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The Epidemiology of Plasmodium Vivax among Adults in the Democratic Republic of the Congo


Brazeau, Nicholas F.; Mitchell, Cedar L.; Morgan, Andrew P.; Deutsch-Feldman, Molly; Watson, Oliver John; Thwai, Kyaw L.; Gelabert, Pere; van Dorp, Lucy; Keeler, Corinna Y.; & Waltmann, Andreea, et al. (2021). The Epidemiology of Plasmodium Vivax among Adults in the Democratic Republic of the Congo. Nature Communications, 12(1), 4169. PMCID: PMC8263614


Reports of P. vivax infections among Duffy-negative hosts have accumulated throughout sub-Saharan Africa. Despite this growing body of evidence, no nationally representative epidemiological surveys of P. vivax in sub-Saharan Africa have been performed. To overcome this gap in knowledge, we screened over 17,000 adults in the Democratic Republic of the Congo (DRC) for P. vivax using samples from the 2013-2014 Demographic Health Survey. Overall, we found a 2.97% (95% CI: 2.28%, 3.65%) prevalence of P. vivax infections across the DRC. Infections were associated with few risk-factors and demonstrated a relatively flat distribution of prevalence across space with focal regions of relatively higher prevalence in the north and northeast. Mitochondrial genomes suggested that DRC P. vivax were distinct from circulating non-human ape strains and an ancestral European P. vivax strain, and instead may be part of a separate contemporary clade. Our findings suggest P. vivax is diffusely spread across the DRC at a low prevalence, which may be associated with long-term carriage of low parasitemia, frequent relapses, or a general pool of infections with limited forward propagation.


Reference Type

Journal Article

Article Type


Year Published


Journal Title

Nature Communications


Brazeau, Nicholas F.
Mitchell, Cedar L.
Morgan, Andrew P.
Deutsch-Feldman, Molly
Watson, Oliver John
Thwai, Kyaw L.
Gelabert, Pere
van Dorp, Lucy
Keeler, Corinna Y.
Waltmann, Andreea
Emch, Michael
Gartner, Valerie
Redelings, Ben
Wray, Gregory A.
Mwandagalirwa, Melchior K.
Tshefu, Antoinette K.
Likwela, Joris L.
Edwards, Jessie K.
Verity, Robert J.
Parr, Jonathan B.
Meshnick, Steven R.
Juliano, Jonathan J.



Data Set/Study

Demographic Health Survey (DHS)


Democratic Republic of Congo