{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:23:17Z","timestamp":1790878997526,"version":"4.1.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T00:00:00Z","timestamp":1596758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01TW010870"],"award-info":[{"award-number":["R01TW010870"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AI134990"],"award-info":[{"award-number":["K24AI134990"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI107949"],"award-info":[{"award-number":["R01AI107949"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["F30AI143172"],"award-info":[{"award-number":["F30AI143172"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32HD007168"],"award-info":[{"award-number":["T32HD007168"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R01TW010870"],"award-info":[{"award-number":["R01TW010870"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["T32HD007168"],"award-info":[{"award-number":["T32HD007168"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["T32ES007018"],"award-info":[{"award-number":["T32ES007018"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Plasmodium ovale is an understudied malaria species prevalent throughout much of sub-Saharan Africa. Little is known about the distribution of ovale malaria and risk factors for infection in areas of high malaria endemicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using the 2013 Democratic Republic of the Congo (DRC) Demographic and Health Survey, we conducted a risk factor analysis for P. ovale infections. We evaluated geographic clustering of infections and speciated to P. ovale curtisi and P. ovale wallikeri through deep sequencing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 18 149 adults tested, we detected 143 prevalent P. ovale infections (prevalence estimate 0.8%; 95% confidence interval [CI], .59%\u2013.98%). Prevalence ratios (PR) for significant risk factors were: male sex PR\u2005=\u20052.12 (95% CI, 1.38\u20133.26), coprevalent P. falciparum PR\u2005=\u20053.52 (95% CI, 2.06\u20135.99), and rural residence PR\u2005=\u20052.19 (95% CI, 1.31\u20133.66). P. ovale was broadly distributed throughout the DRC; an elevated cluster of infections was detected in the south-central region. Speciation revealed P. ovale curtisi and P. ovale wallikeri circulating throughout the country.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>P. ovale persists broadly in the DRC, a high malaria burden country. For successful elimination of all malaria species, P. ovale needs to be on the radar of malaria control programs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaa478","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T19:13:27Z","timestamp":1596568407000},"page":"1005-1014","source":"Crossref","is-referenced-by-count":40,"title":["Under the Radar: Epidemiology of <i>Plasmodium ovale<\/i> in the Democratic Republic of the Congo"],"prefix":"10.1093","volume":"223","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4811-2074","authenticated-orcid":false,"given":"Cedar L","family":"Mitchell","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas F","family":"Brazeau","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Keeler","sequence":"additional","affiliation":[{"name":"Department of Geography, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melchior Kashamuka","family":"Mwandagalirwa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA"},{"name":"Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette K","family":"Tshefu","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Juliano","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA"},{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Curriculum in Genetics and Molecular Biology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R","family":"Meshnick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA"},{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"key":"2021032911264500800_CIT0001","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1086\/652240","article-title":"Two nonrecombining sympatric forms of the human malaria parasite Plasmodium ovale occur globally","volume":"201","author":"Sutherland","year":"2010","journal-title":"J Infect Dis"},{"key":"2021032911264500800_CIT0002","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/nature21038","article-title":"Plasmodium malariae and P. ovale genomes provide insights into malaria parasite evolution","volume":"542","author":"Rutledge","year":"2017","journal-title":"Nature"},{"key":"2021032911264500800_CIT0003","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijpara.2016.05.008","article-title":"Out of Africa: origins and evolution of the human malaria parasites Plasmodium falciparum and Plasmodium vivax","volume":"47","author":"Loy","year":"2017","journal-title":"Int J Parasitol"},{"key":"2021032911264500800_CIT0004","first-page":"383","article-title":"An analysis of the geographical distribution of Plasmodium ovale","volume":"40","author":"Lysenko","year":"1969","journal-title":"Bull World Health Organ"},{"key":"2021032911264500800_CIT0005","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.pt.2007.04.009","article-title":"Plasmodium malariae and Plasmodium ovale\u2014the \u201cbashful\u201d malaria parasites","volume":"23","author":"Mueller","year":"2007","journal-title":"Trends Parasitol"},{"key":"2021032911264500800_CIT0006","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1128\/CMR.18.3.570-581.2005","article-title":"Plasmodium ovale: parasite and disease","volume":"18","author":"Collins","year":"2005","journal-title":"Clin Microbiol