{"doi":"10.1016/j.ijid.2021.05.009","title":"Contrasting epidemiology and genetic variation of Plasmodium vivax infecting Duffy-negative individuals across Africa","abstract":"OBJECTIVES: Plasmodium vivax malaria was thought to be rare in Africans who lack the Duffy blood group antigen expression. However, recent studies indicate that P. vivax can infect Duffy-negative individuals and has spread into areas of high Duffy negativity across Africa. Our study compared epidemiological and genetic features of P. vivax between African regions. METHODS: A standardized approach was used to identify and quantify P. vivax from Botswana, Ethiopia, and Sudan, where Duffy-positive and Duffy-negative individuals coexist. The study involved sequencing the Duffy binding protein (DBP) gene and inferring genetic relationships among P. vivax populations across Africa. RESULTS: Among 1215 febrile patients, the proportions of Duffy negativity ranged from 20-36% in East Africa to 84% in southern Africa. Average P. vivax prevalence among Duffy-negative populations ranged from 9.2% in Sudan to 86% in Botswana. Parasite density in Duffy-negative infections was significantly lower than in Duffy-positive infections. P. vivax in Duffy-negative populations were not monophyletic, with P. vivax in Duffy-negative and Duffy-positive populations sharing similar DBP haplotypes and occurring in multiple, well-supported clades. CONCLUSIONS: Duffy-negative Africans are not resistant to P. vivax, and the public health significance of this should not be neglected. Our study highlights the need for a standardized approach and more resources/training directed towards the diagnosis of vivax malaria in Africa.","journal":"International Journal of Infectious Diseases","year":2021,"id":163330,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":42,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8372,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":586878,"name":"Gianluca Russo","orcid":"0000-0002-8764-7389","position":1,"is_corresponding":false},{"id":586879,"name":"Kareen Pestana","orcid":"0000-0001-9775-5378","position":2,"is_corresponding":false},{"id":476981,"name":"Daniel Kepple","orcid":"0000-0003-0566-3623","position":3,"is_corresponding":false},{"id":476982,"name":"Beka Raya Abagero","orcid":"0000-0002-7205-9496","position":4,"is_corresponding":false},{"id":586880,"name":"Ghyslaine Bruna Djeunang Dongho","orcid":"0000-0002-7810-9095","position":5,"is_corresponding":false},{"id":478053,"name":"Karthigayan Gunalan","orcid":null,"position":6,"is_corresponding":false},{"id":333594,"name":"Louis H. Miller","orcid":"0000-0002-3709-0092","position":7,"is_corresponding":false},{"id":487115,"name":"Muzamil Mahdi Abdel Hamid","orcid":"0000-0002-6157-4388","position":8,"is_corresponding":false},{"id":269981,"name":"Delenasaw Yewhalaw","orcid":"0000-0002-2907-9360","position":9,"is_corresponding":false},{"id":586881,"name":"Giacomo Maria Paganotti","orcid":"0000-0002-0751-0682","position":10,"is_corresponding":false},{"id":337677,"name":"Eugenia Lo","orcid":"0000-0002-5631-4709","position":0,"is_corresponding":true}],"reference_count":53,"raw_metadata":null,"created_at":"2026-07-18T23:45:17.971865Z","pmid":"33991680","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}