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Malaria Journal Jan 2024Progress toward malaria elimination is increasing as many countries near zero indigenous malaria cases. In settings nearing elimination, interventions will be most... (Review)
Review
BACKGROUND
Progress toward malaria elimination is increasing as many countries near zero indigenous malaria cases. In settings nearing elimination, interventions will be most effective at interrupting transmission when targeted at the residual foci of transmission. These foci may be missed due to asymptomatic infections. To solve this problem, the World Health Organization recommends reactive case detection (RACD). This case study was conducted to identify individuals with asymptomatic malaria, their predisposing risk factors and recommend RACD in Asutsuare, Ghana based on literature review and a cross sectional study.
METHODS
The study involved a search on PubMed and Google Scholar of literature published between 1st January, 2009-14th August, 2023 using the search terms "malaria" in "Asutsuare". Furthermore, structured questionnaires were administered to one hundred individuals without symptoms of malaria and screened using rapid diagnostic test (RDT) kits, microscopy and real-time polymerase chain reaction (rt-PCR). Malaria prevalence based on the three diagnostic techniques as well as potential malaria risk factors were assessed through questionnaires in a cross-sectional study.
RESULTS
Cumulatively, sixty-four (64) studies (Google Scholar, 57 and PubMed, 7) were reviewed and 22 studies included in the literature on malaria in Asutsuare, Ghana. Significant risk factors were occupation, distance from a house to a waterbody, age group and educational level. Out of the 100 samples, 3 (3%) were positive by RDT, 6 (6%) by microscopy and 9 (9%) by rt-PCR. Ages 5-14.9 years had the highest mean malaria parasite densities of 560 parasites/µl with Plasmodium falciparum as the dominant species in 4 participants. Moreover, in the age group ≥ 15, 2 participants (1 each) harboured P. falciparum and Plasmodium malariae parasites. RDT had a higher sensitivity (76.54%; CI 66.82-85.54) than rt-PCR (33.33%; CI 4.33-77.72), while both rt-PCR and RDT were observed to have a higher specificity (92.55; CI 85.26-96.95) and (97.30; CI 93.87-99.13), respectively in the diagnosis of malaria.
CONCLUSION
In Asutsuare, Ghana, a low endemic area, the elimination of malaria may require finding individuals with asymptomatic infections. Given the low prevalence of asymptomatic individuals identified in this study and as repleted in the literature review, which favours RACD, Asutsuare is a possible setting receptive for RACD implementation.
Topics: Humans; Asymptomatic Infections; Cross-Sectional Studies; Diagnostic Tests, Routine; Ghana; Malaria; Malaria, Falciparum; Plasmodium falciparum; Prevalence; Reagent Kits, Diagnostic; Real-Time Polymerase Chain Reaction
PubMed: 38167067
DOI: 10.1186/s12936-023-04792-z -
Microbiology Spectrum Jun 2024Malaria infection remains a serious threat to human health worldwide. Rapid and accurate detection technology is crucial for preventing malaria transmission and...
UNLABELLED
Malaria infection remains a serious threat to human health worldwide. Rapid and accurate detection technology is crucial for preventing malaria transmission and minimizing damage. We aimed to establish and validate a new rapid molecular detection method for malaria, called EasyNAT Malaria Assay, targeting , , , and . The analytical performance of EasyNAT Malaria Assay was determined using positive materials. We identified 42 clinical samples as malaria positive and 95 negative samples. Each sample was examined by four methods: light microscopy, rapid diagnostic test, EasyNAT Malaria Assay, and digital PCR. Diagnostic accuracy and clinical performance were evaluated. The limit of detection (LOD) of EasyNAT Malaria was consistently 40 parasites/mL. It specifically amplified and performed with reliable repeatability and reproducibility. In 137 clinical samples, EasyNAT Malaria detected four more positive samples than microscopic examination and two more positive samples than rapid diagnostic test (RDT). One clinical sample was positive only under digital PCR. However, no significant differences statistically in sensitivity or specificity were observed. Compared with microscopy, the total, positive, and negative concordance rates of EasyNAT were 97.08%, 100%, and 95.79%, respectively. Enhanced diagnostic accuracy of EasyNAT Malaria in patients who had taken anti-malarial medication before their clinical appointment was observed. The EasyNAT Malaria Assay has good detection efficiency for clinical samples, presents a promising molecular detection tool in clinical practice, and is particularly suitable for rapid screening of high-risk populations in the emergency room.
IMPORTANCE
This study established and validated EasyNAT Malaria Assay as a promising molecular detection tool for malaria screening of high-risk populations in clinical practice. This novel isothermal amplification method may effectively facilitate the rapid diagnosis of malaria and prevent its transmission.
PubMed: 38869308
DOI: 10.1128/spectrum.00583-24 -
The American Journal of Tropical... Aug 2023Severe malaria after splenectomy has been reported with infections with Plasmodium falciparum, Plasmodium knowlesi, and Plasmodium malariae, but is less...
Severe malaria after splenectomy has been reported with infections with Plasmodium falciparum, Plasmodium knowlesi, and Plasmodium malariae, but is less well-characterized with Plasmodium vivax. We describe a case of severe P. vivax malaria with hypotension, prostration, and acute kidney injury occurring 2 months after splenectomy in Papua, Indonesia. The patient was treated successfully with intravenous artesunate.
