Abstract
Background. Malaria remains a major public health concern in Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC.Methods. 634 (427 asymptomatic and 207 symptomatic) blood samples were collected from a cross-sectional survey of school-age children aged 6 to 14 years both without and with malaria symptoms. Nested-PCR was performed for malaria parasite species typing. Results. The overall prevalence of Plasmodium spp., Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale was 62.3, 58.1, 19.9 and 10.8% among asymptomatic whereas it was 94.4, 93.2, 12.6 and 15.9% in symptomatic children, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p<0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p<0.001). Amongst asymptomatic malaria parasite carriers, 43% of children in the rural area were co-infected with two or more species with P. falciparum + P. malariae the most common (24%) whereas in the urban setting, fewer children carried co-infections (16%) with P. falciparum + P. malariae again the most common (9%). A fifth of rural-dwelling symptomatic children were co-infected with two or more species with P. falciparum + P. ovale the most common (14%), while a quarter of symptomatic children in the urban area carried multiple species, with co-infections of P. falciparum + P. malariae the most common (11%). Conclusion. School-age children are at significant risk from both asymptomatic and symptomatic malaria parasite infections. Continuous systematic screening and treatment of school-age children in high-transmission settings across the country may reinforce malaria intervention measures.
A rare large cutaneous ulcer from the rural area, Democratic Republic of Congo. What is the diagnosis: Buruli ulcer?
