senior authors contributed equally to this article.

Page created: March 13, 2023
Page updated: May 17, 2023
Page reviewed: May 17, 2023
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