{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:27:23Z","timestamp":1791390443837,"version":"4.3.3"},"reference-count":102,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"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":[[2026,6,3]]},"abstract":"ABSTRACT.<\/jats:title>\n \n The prevalence and clinical significance of mixed\n Plasmodium<\/jats:italic>\n infections in children with severe\n Plasmodium falciparum<\/jats:italic>\n (\n P. falciparum<\/jats:italic>\n ) malaria are not well characterized. In a cohort of 440 Ugandan children hospitalized with severe malaria who were diagnosed with\n Plasmodium<\/jats:italic>\n species via microscopy, nested polymerase chain reaction (nPCR) testing was used to detect\n P. falciparum<\/jats:italic>\n ,\n Plasmodium ovale<\/jats:italic>\n (\n P. ovale<\/jats:italic>\n ),\n Plasmodium malariae<\/jats:italic>\n (\n P. malariae<\/jats:italic>\n ), and\n Plasmodium vivax<\/jats:italic>\n (\n P. vivax<\/jats:italic>\n ) infections and assess their association with adverse clinical outcomes during hospitalization. Using nPCR testing, the\n Plasmodium<\/jats:italic>\n 18S<\/jats:italic>\n small-subunit ribosomal RNA gene was detected in 440 children.\n Plasmodium falciparum<\/jats:italic>\n mono-infection was identified in 329 (74.8%) children,\n P. malariae<\/jats:italic>\n mono-infection was detected in one (0.2%),\n P. falciparum<\/jats:italic>\n and\n P. ovale<\/jats:italic>\n mixed infections were detected in 100 (22.8%),\n P. falciparum<\/jats:italic>\n and\n P. malariae<\/jats:italic>\n mixed infection was detected in one (0.2%), and\n P. falciparum<\/jats:italic>\n ,\n P. ovale<\/jats:italic>\n , and\n P. malariae<\/jats:italic>\n triple infections were detected in nine (2.1%). Children with triple infections of\n P. falciparum<\/jats:italic>\n ,\n P. ovale<\/jats:italic>\n , and\n P. malariae<\/jats:italic>\n exhibited higher mortality rates than those with\n P. falciparum<\/jats:italic>\n mono-infection (3\/9 [33%] versus 23\/329 [7%]; odds ratio = 7.0; 95% CI = 1.8\u201328;\n P<\/jats:italic>\n = 0.005). They were also more likely to experience respiratory distress (6\/9 [67%] versus 115\/329 [35%];\n P<\/jats:italic>\n = 0.08). In the present study, a high proportion of children with severe\n falciparum<\/jats:italic>\n malaria had mixed\n P. ovale<\/jats:italic>\n infections, and\n P. falciparum<\/jats:italic>\n ,\n P. ovale<\/jats:italic>\n , and\n P. malariae<\/jats:italic>\n triple infections were associated with increased mortality. Improved detection and broader surveillance of non-\n falciparum<\/jats:italic>\n malaria may help identify epidemiologic patterns associated with adverse outcomes in severe malaria.\n <\/jats:p>","DOI":"10.4269\/ajtmh.25-0514","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T15:22:44Z","timestamp":1776352964000},"page":"1120-1127","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Plasmodium ovale and Plasmodium malariae Mixed Infections and Associated Mortality in Children with Severe Falciparum Malaria"],"prefix":"10.4269","volume":"114","author":[{"given":"Giselle","family":"Lima-Cooper","sequence":"first","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dibyadyuti","family":"Datta","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Bond","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kagan A.","family":"Mellencamp","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Namazzi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Gupta","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, Michigan, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea L.","family":"Conroy","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert O.","family":"Opoka","sequence":"additional","affiliation":[{"name":"Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandy C.","family":"John","sequence":"additional","affiliation":[{"name":"Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Malar