Rev"},{"key":"2021032911264500800_CIT0007","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.ijpara.2011.01.004","article-title":"Plasmodium ovale curtisi and Plasmodium ovale wallikeri circulate simultaneously in African communities","volume":"41","author":"Oguike","year":"2011","journal-title":"Int J Parasitol"},{"key":"2021032911264500800_CIT0008","doi-asserted-by":"crossref","first-page":"4213","DOI":"10.1128\/JCM.01527-13","article-title":"Genetic marker suitable for identification and genotyping of Plasmodium ovale curtisi and Plasmodium ovale wallikeri","volume":"51","author":"Tanomsing","year":"2013","journal-title":"J Clin Microbiol"},{"key":"2021032911264500800_CIT0009","doi-asserted-by":"crossref","first-page":"e16420","DOI":"10.1371\/journal.pone.0016420","article-title":"Molecular malaria epidemiology: mapping and burden estimates for the Democratic Republic of the Congo, 2007","volume":"6","author":"Taylor","year":"2011","journal-title":"PLoS One"},{"key":"2021032911264500800_CIT0010","doi-asserted-by":"crossref","DOI":"10.30875\/7e6f8c91-en","volume-title":"World malaria report 2019","author":"World Health Organization","year":"2019"},{"key":"2021032911264500800_CIT0011","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1186\/s12936-016-1409-0","article-title":"Low prevalence of Plasmodium malariae and Plasmodium ovale mono-infections among children in the Democratic Republic of the Congo: a population-based, cross-sectional study","volume":"15","author":"Doctor","year":"2016","journal-title":"Malar J"},{"key":"2021032911264500800_CIT0012","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12936-018-2183-y","article-title":"Effect of individual and community-level bed net usage on malaria prevalence among under-fives in the Democratic Republic of Congo","volume":"17","author":"Levitz","year":"2018","journal-title":"Malar J"},{"key":"2021032911264500800_CIT0013","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1038\/s41467-020-15779-8","article-title":"The impact of antimalarial resistance on the genetic structure of Plasmodium falciparum in the DRC","volume":"11","author":"Verity","year":"2020","journal-title":"Nat Commun"},{"key":"2021032911264500800_CIT0014","doi-asserted-by":"crossref","first-page":"565","DOI":"10.4269\/ajtmh.1995.52.565","article-title":"Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa","volume":"52","author":"Plowe","year":"1995","journal-title":"Am J Trop Med Hyg"},{"key":"2021032911264500800_CIT0015","doi-asserted-by":"crossref","first-page":"e0175771","DOI":"10.1371\/journal.pone.0175771","article-title":"Four human Plasmodium species quantification using droplet digital PCR","volume":"12","author":"Srisutham","year":"2017","journal-title":"PLoS One"},{"key":"2021032911264500800_CIT0016","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/S0020-7519(02)00111-X","article-title":"Three multigene families in Plasmodium parasites: facts and questions","volume":"32","author":"Mercereau-Puijalon","year":"2002","journal-title":"Int J Parasitol"},{"key":"2021032911264500800_CIT0017","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1038\/nmeth.2634","article-title":"Practical innovations for high-throughput amplicon sequencing","volume":"10","author":"Lundberg","year":"2013","journal-title":"Nat Methods"},{"key":"2021032911264500800_CIT0018","doi-asserted-by":"crossref","first-page":"2435","DOI":"10.1128\/JCM.43.5.2435-2440.2005","article-title":"Real-time PCR for detection and identification of Plasmodium spp","volume":"43","author":"Mangold","year":"2005","journal-title":"J Clin Microbiol"},{"key":"2021032911264500800_CIT0019","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1093\/nar\/gkx1201","article-title":"SeekDeep: single-base resolution de novo clustering for amplicon deep sequencing","volume":"46","author":"Hathaway","year":"2018","journal-title":"Nucleic Acids Res"},{"key":"2021032911264500800_CIT0020","doi-asserted-by":"crossref","first-page":"799","DOI":"10.4269\/ajtmh.19-0081","article-title":"Prevalence of molecular markers of antimalarial drug resistance across altitudinal transmission zones in highland Western Uganda","volume":"101","author":"Boyce","year":"2019","journal-title":"Am J Trop Med Hyg"},{"key":"2021032911264500800_CIT0021","doi-asserted-by":"crossref","first-page":"e002316","DOI":"10.1136\/bmjgh-2020-002316","article-title":"Spatial and epidemiological drivers of Plasmodium falciparum malaria among adults in the Democratic Republic of the Congo","volume":"5","author":"Deutsch-Feldman","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2021032911264500800_CIT0022","volume-title":"Guide to DHS statistics","author":"Croft","year":"2018"},{"key":"2021032911264500800_CIT0023","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v009.i08","article-title":"Analysis of complex survey samples","volume":"9","author":"Lumley","year":"2004","journal-title":"J Stat Softw"},{"key":"2021032911264500800_CIT0024","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1080\/03610929708831995","article-title":"A spatial scan statistic","volume":"26","author":"Kulldorff","year":"1997","journal-title":"Commun Stat Theory Methods"},{"key":"2021032911264500800_CIT0025","author":"Humanitarian Data Exchange"},{"key":"2021032911264500800_CIT0026","doi-asserted-by":"crossref","first-page":"5271","DOI":"10.1128\/AAC.00559-12","article-title":"Various pfcrt and pfmdr1 genotypes of Plasmodium falciparum cocirculate with P. malariae, P. ovale spp., and P. vivax in northern Angola","volume":"56","author":"Fan\u00e7ony","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2021032911264500800_CIT0027","first-page":"131","article-title":"Epidemiological