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. 2021 Sep 21;13(9):1887. doi: 10.3390/v13091887

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© 2021 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Plasmodium falciparum incidence (a), Plasmodium vivax incidence (b), Duffy negativity phenotype frequency (c), Duffy negativity phenotype frequency and Plasmodium vivax incidence overlay (d), Effective treatment with an antimalarial drug (e), and Artemisinin-based combination therapy (ACT) coverage (f). Source: Malaria Atlas Project, https://malariaatlas.org/explorer/#/ accessed on 5 July 2021. Note: high incidence regions of the two major plasmodium species, Plasmodium falciparum and Plasmodium vivax, partially overlap; however, they show large discrepancies in sub-Saharan Africa despite similar climatic needs. This may be considered a consequence of the high level of Duffy negativity in the sub-Saharan African population, which serves as the entry receptor for Plasmodium vivax into erythrocytes, whereas Plasmodium falciparum uses multiple entry receptors. Among the countries with effective treatment with anti-malaria drugs, only Africa has high ACT coverage.