J","first-page":"246","article-title":"Risk factors of malaria in children under the age of five years old in Uganda","volume":"15","author":"Roberts","year":"2016"},{"key":"b2","article-title":"World Malaria Report 2023.","year":"2023"},{"issue":"3","key":"b3","series-title":"Am J Trop Med Hyg","first-page":"753","article-title":"Plasmodium species infecting children presenting with malaria in Uganda","volume":"97","author":"Asua","year":"2017"},{"issue":"7","key":"b4","series-title":"J Infect Dis","first-page":"1099","article-title":"Emergence of nonfalciparum Plasmodium infection despite regular artemisinin combination therapy in an 18-month longitudinal study of Ugandan children and their mothers","volume":"217","author":"Betson","year":"2018"},{"key":"b5","series-title":"Int J Parasitol Drugs Drug Resist","first-page":"45","article-title":"Persistent detection of Plasmodium falciparum, P. malariae, P. ovale curtisi and P. ovale wallikeri after ACT treatment of asymptomatic Ghanaian school-children","volume":"3","author":"Dinko","year":"2013"},{"key":"b6","series-title":"Malar J","first-page":"350","article-title":"Low prevalence of Plasmodium malariae and Plasmodium ovale mono-infections among children in the Democratic Republic of the Congo: A population-based, cross-sectional study","volume":"15","author":"Doctor","year":"2016"},{"key":"b7","series-title":"BMJ","first-page":"576","article-title":"Lethal malaria caused by Plasmodium malariae in an asplenic patient in Brazil","volume":"331","author":"Kirchgatter","year":"2005"},{"issue":"3","key":"b8","series-title":"J Travel Med","first-page":"201","article-title":"Severe Plasmodium malariae malaria in a patient with multiple susceptibility genes","volume":"17","author":"Bellanger","year":"2010"},{"issue":"5","key":"b9","series-title":"Emerg Infect Dis","first-page":"832","article-title":"Near-fatal multiple organ dysfunction syndrome induced by Plasmodium malariae","volume":"15","author":"Descheemaeker","year":"2009"},{"key":"b10","series-title":"Malar J","first-page":"389","article-title":"Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome","volume":"12","author":"Lau","year":"2013"},{"issue":"3","key":"b11","series-title":"Am J Trop Med Hyg","first-page":"391","article-title":"Acute respiratory distress syndrome in a case of Plasmodium ovale malaria","volume":"79","author":"Rojo-Marcos","year":"2008"},{"key":"b12","series-title":"Malar J","first-page":"139","article-title":"Severe Plasmodium ovale malaria complicated by acute respiratory distress syndrome in a young Caucasian man","volume":"17","author":"D\u2019Abramo","year":"2018"},{"issue":"8","key":"b13","series-title":"J Infect Dis","first-page":"1335","article-title":"Severity of Plasmodium falciparum and non-falciparum malaria in travelers and migrants: A nationwide observational study over 2 decades in Sweden","volume":"220","author":"W\u00e5ngdahl","year":"2019"},{"issue":"7761","key":"b14","series-title":"Lancet","first-page":"1143","article-title":"Quartan malarial nephrotic syndrome. Collaborative clinicopathological study in Nigerian children","volume":"1","author":"Hendrickse","year":"1972"},{"issue":"1","key":"b15","series-title":"Kidney Int","first-page":"64","article-title":"Quartan malarial nephrotic syndrome in children","volume":"16","author":"Hendrickse","year":"1979"},{"issue":"5","key":"b16","series-title":"Transfusion","first-page":"955","article-title":"Malaria parasitemia among blood donors in Uganda","volume":"60","author":"Murphy","year":"2020"},{"issue":"8","key":"b17","series-title":"Emerg Infect Dis","first-page":"1494","article-title":"Asymptomatic Plasmodium infections in children in low malaria transmission setting, Southwestern Uganda(1)","volume":"22","author":"Roh","year":"2016"},{"issue":"1","key":"b18","series-title":"Lancet Microbe","first-page":"e72","article-title":"Assessing