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Peer-reviewedCC BY 4.0PLOS One

High prevalence of Plasmodium ovalewallikeri in co-infections with Plasmodium falciparum in symptomatic than asymptomatic Plasmodium parasite infections in Kisumu, Kenya

  • Jackline A. Juma1
  • Oliver J. Watson2
  • Dennis W. Juma3
  • Benjamin H. Opot4
  • Gladys Chemwor5
  • Mary Mutahi6
  • Raphael Okoth7
  • Edwin W. Mwakio8
  • Redemptah Yeda9
  • Charles O. Okello
  • Agnes Cheruiyot
  • Duke Omariba
15 more authors
  • Liliana Dayo
  • Hellen A. Ogola
  • Gladys Biwott
  • Charles Adega
  • Fredrick Oluoch
  • Vincent Omondi
  • George Otieno
  • Edwin Kamau
  • Ben Andagalu
  • Peter Sifuna
  • Amanda Roth
  • Sammy Khagayi
  • Eric C. Garges
  • Bernhards Ogutu
  • Hoseah M. Akala
9 affiliations
  1. 1Department of Emerging and Infectious Diseases, Walter Reed Army Institute of Research-Africa/Centre for Clinical Research, Kenya Medical Research Institute, Kisumu, Kenya
  2. 2Department of Infectious Disease Epidemiology, Medical Research Council, Centre for Global Infectious Disease Analysis, Imperial College London, London, England
  3. 3The Kenya Medical Research Institute (KEMRI) / Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
  4. 4Department of Health County Government of Kisumu, Ministry of Health, Nairobi, Kenya
  5. 5Department of Pathology and Laboratory Medicine, Tripler Amy Medical Center, Honolulu, Hawaii, United States of America
  6. 6Medical Communications for Combat Casualty Care, Fort Detrick, Maryland, United States of America
  7. 7Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
  8. 8Walter Reed Army Institute of Research-Africa, Nairobi, Kenya
  9. 9Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
Open at sourcePDFDOICite

Abstract

Plasmodium falciparum (Pf), Plasmodium ovalewallikeri (Pow), Plasmodium ovalecurtisi (Poc), and Plasmodium malariae (Pm) coexists in Kenya sympatrically. Some infections progress to classical symptoms of malaria prompting hospital visits, while others remain asymptomatic. There is limited information on whether the species composition status of infections in endemic areas influences progression to either asymptomatic or symptomatic infection. This cross-sectional study determined the composition of Plasmodium species among symptomatic versus asymptomatic participants in Kombewa, Kenya. Between 2015 and 2016, samples from 741 individuals, comprising of 437 from symptomatic participants at Kombewa Subcounty hospital and 304 from asymptomatic participants from within Kombewa Subcounty hospital’s catchment area were analyzed for Plasmodium species composition using real-time qPCR assay targeting the small subunit ribosomal RNA (ssrRNA) gene. R Studio was used to describe Plasmodium species prevalence, and the odds of occurring within a given infection presentation. Co-infection analysis revealed 741 samples predominantly contained Pf 655/741 (88.3%) followed by Pow 153/741 (20.6%), Pm 70/741 (9.4%) and Poc 64/741 (8.6%); 12/741 (1.62%) samples did not amplify any species. A total of 535/741 (72.2%) samples contained single species, and 194/741 (26.18%) samples contained multiple species. Species distribution differed significantly, with Pf and Pow more prevalent in symptomatic cases, while Pm and Poc were more common in asymptomatic individuals (p = 0.000). Pm and Poc single-species infections occurred among asymptomatic infections only. There were significantly higher odds of multiple species occurrence for infections containing Pf/Pow 92 (95.8%) among symptomatic than asymptomatic infections (OR 1.5, 95% CI [1.36–1.65], p = 0.000). Overall, mixed-species infections involving Pf and Pow were significantly more common in symptomatic individuals, posing a risk of false diagnosis by Pf-Histidine-Rich Protein 2 test. This underscores the need for deployment of interventions that target all Plasmodium species. These findings on the burden across symptomatic vs asymptomatic infections suggest a need for determination of the role of species composition in disease progression.