aspects of malaria in 2 villages of the Manyemen forest region (Cameroon, southwest province)","volume":"46","author":"Cornu","year":"1986","journal-title":"Med Trop (Mars)"},{"key":"2021032911264500800_CIT0028","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/1471-2334-14-109","article-title":"Performance of Paracheck\u2122-Pf, SD Bioline malaria Ag-Pf and SD Bioline malaria Ag-Pf\/pan for diagnosis of falciparum malaria in the Central African Republic","volume":"14","author":"Djall\u00e9","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2021032911264500800_CIT0029","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/1475-2875-7-174","article-title":"Failure to detect Plasmodium vivax in West and Central Africa by PCR species typing","volume":"7","author":"Culleton","year":"2008","journal-title":"Malar J"},{"key":"2021032911264500800_CIT0030","doi-asserted-by":"crossref","first-page":"e0007414","DOI":"10.1371\/journal.pntd.0007414","article-title":"Persistent transmission of Plasmodium malariae and Plasmodium ovale species in an area of declining Plasmodium falciparum transmission in eastern Tanzania","volume":"13","author":"Yman","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"key":"2021032911264500800_CIT0031","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s12879-015-0935-7","article-title":"Patterns of mixed Plasmodium species infections among children six years and under in selected malaria hyper-endemic communities of Zambia: population-based survey observations","volume":"15","author":"Sitali","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2021032911264500800_CIT0032","doi-asserted-by":"crossref","first-page":"e2775","DOI":"10.1371\/journal.pone.0002775","article-title":"Effect of transmission setting and mixed species infections on clinical measures of malaria in Malawi","volume":"3","author":"Bruce","year":"2008","journal-title":"PLoS One"},{"key":"2021032911264500800_CIT0033","doi-asserted-by":"crossref","first-page":"858","DOI":"10.4269\/ajtmh.1978.27.858","article-title":"Species prevalence of malaria in northern and southern Sudan, and control by mass chemoprophylaxis","volume":"27","author":"Omer","year":"1978","journal-title":"Am J Trop Med Hyg"},{"key":"2021032911264500800_CIT0034","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ijpddr.2013.01.001","article-title":"Persistent detection of Plasmodium falciparum, P. malariae, P. ovale curtisi and P. ovale wallikeri after ACT treatment of asymptomatic Ghanaian school-children","volume":"3","author":"Dinko","year":"2013","journal-title":"Int J Parasitol Drugs Drug Resist"},{"key":"2021032911264500800_CIT0035","volume-title":"Nigeria Malaria Indicator Survey 2010","author":"National Population Commission (NPC), National Malaria Control Programme (NMCP), ICF International","year":"2012"},{"key":"2021032911264500800_CIT0036","doi-asserted-by":"crossref","first-page":"961","DOI":"10.4269\/ajtmh.1957.6.961","article-title":"Plasmodium ovale in Liberia","volume":"6","author":"Bray","year":"1957","journal-title":"Am J Trop Med Hyg"},{"key":"2021032911264500800_CIT0037","doi-asserted-by":"crossref","first-page":"e87169","DOI":"10.1371\/journal.pone.0087169","article-title":"A 20-year longitudinal study of Plasmodium ovale and Plasmodium malariae prevalence and morbidity in a West African population","volume":"9","author":"Roucher","year":"2014","journal-title":"PLoS One"},{"key":"2021032911264500800_CIT0038","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1093\/molbev\/msy096","article-title":"MEGA X: molecular evolutionary genetics analysis across computing platforms","volume":"35","author":"Kumar","year":"2018","journal-title":"Mol Biol Evol"},{"key":"2021032911264500800_CIT0039","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1186\/s12859-018-2336-6","article-title":"Rapid and precise alignment of raw reads against redundant databases with KMA","volume":"19","author":"Clausen","year":"2018","journal-title":"BMC Bioinformatics"},{"key":"2021032911264500800_CIT0040","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.1093\/bioinformatics\/btr507","article-title":"FLASH: fast length adjustment of short reads to improve genome assemblies","volume":"27","author":"Mago\u010d","year":"2011","journal-title":"Bioinformatics"},{"key":"2021032911264500800_CIT0041","article-title":"The mineral industry of Congo (Kinshasa)","volume-title":"Minerals Yearbook,","author":"Yager","year":"2013"},{"key":"2021032911264500800_CIT0042","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3201\/eid2003.130745","article-title":"Comparison of imported Plasmodium ovale curtisi and P. ovale wallikeri infections among patients in Spain, 2005\u20132011","volume":"20","author":"Rojo-Marcos","year":"2014","journal-title":"Emerg Infect Dis"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaa478\/33701448\/jiaa478.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/223\/6\/1005\/36785084\/jiaa478.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/223\/6\/1005\/36785084\/jiaa478.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T11:28:19Z","timestamp":1617017299000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/223\/6\/1005\/5885064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,7]]},"references-count":42,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,8,7]]},"published-print":{"date-parts":[[2021,3,29]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaa478","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,15]]},"published":{"date-parts":[[2020,8,7]]}}}