the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda: A longitudinal cohort study","volume":"5","author":"Hergott","year":"2024"},{"issue":"1","key":"b19","series-title":"Malar J","first-page":"207","article-title":"Non-falciparum malaria infections in Uganda, does it matter? A review of the published literature","volume":"23","author":"Ranjbar","year":"2024"},{"issue":"9","key":"b20","series-title":"Clin Infect Dis","first-page":"1511","article-title":"Acute kidney injury interacts with coma, acidosis, and impaired perfusion to significantly increase risk of death in children with severe malaria","volume":"75","author":"Namazzi","year":"2022"},{"key":"b21","series-title":"EClinicalMedicine","first-page":"101292","article-title":"Acute kidney injury, persistent kidney disease, and post-discharge morbidity and mortality in severe malaria in children: A prospective cohort study","volume":"44","author":"Namazzi","year":"2022"},{"key":"b22","article-title":"WHO Guidelines for Malaria.","year":"2023"},{"issue":"1","key":"b23","series-title":"BMC Med","first-page":"98","article-title":"Acute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria","volume":"17","author":"Conroy","year":"2019"},{"issue":"5","key":"b24","series-title":"mBio","first-page":"e0132522","article-title":"Intestinal injury biomarkers predict mortality in pediatric severe malaria","volume":"13","author":"Sarangam","year":"2022"},{"key":"b25","series-title":"Methods Mol Med","first-page":"189","article-title":"Nested PCR analysis of Plasmodium parasites","volume":"72","author":"Snounou","year":"2002"},{"issue":"4","key":"b26","series-title":"Am J Trop Med Hyg","first-page":"687","article-title":"A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies","volume":"60","author":"Singh","year":"1999"},{"issue":"3","key":"b27","series-title":"Am J Trop Med Hyg","first-page":"444","article-title":"Polymerase chain reaction detection of Plasmodium vivax and Plasmodium falciparum DNA from stored serum samples: Implications for retrospective diagnosis of malaria","volume":"77","author":"Bharti","year":"2007"},{"issue":"5","key":"b28","series-title":"PLoS Negl Trop Dis","first-page":"e0007290","article-title":"Molecular detection of P. vivax and P. ovale foci of infection in asymptomatic and symptomatic children in Northern Namibia","volume":"13","author":"Haiyambo","year":"2019"},{"issue":"6","key":"b29","series-title":"Emerg Infect Dis","first-page":"1143","article-title":"Similar prevalence of Plasmodium falciparum and non-P. falciparum malaria infections among schoolchildren, Tanzania(1)","volume":"29","author":"Sendor","year":"2023"},{"issue":"6","key":"b30","series-title":"Trends Parasitol","first-page":"278","article-title":"Plasmodium malariae and Plasmodium ovale\u2013The \u201cbashful\u201d malaria parasites","volume":"23","author":"Mueller","year":"2007"},{"issue":"1","key":"b31","series-title":"Malar J","first-page":"93","article-title":"A case of severe Plasmodium ovale malaria with acute respiratory distress syndrome and splenic infarction in a male traveller presenting in Italy","volume":"23","author":"Tomassi","year":"2024"},{"issue":"6","key":"b32","series-title":"PLoS One","first-page":"e0235014","article-title":"Severity and mortality of severe Plasmodium ovale infection: A systematic review and meta-analysis","volume":"15","author":"Kotepui","year":"2020"},{"issue":"1","key":"b33","series-title":"Malar J","first-page":"274","article-title":"Global prevalence and mortality of severe Plasmodium malariae infection: A systematic review and meta-analysis","volume":"19","author":"Kotepui","year":"2020"},{"issue":"6","key":"b34","series-title":"Signa Vitae","first-page":"145","article-title":"Fatal imported case of Plasmodium mixed infection: Cerebral malaria, thrombocytopenia and multi organ dysfunctions (MODs)","volume":"17","author":"Angeletti","year":"2021"},{"issue":"1","key":"b35","series-title":"Sci