Prevalence of P. falciparum Gametocyte Carrying between Two Sympatric Ethnic Groups Living in Seasonal Malaria Transmission Setting of Burkina Faso after Universal Bed Nets Coverage Campaigns

Aims: This study aimed to compare the prevalence of P. falciparum gametocyte carriage in two sympatric ethnic groups living in seasonal malaria transmission setting in Burkina Faso. Study Design: A cross-sectional survey was conducted from September to November 2017 in children aged from 2 to 12 years and living in Barkoundouba, avillage located at the Northeast part of Ouagadougou, capital city of Burkina Faso. The study participants were subject to clinical examination including axillary temperature. Blood samples were collected from finger pricks to performed RDT and blood smears for malaria diagnosis and on filter paper for molecular detection of the parasite. Any case of fever (temperature ≥ 37.5°C) with RDT positive was treated according to national guideline. Methodology: We included 461 patients in this study. P. falciparum presence and densities were determined by microscopy using Giemsa-stained thick blood smears. The nested PCR was used to confirm the presence of the asexual parasites assessed by the microscopy. Results: P. falciparum prevalence assessed by microscopy was 83 (32.55%) and 103 (50%) for Fulani and Mossi respectively, whereas the prevalence by nested PCR was 88 (39.11%) for Fulani and 121 (68.75%) for Mossi. The gametocyte carriage in the two ethnic groups was: 3.53% for Fulani and 11.65% for Mossi. The prevalence ratio for P. falciparum asymptomatic and gametocyte carriers was 1.5 and 3 in favor of Mossi group respectively. Conclusion: This study showed that the Fulani have a lower prevalence of P. falciparum compared to the Mossi group despite the decrease of parasitemia and prevalence in both groups compared to previous studies

Persistent Submicroscopic Plasmodium falciparum Parasitemia 72 Hours after Treatment with Artemether-Lumefantrine Predicts 42-Day Treatment Failure in Mali and Burkina Faso.

A recent randomized controlled trial, the WANECAM (West African Network for Clinical Trials of Antimalarial Drugs) trial, conducted at seven centers in West Africa, found that artemether-lumefantrine, artesunate-amodiaquine, pyronaridine-artesunate, and dihydroartemisinin-piperaquine all displayed good efficacy. However, artemether-lumefantrine was associated with a shorter interval between clinical episodes than the other regimens. In a further comparison of these therapies, we identified cases of persisting submicroscopic parasitemia by quantitative PCR (qPCR) at 72 h posttreatment among WANECAM participants from 5 sites in Mali and Burkina Faso, and we compared treatment outcomes for this group to those with complete parasite clearance by 72 h. Among 552 evaluable patients, 17.7% had qPCR-detectable parasitemia at 72 h during their first treatment episode. This proportion varied among sites, reflecting differences in malaria transmission intensity, but did not differ among pooled drug treatment groups. However, patients who received artemether-lumefantrine and were qPCR positive at 72 h were significantly more likely to have microscopically detectable recurrent Plasmodium falciparum parasitemia by day 42 than those receiving other regimens and experienced, on average, a shorter interval before the next clinical episode. Haplotypes of pfcrt and pfmdr1 were also evaluated in persisting parasites. These data identify a possible threat to the parasitological efficacy of artemether-lumefantrine in West Africa, over a decade since it was first introduced on a large scale