{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:52:06Z","timestamp":1788868326325,"version":"build-2803163510"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Plasmodium falciparum<\/jats:italic> and <jats:italic>Plasmodium vivax<\/jats:italic> are co-endemic in Ethiopia. This study investigated whether mixed infections were missed by microscopy from a 2017 therapeutic efficacy study at two health facilities in Ethiopia. All patients (<jats:italic>N<\/jats:italic> = 304) were initially classified as having single-species <jats:italic>P. falciparum<\/jats:italic> (<jats:italic>n<\/jats:italic> = 148 samples) or <jats:italic>P. vivax<\/jats:italic> infections (<jats:italic>n<\/jats:italic> = 156). Dried blood spots were tested for <jats:italic>Plasmodium<\/jats:italic> antigens by bead-based multiplex assay for pan-<jats:italic>Plasmodium<\/jats:italic> aldolase, pan-<jats:italic>Plasmodium<\/jats:italic> lactate dehydrogenase, <jats:italic>P. vivax<\/jats:italic> lactate dehydrogenase, and histidine-rich protein 2. Of 304 blood samples, 13 (4.3%) contained both <jats:italic>P. falciparum<\/jats:italic> and <jats:italic>P. vivax<\/jats:italic> antigens and were analyzed by polymerase chain reaction for species-specific DNA. Of these 13 samples, five were confirmed by polymerase chain reaction for <jats:italic>P. falciparum<\/jats:italic>\/<jats:italic>P. vivax<\/jats:italic> co-infection. One sample, initially classified as <jats:italic>P. vivax<\/jats:italic> by microscopy, was found to only have <jats:italic>Plasmodium ovale<\/jats:italic> DNA. <jats:italic>Plasmodium falciparum\/P. vivax<\/jats:italic> mixed infections can be missed by microscopy even in the context of a therapeutic efficacy study with multiple trained readers.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0796","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T17:55:12Z","timestamp":1638294912000},"page":"667-670","source":"Crossref","is-referenced-by-count":19,"title":["Missed Plasmodium falciparum and Plasmodium vivax Mixed Infections in Ethiopia Threaten Malaria Elimination"],"prefix":"10.4269","volume":"106","author":[{"given":"Colleen M.","family":"Leonard","sequence":"first","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Mohammed","sequence":"additional","affiliation":[{"name":"2Ethiopia Public Health Institute, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekonnen","family":"Tadesse","sequence":"additional","affiliation":[{"name":"3ICAP at Columbia University, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica N.","family":"McCaffery","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Nace","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Halsey","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"4U.S. President\u2019s Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Girma","sequence":"additional","affiliation":[{"name":"5U.S. President\u2019s Malaria Initiative, USAID, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashenafi","family":"Assefa","sequence":"additional","affiliation":[{"name":"2Ethiopia Public Health Institute, Addis Ababa, Ethiopia;"},{"name":"6Infectious Disease Ecology and Epidemiology Lab, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimee","family":"Hwang","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"4U.S. President\u2019s Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rogier","sequence":"additional","affiliation":[{"name":"1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p667.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/2\/article-p667.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T14:58:09Z","timestamp":1643813889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p667.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,2]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0796","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,2]]}}}