Rep","first-page":"11068","article-title":"Plasmodium spp. mixed infection leading to severe malaria: A systematic review and meta-analysis","volume":"10","author":"Kotepui","year":"2020"},{"issue":"1","key":"b36","series-title":"Malar J","first-page":"112","article-title":"A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria","volume":"16","author":"Groger","year":"2017"},{"key":"b37","series-title":"Malar J","first-page":"330","article-title":"Characterization of a malaria outbreak in Colombia in 2010","volume":"12","author":"Chaparro","year":"2013"},{"issue":"654","key":"b38","series-title":"Sci Transl Med","first-page":"eabn5040","article-title":"Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations","volume":"14","author":"Watson","year":"2022"},{"issue":"5","key":"b39","series-title":"Trends Parasitol","first-page":"233","article-title":"Mixed-species malaria infections in humans","volume":"20","author":"Mayxay","year":"2004"},{"key":"b40","series-title":"Front Immunol","first-page":"3072","article-title":"The consequences of mixed-species malaria parasite co-infections in mice and mosquitoes for disease severity, parasite fitness, and transmission success","volume":"10","author":"Tang","year":"2019"},{"issue":"7","key":"b41","series-title":"PLoS One","first-page":"e11759","article-title":"Incidence of malaria and efficacy of combination antimalarial therapies over 4 years in an urban cohort of Ugandan children","volume":"5","author":"Clark","year":"2010"},{"issue":"5","key":"b42","series-title":"PLoS One","first-page":"e19801","article-title":"Transmission of Plasmodium vivax in south-western Uganda: Report of three cases in pregnant women","volume":"6","author":"Dhorda","year":"2011"},{"key":"b43","series-title":"Nat Commun","first-page":"266","article-title":"The global distribution of the Duffy blood group","volume":"2","author":"Howes","year":"2011"},{"issue":"1","key":"b44","series-title":"Sci Rep","first-page":"3998","article-title":"Prevalence and risk of Plasmodium vivax infection among Duffy-negative individuals: A systematic review and meta-analysis","volume":"12","author":"Wilairatana","year":"2022"},{"issue":"1","key":"b45","series-title":"Nat Commun","first-page":"6618","article-title":"Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo","volume":"14","author":"Sendor","year":"2023"},{"issue":"1","key":"b46","series-title":"Parasit Vectors","first-page":"209","article-title":"Prevalence of non-Plasmodium falciparum species in southern districts of Brazzaville in The Republic of the Congo","volume":"15","author":"Mbama Ntabi","year":"2022"},{"issue":"6","key":"b47","series-title":"Am J Trop Med Hyg","first-page":"2208","article-title":"Seroprevalence and parasite rates of Plasmodium malariae in a high malaria transmission setting of southern Nigeria","volume":"103","author":"Oriero","year":"2020"},{"issue":"1","key":"b48","series-title":"Malar J","first-page":"211","article-title":"Molecular epidemiology of non-falciparum Plasmodium infections in three different areas of the Ivory Coast","volume":"22","author":"Miezan","year":"2023"},{"issue":"1","key":"b49","series-title":"Int J Parasitol","first-page":"23","article-title":"High prevalence of Plasmodium malariae and Plasmodium ovale in co-infections with Plasmodium falciparum in asymptomatic malaria parasite carriers in southwestern Nigeria","volume":"52","author":"Abdulraheem","year":"2022"},{"issue":"4","key":"b50","series-title":"Lancet Microbe","first-page":"e141","article-title":"Plasmodium interspecies interactions during a period of increasing prevalence of Plasmodium ovale in symptomatic individuals seeking treatment: An observational study","volume":"2","author":"Akala","year":"2021"},{"issue":"1","key":"b51","series-title":"Malar J","first-page":"130","article-title":"Distribution of Plasmodium species and assessment of performance of diagnostic tools used during a