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How frequent was SARS-CoV-2 and malaria co-infection through the first wave of the pandemic?

In a current examine posted to the medRxiv* preprint server, researchers decided the prevalence of circulating extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the frequency of co-occurrence of coronavirus illness 2019 (COVID-19) and malaria in Burkina Faso, West Africa.

Research: Prevalence of SARS-CoV-2 and co-occurrence/co-infection with malaria through the first wave of the pandemic (the Burkina Faso case). Picture Credit score: Christoph Burgstedt/Shutterstock


SARS-CoV-2 transmission in Africa has been reported to have a decrease incidence, comprising largely asymptomatic circumstances, and decrease related demise charges in comparison with developed nations. A larger proportion of kids and socioecological variability (i.e., low populace, heat climate, and educated immune responses in opposition to infectious issues) and immediate enforcement of well being measures equivalent to authorities lockdowns can clarify the decrease incidence.

Research have documented that the COVID-19 pandemic impacted some international locations (equivalent to Tunisia, Morocco, and South Africa) extra prominently, indicative of region-specific SARS-CoV-2 unfold; nevertheless, the findings may very well be on account of low and disproportionate ranges of diagnostic testing and surveillance measures.

Additional, malaria is endemic to Africa, the circumstances of which have elevated through the preliminary COVID-19 wave, which can have been on account of disruptions in malaria campaigns, and diagnostic and testing capacities through the preliminary pandemic wave.

In regards to the examine

Within the current population-based examine, researchers evaluated the frequency of COVID-19 and malaria co-infections within the Burkina Faso nation in West Africa.

The examine was carried out on 998 asymptomatic volunteers residing in several rural or city areas throughout 11 villages in southern areas of Burkina Faso between 22 August and 19 November 2020. Blood samples had been obtained from the members and subjected to microscopic examination for the malaria parasite, Plasmodium falciparum detection (within the asexual and gametocyte levels), and speedy diagnostic checks for SARS-CoV-2 detection based mostly on the presence of serum immunoglobulin G (IgG), A and M antibodies in opposition to SARS-CoV-2 nucleocapsid (N) protein.

SARS-CoV-2 seroprevalence was estimated because the fraction of members with anti-SARS-CoV-2 N antibodies. As well as, nasopharyngeal swab specimens had been obtained from the examine members for quantitative reverse transcription-polymerase chain response (RT-qPCR) evaluation, and the cycle threshold (Ct) values had been obtained. Additional, SARS-CoV-2 ribonucleic acid (RNA) was extracted from seropositive people samples with Ct values ≤35 (n=19) and subjected to entire genome sequencing (WGS) evaluation, following which genome libraries had been constructed.

The sequences had been additionally analyzed by way of comparative genomic and phylogenetic analyses, and the PANGOLIN (phylogenetic task of named international outbreak lineages) classification was used to determine SARS-CoV-2 lineages and clades. Demographical and medical knowledge obtained from the members included intercourse, physique temperature, and age.


Most members (55%, n=549) had been ladies, and the people had been age-stratified into the next age teams: 5 years to 12 years, 13 years to twenty years, 21 years to 40 years, and above 40 years. The evaluation confirmed a 3.2% SARS-CoV-2 seroprevalence (n=32), 2.5% SARS-CoV-2 RT-qPCR positivity, and 22% malaria incidence (n=219) with most co-infection circumstances detected amongst youngsters aged <12 years (42%) with no vital sex-based variations.

The best SARS-CoV-2 seropositivity (5 p.c) was reported for the Bobo-Dioulasso metropolis in city areas of West Africa and was considerably increased amongst people aged above 40 years (seven p.c), adopted by these aged 13 years to twenty years (three p.c), 5 years to 12 years (two p.c), and 21 years to 40 years (one p.c). Considerably increased SARS-CoV-2 an infection incidence charges (six p.c) had been noticed in November 2020; nevertheless, no vital sex-based variations had been noticed in SARS-CoV-2 seroprevalence and PCR positivity.

The WGS evaluation demonstrated 13 SARS-CoV-2 strains circulating in Burkina Faso through the examine interval, assigned to the A.19, A.21, B.1, B.1.1.118, and B.1.1.404 lineages clustered within the 19B, 20A and 20B clades. The circulating lineages present in Burkina Faso through the first wave of the pandemic had been early clades derived from the Wuhan pressure. Many of the reported lineages have been beforehand described in Burkina Faso or neighboring international locations. Nonetheless, we additionally recognized two much less frequent lineages (B.1.1.118 and B.1) that had been in all probability imported to Burkina-Faso from the USA or Europe.

Of the SARS-CoV-2 seropositive/RT-qPCR-positive specimens (n=7), none confirmed malaria co-infection, whereas malaria and COVID-19 co-occurred in two (out of 17) seronegative/RT-qPCR-positive specimens. Out of the remaining seropositive/RT-qPCR-negative people (n=25), eight confirmed malaria co-infection. Subsequently, two and eight circumstances of confirmed and suspected co-infections had been detected, respectively, of which eight had been aged <14 years and two had been aged >40 years. Just one (out of two) RT-qPCR-positive co-infected samples was sequenced and assigned the A.21 lineage.

Many of the age teams most affected by the 2 ailments didn’t present overlapping; nevertheless, ten co-infection circumstances had been noticed amongst kids. The serology checks measured whole antibody titers (IgG, A, and M) in opposition to SARS-CoV-2, making it tough to delineate seropositive earlier an infection circumstances from present SARS-CoV-2 infections and, due to this fact, whether or not the information denoted a re-infection or a co-infection can’t be outlined clearly.

Much like the noticed COVID-19 temporal developments, malaria circumstances elevated considerably from 5 p.c at examine graduation to 29% by the top of the examine interval, indicative of a possible affect on malaria an infection management because of the COVID-19 pandemic.


The examine findings confirmed a low frequency of COVID-19 and malaria co-infections (1%) in Burkina Faso. The authors imagine that the current examine is the primary of its sort and offers knowledge for estimating the true prevalence and circulating variants of SARS-CoV-2 infections in Sub-Saharan Africa.

*Vital discover

medRxiv publishes preliminary scientific studies that aren’t peer-reviewed and, due to this fact, shouldn’t be thought to be conclusive, information medical follow/health-related habits, or handled as established info.



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