Mixed Plasmodium Species Infections and Malaria Susceptibility among Fulani, Lobi and Birifor Ethnic Groups in Bouna, Côte d’Ivoire

Abstract

Background: Malaria remains a major health problem in sub-Saharan Africa. One of the main challenges that researchers are facing in eliminating the parasite is chemoresistance to antimalarial drugs. Resistance to artemisinin, the main molecule of drug combinations used in malaria treatment, has been observed in Asia, as well as in Africa. Aims: The aim is to study malaria susceptibility among a rural population of Bouna, in Côte d’Ivoire, that includes the Fulani and understand the influence of mixed infections on this susceptibility. Methodology: This is a Cross-sectional study. The study was conducted in ten villages of Niandegué (Bouna, Côte d’Ivoire) between June and September 2018. Two hundred and sixty-five (265) participants were enrolled. They included the Fulani (181), Lobi (70), and Birifor (14) sub-populations, with ages ranging from 4 to 15 years. Four (4) ml of whole blood were collected for the identification of Plasmodium species using RDT-HRP2, blood smears, and PCR tests.   Results: This study shows differences in malaria susceptibility among populations living in Bouna. The Fulani ethnic group are associated with asymptomatic malaria (107/181) and the Lobi with symptomatic malaria (16/70) (P=.002). Multiple correspondence analysis show that the Birifor ethnic group has low malaria susceptibility as the Fulani. This study also highlights that triple infections (Plasmodium falciparum/Plasmodiium malariae/Plasmodiium ovale) are less observed in Fulani people compared to the other groups (P = 0.038). Conclusion: The Fulani seem to have developed a cross-species immunity which able them to resist to malaria. Birifor also seems to be less susceptible to malaria. More studies targeting the Fulani but also the Birifor ethnic groups need to be carried out to attest the results fund and well understand the mechanism of their resistance to malaria.