malaria survey in Southern and Western Provinces of Zambia","volume":"18","author":"Sitali","year":"2019"},{"key":"b1","series-title":"Malar J","first-page":"246","article-title":"Risk factors of malaria in children under the age of five years old in Uganda","volume":"15","author":"Roberts","year":"2016"},{"key":"b2","article-title":"World Malaria Report 2023.","year":"2023"},{"issue":"3","key":"b3","series-title":"Am J Trop Med Hyg","first-page":"753","article-title":"Plasmodium species infecting children presenting with malaria in Uganda","volume":"97","author":"Asua","year":"2017"},{"issue":"7","key":"b4","series-title":"J Infect Dis","first-page":"1099","article-title":"Emergence of nonfalciparum Plasmodium infection despite regular artemisinin combination therapy in an 18-month longitudinal study of Ugandan children and their mothers","volume":"217","author":"Betson","year":"2018"},{"key":"b5","series-title":"Int J Parasitol Drugs Drug Resist","first-page":"45","article-title":"Persistent detection of Plasmodium falciparum, P. malariae, P. ovale curtisi and P. ovale wallikeri after ACT treatment of asymptomatic Ghanaian school-children","volume":"3","author":"Dinko","year":"2013"},{"key":"b6","series-title":"Malar J","first-page":"350","article-title":"Low prevalence of Plasmodium malariae and Plasmodium ovale mono-infections among children in the Democratic Republic of the Congo: A population-based, cross-sectional study","volume":"15","author":"Doctor","year":"2016"},{"key":"b7","series-title":"BMJ","first-page":"576","article-title":"Lethal malaria caused by Plasmodium malariae in an asplenic patient in Brazil","volume":"331","author":"Kirchgatter","year":"2005"},{"issue":"3","key":"b8","series-title":"J Travel Med","first-page":"201","article-title":"Severe Plasmodium malariae malaria in a patient with multiple susceptibility genes","volume":"17","author":"Bellanger","year":"2010"},{"issue":"5","key":"b9","series-title":"Emerg Infect Dis","first-page":"832","article-title":"Near-fatal multiple organ dysfunction syndrome induced by Plasmodium malariae","volume":"15","author":"Descheemaeker","year":"2009"},{"key":"b10","series-title":"Malar J","first-page":"389","article-title":"Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome","volume":"12","author":"Lau","year":"2013"},{"issue":"3","key":"b11","series-title":"Am J Trop Med Hyg","first-page":"391","article-title":"Acute respiratory distress syndrome in a case of Plasmodium ovale malaria","volume":"79","author":"Rojo-Marcos","year":"2008"},{"key":"b12","series-title":"Malar J","first-page":"139","article-title":"Severe Plasmodium ovale malaria complicated by acute respiratory distress syndrome in a young Caucasian man","volume":"17","author":"D\u2019Abramo","year":"2018"},{"issue":"8","key":"b13","series-title":"J Infect Dis","first-page":"1335","article-title":"Severity of Plasmodium falciparum and non-falciparum malaria in travelers and migrants: A nationwide observational study over 2 decades in Sweden","volume":"220","author":"W\u00e5ngdahl","year":"2019"},{"issue":"7761","key":"b14","series-title":"Lancet","first-page":"1143","article-title":"Quartan malarial nephrotic syndrome. 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A review of the published literature","volume":"23","author":"Ranjbar","year":"2024"},{"issue":"9","key":"b20","series-title":"Clin Infect Dis","first-page":"1511","article-title":"Acute kidney injury interacts with coma, acidosis, and impaired perfusion to significantly increase risk of death in children with severe malaria","volume":"75","author":"Namazzi","year":"2022"},{"key":"b21","series-title":"EClinicalMedicine","first-page":"101292","article-title":"Acute kidney injury, persistent kidney disease, and post-discharge morbidity and mortality in severe malaria in children: A prospective cohort study","volume":"44","author":"Namazzi","year":"2022"},{"key":"b22","article-title":"WHO