{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:04:38Z","timestamp":1775145878630,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011326","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000}}],"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The interaction between the <jats:italic>Plasmodium vivax<\/jats:italic> Duffy-binding protein and the corresponding Duffy Antigen Receptor for Chemokines (DARC) is primarily responsible for the invasion of reticulocytes by <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic>. The Duffy-negative host phenotype, highly prevalent in sub-Saharan Africa, is caused by a single point mutation in the GATA-1 transcription factor binding site of the DARC gene promoter. The aim of this study was to assess the Duffy status of patients with <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infection from different study sites in Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was conducted from February 2021 to September 2022 at five varying eco-epidemiological malaria endemic sites in Ethiopia. Outpatients who were diagnosed with <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infection (pure and mixed <jats:italic>P<\/jats:italic>. <jats:italic>vivax\/P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic>) by microscopy and Rapid Diagnostic Test (RDT) were subjected to PCR genotyping at the DARC promoter. The associations between <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infection, host genotypes and other factors were evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>In total, 361 patients with <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infection were included in the study. Patients with pure <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infections accounted for 89.8% (324\/361), while the remaining 10.2% (37\/361) had mixed <jats:italic>P<\/jats:italic>. <jats:italic>vivax\/P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infections. About 95.6% (345\/361) of the participants were Duffy-positives (21.2% homozygous and 78.8%, heterozygous) and 4.4% (16\/361) were Duffy-negatives. The mean asexual parasite density in homozygous and heterozygous Duffy-positives was 12,165 p\/\u03bcl (IQR25-75: 1,640\u201324,234 p\/\u03bcl) and11,655 p\/\u03bcl (IQR25-75: 1,676\u201314,065 p\/\u03bcl), respectively, significantly higher than that in Duffy-negatives (1,227p\/\u03bcl; IQR25-75: 539\u20131,732p\/\u03bcl).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study confirms that Duffy-negativity does not provide complete protection against <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infection. The development of <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic>-specific elimination strategies, including alternative antimalarial vaccines should be facilitated by a better understanding of the epidemiological landscape of <jats:italic>vivax<\/jats:italic> malaria in Africa. More importantly, low parasitemia associated with <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> infections in Duffy-negative patients may represent hidden reservoirs of transmission in Ethiopia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011326","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T17:27:15Z","timestamp":1688405235000},"page":"e0011326","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Potential hidden Plasmodium vivax malaria reservoirs from low parasitemia Duffy-negative Ethiopians: Molecular evidence"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-9131","authenticated-orcid":true,"given":"Abnet","family":"Abebe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Bouyssou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solenne","family":"Mabilotte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisay","family":"Dugassa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashenafi","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia","family":"Lo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Menard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lemu","family":"Golassa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"pntd.0011326.ref001","author":"World Health Organization","journal-title":"World Malaria Report 2022"},{"issue":"12","key":"pntd.0011326.ref002","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1086\/599041","article-title":"Vivax malaria: A major cause of morbidity in early infancy","volume":"48","author":"JR Poespoprodjo","year":"2009","journal-title":"Clinical Infectious Diseases"},{"issue":"1","key":"pntd.0011326.ref003","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1128\/CMR.00074-12","article-title":"Evidence and implications of mortality associated with acute plasmodium vivax malaria","volume":"26","author":"J. 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