{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:00:11Z","timestamp":1790690411387,"version":"4.1.0"},"posted":{"date-parts":[[2023,9,20]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":48,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,9,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Recent data indicate that non-\n                  <jats:italic>Plasmodium falciparum<\/jats:italic>\n                  species may be more prevalent than previously realized in sub-Saharan Africa, the region where 95% of the world\u2019s malaria cases occur. Although\n                  <jats:italic>Plasmodium malariae, Plasmodium ovale<\/jats:italic>\n                  spp., and\n                  <jats:italic>Plasmodium vivax<\/jats:italic>\n                  are generally less severe than\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  , treatment and control are more challenging, and their geographic distributions are not well characterized. In order to characterize the distribution of malaria species in Mainland Tanzania (which has a high burden and geographically heterogeneous transmission levels), we randomly selected 3,284 samples from 12,845 samples to determine presence and parasitemia of different malaria species. The samples were collected from cross-sectional surveys in 100 health facilities across ten regions and analyzed via quantitative real-time PCR to characterize regional positivity rates for each species.\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  was most prevalent, but\n                  <jats:italic>P. malariae<\/jats:italic>\n                  and\n                  <jats:italic>P. ovale<\/jats:italic>\n                  were found in all regions except Dar es Salaam, with high levels (&gt;5%) of\n                  <jats:italic>P. ovale<\/jats:italic>\n                  in seven regions (70%). The highest positivity rate of\n                  <jats:italic>P. malariae<\/jats:italic>\n                  was 4.5% in Mara region and eight regions (80%) had positivity rates \u22651%. We also detected three\n                  <jats:italic>P. vivax<\/jats:italic>\n                  infections in the very low-transmission Kilimanjaro region. While most samples that tested positive for non-falciparum malaria were co-infected with\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  , 23.6% (n = 13\/55) of\n                  <jats:italic>P. malariae<\/jats:italic>\n                  and 14.7% (n = 24\/163) of\n                  <jats:italic>P. ovale<\/jats:italic>\n                  spp. samples were mono-infections.\n                  <jats:italic>P. falciparum<\/jats:italic>\n                  remains by far the largest threat, but our data indicate that malaria elimination efforts in Tanzania will require increased surveillance and improved understanding of the biology of non-falciparum species.\n                <\/jats:p>","DOI":"10.1101\/2023.09.19.23295562","type":"posted-content","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T22:05:11Z","timestamp":1695247511000},"source":"Crossref","is-referenced-by-count":5,"title":["Malaria species positivity rates among symptomatic individuals across regions of differing transmission intensities in Mainland Tanzania"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5975-9415","authenticated-orcid":false,"given":"Zachary R.","family":"Popkin Hall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6743-4108","authenticated-orcid":false,"given":"Misago D.","family":"Seth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid A.","family":"Madebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0297-9219","authenticated-orcid":false,"given":"Rule","family":"Budodo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8710-1765","authenticated-orcid":false,"given":"Catherine","family":"Bakari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1000-4729","authenticated-orcid":false,"given":"Filbert","family":"Francis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-1312","authenticated-orcid":false,"given":"Dativa","family":"Pereus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2498-4705","authenticated-orcid":false,"given":"David J.","family":"Giesbrecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4317-4425","authenticated-orcid":false,"given":"Celine I.","family":"Mandara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mbwambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijenunu","family":"Aaron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samwel","family":"Lazaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-8204","authenticated-orcid":false,"given":"Jeffrey A.","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-0850","authenticated-orcid":false,"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-3416","authenticated-orcid":false,"given":"Deus S.","family":"Ishengoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2023092305401214000_2023.09.19.23295562v1.1","unstructured":"World Health Organization. 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