Guidelines for Malaria.","year":"2023"},{"issue":"1","key":"b23","series-title":"BMC Med","first-page":"98","article-title":"Acute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria","volume":"17","author":"Conroy","year":"2019"},{"issue":"5","key":"b24","series-title":"mBio","first-page":"e0132522","article-title":"Intestinal injury biomarkers predict mortality in pediatric severe malaria","volume":"13","author":"Sarangam","year":"2022"},{"key":"b25","series-title":"Methods Mol Med","first-page":"189","article-title":"Nested PCR analysis of Plasmodium parasites","volume":"72","author":"Snounou","year":"2002"},{"issue":"4","key":"b26","series-title":"Am J Trop Med Hyg","first-page":"687","article-title":"A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies","volume":"60","author":"Singh","year":"1999"},{"issue":"3","key":"b27","series-title":"Am J Trop Med Hyg","first-page":"444","article-title":"Polymerase chain reaction detection of Plasmodium vivax and Plasmodium falciparum DNA from stored serum samples: Implications for retrospective diagnosis of malaria","volume":"77","author":"Bharti","year":"2007"},{"issue":"5","key":"b28","series-title":"PLoS Negl Trop Dis","first-page":"e0007290","article-title":"Molecular detection of P. vivax and P. ovale foci of infection in asymptomatic and symptomatic children in Northern Namibia","volume":"13","author":"Haiyambo","year":"2019"},{"issue":"6","key":"b29","series-title":"Emerg Infect Dis","first-page":"1143","article-title":"Similar prevalence of Plasmodium falciparum and non-P. falciparum malaria infections among schoolchildren, Tanzania(1)","volume":"29","author":"Sendor","year":"2023"},{"issue":"6","key":"b30","series-title":"Trends Parasitol","first-page":"278","article-title":"Plasmodium malariae and Plasmodium ovale\u2013The \u201cbashful\u201d malaria parasites","volume":"23","author":"Mueller","year":"2007"},{"issue":"1","key":"b31","series-title":"Malar J","first-page":"93","article-title":"A case of severe Plasmodium ovale malaria with acute respiratory distress syndrome and splenic infarction in a male traveller presenting in Italy","volume":"23","author":"Tomassi","year":"2024"},{"issue":"6","key":"b32","series-title":"PLoS One","first-page":"e0235014","article-title":"Severity and mortality of severe Plasmodium ovale infection: A systematic review and meta-analysis","volume":"15","author":"Kotepui","year":"2020"},{"issue":"1","key":"b33","series-title":"Malar J","first-page":"274","article-title":"Global prevalence and mortality of severe Plasmodium malariae infection: A systematic review and meta-analysis","volume":"19","author":"Kotepui","year":"2020"},{"issue":"6","key":"b34","series-title":"Signa Vitae","first-page":"145","article-title":"Fatal imported case of Plasmodium mixed infection: Cerebral malaria, thrombocytopenia and multi organ dysfunctions (MODs)","volume":"17","author":"Angeletti","year":"2021"},{"issue":"1","key":"b35","series-title":"Sci Rep","first-page":"11068","article-title":"Plasmodium spp. mixed infection leading to severe malaria: A systematic review and meta-analysis","volume":"10","author":"Kotepui","year":"2020"},{"issue":"1","key":"b36","series-title":"Malar J","first-page":"112","article-title":"A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria","volume":"16","author":"Groger","year":"2017"},{"key":"b37","series-title":"Malar J","first-page":"330","article-title":"Characterization of a malaria outbreak in Colombia in 2010","volume":"12","author":"Chaparro","year":"2013"},{"issue":"654","key":"b38","series-title":"Sci Transl Med","first-page":"eabn5040","article-title":"Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations","volume":"14","author":"Watson","year":"2022"},{"issue":"5","key":"b39","series-title":"Trends Parasitol","first-page":"233","article-title":"Mixed-species malaria infections in 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