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Prevalence of Plasmodium falciparum infection in asymptomatic rural Gabonese populations

Dieudonné Nkoghe123*, Jean-Paul Akue1, Jean-Paul Gonzalez1 and Eric M Leroy14

Author Affiliations

1 Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon

2 Ministry of Health, Libreville, Gabon

3 Department of Immunodeficiency and Infectious Diseases, University of Liege, Belgium

4 UMR 190 Emergences des pathologies virales, Université Aix- Marseille II, Institut de Recherches pour le Développement, Marseille, France

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Malaria Journal 2011, 10:33  doi:10.1186/1475-2875-10-33

Published: 9 February 2011

Abstract

Background

Malaria may be perennial or epidemic in sub-Saharan Africa, and its transmission may be stable or unstable, depending on the region. The prevalence of asymptomatic Plasmodium falciparum carriage is poorly documented in Gabon. A large survey of P. falciparum infection was conducted in asymptomatic individuals living in rural Gabon.

Methods

Two hundred and twenty-two villages were randomly selected in the nine administrative regions. With the participants' informed consent, blood samples were collected for thick and thin blood film examination after 20% Giemsa staining. Prevalence rates were calculated per village, per region and per ecosystem, and nationwide. Demographic risk factors were identified with STATA software version 9.0. Significance was assumed at p < 0.05.

Results and discussion

The prevalence of P. falciparum in adults was 6.2% (269/4342) nationwide, with a maximum of 37.2% in one village; a linear decrease was observed with increasing age (p = 0.045). Only 5% of the 399 children from forest areas tested positive. The prevalence was significantly higher in forest areas (7%) than in savannah (4%) and lakeland (2.5%). Within the forest region, the prevalence was significantly higher in forest grassland (10.9%) than in the mountain forest (3.5%), interior forest (6.8%) and north-eastern forest (4.5%).

Conclusion

Plasmodium falciparum carriage remains high among adults in rural Gabon. Control measures must be adapted to the region and ecosystem. Routine treatment of asymptomatic individuals should be considered.