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. 2024 Feb 20;110(4):639-647.
doi: 10.4269/ajtmh.23-0508. Print 2024 Apr 3.

Burden of Submicroscopic Plasmodium Infections and Detection of kelch13 Mutant Parasites in Military and Civilian Populations in Papua New Guinea

Paul A Pickering  1 , Ivor Harris  1 , David Smith  1 , Fiona McCallum  1 , Peter Kaminiel  2 , Alyson Auliff  1 , Qin Cheng  1
Affiliations

Burden of Submicroscopic Plasmodium Infections and Detection of kelch13 Mutant Parasites in Military and Civilian Populations in Papua New Guinea

Paul A Pickering et al. Am J Trop Med Hyg. .

Abstract

Malaria remains a major public health problem in Papua New Guinea (PNG) and an important force health protection issue for both PNG and Australian Defence Forces. To investigate the malaria burden in the military and civilians residing on military bases, a cross-sectional survey was conducted in April 2019 at three military bases in Wewak, Manus Island, and Vanimo, PNG. A total of 1,041 participants were enrolled; 235 military personnel from three bases and 806 civilians from Wewak and Vanimo. Polymerase chain reaction (PCR) revealed an overall high prevalence of Plasmodium infection in both the military and civilians. Among the military, the infection prevalence was significantly higher in Wewak (35.5%) and Vanimo (33.3%) bases than on Manus Island (11.8%). Among civilians, children (<16 years old) had significantly higher odds of being PCR positive than adults (≥16 years old). At Wewak and Vanimo, Plasmodium vivax accounted for 85.4%, 78.2%, and 66.2% of infections in military, children, and adult populations. Overall, 87.3%, 41.3%, and 61.3% of Plasmodium infections in the military, children, and adults, respectively, were detected only by PCR, not by microscopy (submicroscopic [SM] infections). Children had a significantly lower proportion of SM infections than adults and Papua New Guinea Defence Force personnel. Infection status was not associated with hemoglobin levels in these populations at the time of the survey. Mutant kelch13 (C580Y) parasites were identified in 5/68 Plasmodium falciparum-infected individuals. The survey results indicate extensive malaria transmission on these bases, especially in Wewak and Vanimo. More intensified interventions are required to reduce malaria transmission on PNG military bases.

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Conflict of interest statement

Disclosure: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of Defence, Australia and the PNG Defence Force. Ethical approvals for the conduct of the survey and laboratory tests were granted by the Departments of Defence and Veterans’ Affairs Human Research Ethics Committee (DDVA HREC 084-18) and the Medical Research Advisory Committee of PNG (MRAC No: 18.21).

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