Abstract

Objective: To assess the level of sub-microscopic and mixed Plasmodium species infection in children in North-Central Nigeria. Methods: Blood sample was obtained from 960 apparently healthy children aged 2–18 years. Plasmodial parasites were identified by Giemsa-stained light microscopy and by DNA amplification of the 18S rRNA gene. Results: A total of 126 out of 960 samples (13.1%) were positive for plasmodial parasites by microscopy while 284 of the 960 samples (29.6%) were positive by the nested PCR assay. The prevalence of sub-microscopic infection was 16.5% (158/960). The proportion of microscopic asymptomatic infections was found to be significantly higher in younger children than in older children (χ2 = 16.86; df= 2; P = 0.014), while sub-microscopic infections were more frequent in older children than in younger ones. Mono-infections of Plasmodium falciparum, Plasmodium malariae, and Plasmodium ovale were 96.1%, 1.1%, and 0.7%, respectively while 2.1% of the samples had mixed infections. Conclusions: Our results showed that sub-microscopic infections were more prevalent in the study region and this has consequences for sustaining malaria transmission in the area. The inability of microscopy to correctly identify non-falciparum species and mixed Plasmodium species infection in this study clearly shows the importance of molecular screening tools for active field surveillance.

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