{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:07:00Z","timestamp":1780596420777,"version":"3.54.1"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R21AI190606"],"award-info":[{"award-number":["R21AI190606"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]}],"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>\n                      Malaria remains a major public health concern in sub-Saharan Africa.\n                      <jats:italic>Plasmodium vivax<\/jats:italic>\n                      (\n                      <jats:italic>P. vivax<\/jats:italic>\n                      ), historically considered rare due to the predominance of Duffy-negative individuals, is increasingly reported in Central and West Africa. The ability of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      to infect Duffy-negative populations challenges long-standing assumptions regarding parasite invasion biology and highlight surveillance gaps across Africa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>\n                      This study investigated\n                      <jats:italic>P. vivax<\/jats:italic>\n                      prevalence and genetic diversity across three ecological zones in Cameroon. A total of 1,373 samples were screened by microscopy, rapid diagnostic tests (RDTs), and qPCR; and all participants were genotyped for Duffy antigen status.\n                      <jats:italic>PvDBP1<\/jats:italic>\n                      region II was successfully sequenced from 75\n                      <jats:italic>P. vivax<\/jats:italic>\n                      isolates.\n                      <jats:italic>P. vivax<\/jats:italic>\n                      prevalence was 10.8% among hospital patients (86\/793) and 5.5% in community participants (32\/580), and all confirmed infections occurred in Duffy-negative individuals. Hospital infections exhibited significantly higher parasitemia than asymptomatic cases. PvLDH-based RDTs failed to detect over 85% of qPCR-confirmed infections. Genetic analysis of\n                      <jats:italic>PvDBP1<\/jats:italic>\n                      identified eight nonsynonymous mutations, with I379L (74.1%) and E225K (61.3%) as the most common variants, suggesting possible adaptive evolution. Phylogenetic analysis clustered Cameroonian\n                      <jats:italic>P. viv<\/jats:italic>\n                      axisolates with those from Botswana, distinct from East African and Asian lineages, indicating regional adaptation and potential gene flow within Central-Southern Africa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion\/Significance<\/jats:title>\n                    <jats:p>\n                      This study provides the first integrated epidemiological and\n                      <jats:italic>PvDBP1<\/jats:italic>\n                      genetic characterization of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      infections in Duffy-negative Central Africans, revealing widespread subclinical infections and poor diagnostic performance of current PvLDH-based RDTs. The observed genetic signatures of adaptation highlight the urgent need to prioritize\n                      <jats:italic>P. vivax<\/jats:italic>\n                      within national malaria programs and investigate alternative invasion pathways beyond\n                      <jats:italic>PvDBP1<\/jats:italic>\n                      to guide improved diagnostic and vaccine strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014404","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:24:41Z","timestamp":1780593881000},"page":"e0014404","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological insights and genetic diversity of the Duffy binding protein of Plasmodium vivax in Duffy-negative 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