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Moreover, there is a notable lack of understanding of mixed-species infections and their clinical implications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted eight school-based cross-sectional malariometric surveys in the Lake Victoria region of western Kenya between January\u2013February 2012 and September\u2013October 2018. In each survey, a minimum of 100 children aged 3 to 15\u00a0years were randomly chosen from a school in Ungoye village on the mainland and as well as from each school selected in every catchment area on Mfangano island.\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infection was determined by microscopy and nested polymerase chain reaction (PCR). The multiple-kind lottery (MKL) model calculated the expected distribution of\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      infections in the population and compared it to observed values using a chi-squared test (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      prevalence was 25.9% (2521\/9724) by microscopy and 51.1% (4969\/9724) by PCR. Among all infections detected by PCR, Pf,\n                      <jats:italic>P. malariae<\/jats:italic>\n                      (Pm)\n                      <jats:italic>,<\/jats:italic>\n                      and\n                      <jats:italic>P. ovale<\/jats:italic>\n                      (Po) mono-infections were 58.6%, 3.1%, and 1.8%, respectively. Pf\/Pm, Pf\/Po, Pm\/Po\n                      <jats:italic>,<\/jats:italic>\n                      and Pf\/Pm\/Po co-infections were 23.5%, 4.3%, 0.1%, and 8.6%, respectively. MKL modelling revealed non-random distributions, with frequencies of Pf\/Pm and Pf\/Pm\/Po co-infections being significantly higher than expected (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20093385.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pf co-infections with Pm and Po were associated with a decreased risk of fever (aOR 0.64, 95% CI 0.46\u20130.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and increased risks of splenomegaly (aOR 12.79, 95% CI 9.69\u201316.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and anaemia (aOR 2.57, 95% CI 2.09\u20133.15;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), compared to single-species infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study sheds light on the potential interaction between Pf and Pm and\/or Po. Given the clinical significance of mixed-species infections, improved diagnostics, and case management of Pm and Po are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-024-00622-3","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T05:02:29Z","timestamp":1722834149000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Non-random distribution of Plasmodium Species infections and associated clinical features in children in the lake Victoria region, Kenya, 2012\u20132018"],"prefix":"10.1186","volume":"52","author":[{"given":"Protus","family":"Omondi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Musyoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takatsugu","family":"Okai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kongere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Kagaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chim W.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mtakai","family":"Ngara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard N.","family":"Kanoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutoshi","family":"Kido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Gitaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2411-3352","authenticated-orcid":false,"given":"Akira","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"key":"622_CR1","volume-title":"World malaria report 2023","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. 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