Molecular Evidence of Malaria and Zoonotic Diseases Among Rapid Diagnostic Test-Negative Febrile Patients in Low-Transmission Season, Mali

From November to December 2012 in Sélingué-Mali, blood samples from 88 febrile patients who tested negative by malaria Paracheck®rapid diagnostic tests (RDTs) were used to assess the presence of sub-RDTPlasmodium falciparumas well asBorrelia,Coxiella burnetii, andBabesiaapplying molecular tools.Plasmodiumsp. was present among 57 (60.2%) of the 88 malaria RDT-negative patients, whereas the prevalence ofBorrelia,C. burnetii, andBabesiawere 3.4% (N= 3), 1.1% (N= 1), and 0.0%, respectively. The additional diagnostic use of polymerase chain reaction (PCR) identified a high proportion ofPlasmodiumsp.-positive samples and although this may be a concern for malaria control, the respective PCR-identified malaria infections were less likely responsible for the observed fevers given the low parasite density. Also, the low infection levels ofBorreliaandC. burnetiiand lack ofBabesiaamong the febrile patients call for further studies to assess the causes of fever among malaria RDT-negative patients in Sélingué.