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. 2019 Jun 8;10(6):437.
doi: 10.3390/genes10060437.

Distribution of Duffy Phenotypes among Plasmodium vivax Infections in Sudan

Musab M A Albsheer  1   2 , Kareen Pestana  3 , Safaa Ahmed  4 , Mohammed Elfaki  5 , Eiman Gamil  6 , Salma M Ahmed  7   8 , Muntaser E Ibrahim  9 , Ahmed M Musa  10 , Eugenia Lo  11 , Muzamil M Abdel Hamid  12
Affiliations

Distribution of Duffy Phenotypes among Plasmodium vivax Infections in Sudan

Musab M A Albsheer et al. Genes (Basel). .

Abstract

Negative Duffy expression on the surface of human red blood cells was believed to be a barrier for Plasmodium vivax infection in most Africans. However, P. vivax has been demonstrated to infect Duffy-negative individuals in several Central and East African countries. In this study, we investigated the distribution of Duffy blood group phenotypes with regard to P. vivax infection and parasitemia in Sudan. Out of 992 microscopic-positive malaria samples, 190 were identified as P. vivax positive infections. Among them, 186 were P. vivax mono-infections and 4 were mixed P. vivax and Plasmodium falciparum infections. A subset of 77 samples was estimated with parasitemia by quantitative real-time PCR. Duffy codons were sequenced from the 190 P. vivax positive samples. We found that the Duffy Fy(a-b+) phenotype was the most prevalent, accounting for 67.9% of all P. vivax infections, while homozygous Duffy-negative Fy(a-b-) accounted for 17.9% of the P. vivax infections. The prevalence of infection in Fy(a-b+) and Fy(a+b-)were significantly higher than Fy(a-b-) phenotypes (p = 0.01 and p < 0.01, respectively). A significantly low proportion of P. vivax infection was observed in Duffy negative individuals Fy(a-b-). This study highlights the prevalence of P. vivax in Duffy-negatives in Sudan and indicates low parasitemia among the Duffy-negative individuals.

Keywords: Duffy-negative; Plasmodium vivax; Sudan; demography; malaria; parasitemia.

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Conflict of interest statement

The authors declare that they have no conflicts of interests

Figures

Figure 1
Figure 1
Proportion of Duffy phenotypes in Plasmodium positive patients among the three sites in River Nile, Khartoum, and New Halfa. The proportion of Fy(a-b-) was significantly higher in River Nile than the other two sites. In addition, Fy(a+b+) was not recorded in any of the healthy or Plasmodium-positive patients.
Figure 2
Figure 2
Estimated log parasite density per μL of blood based on Duffy phenotype. There was no significant difference between Fy(a-b+) and Fy(a+b-) phenotypes, but there was a significant difference between the Fy(a-b-) phenotype and the Fy(a-b+) and the Fy(a+b-) phenotypes (p < 0.001).
Figure 3
Figure 3
(a) Distribution of age of patient in years among the different phenotypes in Plasmodium positive patients; (b) proportion of male and female Plasmodium-positive patients between the different Duffy phenotypes. It is noted that there were two patient samples that we did not have their age data for. Thus, the sample size in Fy(a-b+) was different.
See this image and copyright information in PMC

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