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Cite

BibTeXRIS
BibTeX
@article{juma2026high,
  title = {{High prevalence of Plasmodium ovalewallikeri in co-infections with Plasmodium falciparum in symptomatic than asymptomatic Plasmodium parasite infections in Kisumu, Kenya}},
  author = {Jackline A. Juma and Oliver J. Watson and Dennis W. Juma and Benjamin H. Opot and Gladys Chemwor and Mary Mutahi and Raphael Okoth and Edwin W. Mwakio and Redemptah Yeda and Charles O. Okello and Agnes Cheruiyot and Duke Omariba and Liliana Dayo and Hellen A. Ogola and Gladys Biwott and Charles Adega and Fredrick Oluoch and Vincent Omondi and George Otieno and Edwin Kamau and Ben Andagalu and Peter Sifuna and Amanda Roth and Sammy Khagayi and Eric C. Garges and Bernhards Ogutu and Hoseah M. Akala},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0334188},
  url = {https://doi.org/10.1371/journal.pone.0334188},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - High prevalence of Plasmodium ovalewallikeri in co-infections with Plasmodium falciparum in symptomatic than asymptomatic Plasmodium parasite infections in Kisumu, Kenya
AU  - Jackline A. Juma
AU  - Oliver J. Watson
AU  - Dennis W. Juma
AU  - Benjamin H. Opot
AU  - Gladys Chemwor
AU  - Mary Mutahi
AU  - Raphael Okoth
AU  - Edwin W. Mwakio
AU  - Redemptah Yeda
AU  - Charles O. Okello
AU  - Agnes Cheruiyot
AU  - Duke Omariba
AU  - Liliana Dayo
AU  - Hellen A. Ogola
AU  - Gladys Biwott
AU  - Charles Adega
AU  - Fredrick Oluoch
AU  - Vincent Omondi
AU  - George Otieno
AU  - Edwin Kamau
AU  - Ben Andagalu
AU  - Peter Sifuna
AU  - Amanda Roth
AU  - Sammy Khagayi
AU  - Eric C. Garges
AU  - Bernhards Ogutu
AU  - Hoseah M. Akala
PY  - 2026
DA  - 2026/10/07
JO  - PLOS One
DO  - 10.1371/journal.pone.0334188
UR  - https://doi.org/10.1371/journal.pone.0334188
AB  - Plasmodium falciparum (Pf), Plasmodium ovalewallikeri (Pow), Plasmodium ovalecurtisi (Poc), and Plasmodium malariae (Pm) coexists in Kenya sympatrically. Some infections progress to classical symptoms of malaria prompting hospital visits, while others remain asymptomatic. There is limited information on whether the species composition status of infections in endemic areas influences progression to either asymptomatic or symptomatic infection. This cross-sectional study determined the composition of Plasmodium species among symptomatic versus asymptomatic participants in Kombewa, Kenya. Between 2015 and 2016, samples from 741 individuals, comprising of 437 from symptomatic participants at Kombewa Subcounty hospital and 304 from asymptomatic participants from within Kombewa Subcounty hospital’s catchment area were analyzed for Plasmodium species composition using real-time qPCR assay targeting the small subunit ribosomal RNA (ssrRNA) gene. R Studio was used to describe Plasmodium species prevalence, and the odds of occurring within a given infection presentation. Co-infection analysis revealed 741 samples predominantly contained Pf 655/741 (88.3%) followed by Pow 153/741 (20.6%), Pm 70/741 (9.4%) and Poc 64/741 (8.6%); 12/741 (1.62%) samples did not amplify any species. A total of 535/741 (72.2%) samples contained single species, and 194/741 (26.18%) samples contained multiple species. Species distribution differed significantly, with Pf and Pow more prevalent in symptomatic cases, while Pm and Poc were more common in asymptomatic individuals (p = 0.000). Pm and Poc single-species infections occurred among asymptomatic infections only. There were significantly higher odds of multiple species occurrence for infections containing Pf/Pow 92 (95.8%) among symptomatic than asymptomatic infections (OR 1.5, 95% CI [1.36–1.65], p = 0.000). Overall, mixed-species infections involving Pf and Pow were significantly more common in symptomatic individuals, posing a risk of false diagnosis by Pf-Histidine-Rich Protein 2 test. This underscores the need for deployment of interventions that target all Plasmodium species. These findings on the burden across symptomatic vs asymptomatic infections suggest a need for determination of the role of species composition in disease progression.
SN  - 1932-6203
ER  -