Topics: Humans; Malaria, Vivax; Splenectomy; Malaria; Artesunate; Plasmodium vivax; Plasmodium falciparum
PubMed: 37339765
DOI: 10.4269/ajtmh.23-0147 -
The Journal of Infectious Diseases Apr 2024Recent data indicate that non-Plasmodium falciparum species may be more prevalent than thought in sub-Saharan Africa. Although Plasmodium malariae, Plasmodium ovale...
BACKGROUND
Recent data indicate that non-Plasmodium falciparum species may be more prevalent than thought in sub-Saharan Africa. Although Plasmodium malariae, Plasmodium ovale spp., and Plasmodium vivax are less severe than P. falciparum, treatment and control are more challenging, and their geographic distributions are not well characterized.
METHODS
We randomly selected 3284 of 12 845 samples collected from cross-sectional surveys in 100 health facilities across 10 regions of Mainland Tanzania and performed quantitative real-time PCR to determine presence and parasitemia of each malaria species.
RESULTS
P. falciparum was most prevalent, but P. malariae and P. ovale were found in all but 1 region, with high levels (>5%) of P. ovale in 7 regions. The highest P. malariae positivity rate was 4.5% in Mara and 8 regions had positivity rates ≥1%. We only detected 3 P. vivax infections, all in Kilimanjaro. While most nonfalciparum malaria-positive samples were coinfected with P. falciparum, 23.6% (n = 13 of 55) of P. malariae and 14.7% (n = 24 of 163) of P. ovale spp. were monoinfections.
CONCLUSIONS
P. falciparum remains by far the largest threat, but our data indicate that malaria elimination efforts in Tanzania will require increased surveillance and improved understanding of the biology of nonfalciparum species.
Topics: Humans; Tanzania; Cross-Sectional Studies; Malaria; Malaria, Falciparum; Plasmodium malariae
PubMed: 37992117
DOI: 10.1093/infdis/jiad522 -
Diagnostics (Basel, Switzerland) Mar 2024The early diagnosis of malaria is crucial to controlling morbidity and mortality. The World Health Organization (WHO) recommends diagnosing malaria either using light...
The early diagnosis of malaria is crucial to controlling morbidity and mortality. The World Health Organization (WHO) recommends diagnosing malaria either using light microscopy or a malaria rapid diagnostic test (RDT). Most RDTs use antibodies to detect two histidine-rich proteins named PfHRP2 and PfHRP3. However, false-negative results are known to occur due to the poor performance of RDTs depending on the species and the deletion of the and genes. This study evaluated new malaria RDTs for the detection of the human species. The Acro Malaria P.f./P.v./Pan Rapid Test Cassette allows the qualitative detection of parasite antigens, such as PfHRP2 specific to , PvLDH specific to , and/or panLDH genus lactate dehydrogenase, in the blood of infected individuals. This RDT was assessed against 229 samples collected from imported malaria cases, mainly from Africa. The samples were previously diagnosed using light microscopy and RDT (SD Malaria Ag P.f./Pan, SD Bioline Alere Abbott), then confirmed using real time PCR. The two RDTs were evaluated using a comparison with real time PCR as the reference method, and their performances were compared with each other. Compared to SD RDT, the Acro RDT showed a better sensitivity to (96.8% vs. 89.8%), (78.6% vs. 64.3%), (73.7% vs. 5.3%), and (20.0% vs. 0%). The respective specificities of the Acro RDT and SD RDT are 90.7% vs. 95.3% to , 100% to , and 100% vs. 100% to genus. Therefore, Acro RDT showed better performance in the identification of and low parasitaemia of . In addition, Acro RDT has the advantage of detecting PvLDH-specific antigens. The Acro Malaria RDT presents the benefits of detecting a antigen (PfHRP2) and a antigen (PvLDH) with high sensitivity (96.8% and 73.7%, respectively) and specificity (90.7% and 100%, respectively). Acro Malaria P.f./P.v./Pan rapid diagnostic tests could be effectively used in endemic areas, especially when microscopic examination cannot be performed.
PubMed: 38611637
DOI: 10.3390/diagnostics14070721 -
Parasites & Vectors Mar 2024Recent studies point to the need to incorporate the detection of non-falciparum species into malaria surveillance activities in sub-Saharan Africa, where 95% of the...
BACKGROUND
Recent studies point to the need to incorporate the detection of non-falciparum species into malaria surveillance activities in sub-Saharan Africa, where 95% of the world's malaria cases occur. Although malaria caused by infection with Plasmodium falciparum is typically more severe than malaria caused by the non-falciparum Plasmodium species P. malariae, P. ovale spp. and P. vivax, the latter may be more challenging to diagnose, treat, control and ultimately eliminate. The prevalence of non-falciparum species throughout sub-Saharan Africa is poorly defined. Tanzania has geographical heterogeneity in transmission levels but an overall high malaria burden.
METHODS
To estimate the prevalence of malaria species in Mainland Tanzania, we randomly selected 1428 samples from 6005 asymptomatic isolates collected in previous cross-sectional community surveys across four regions and analyzed these by quantitative PCR to detect and identify the Plasmodium species.
RESULTS
Plasmodium falciparum was the most prevalent species in all samples, with P. malariae and P. ovale spp. detected at a lower prevalence (< 5%) in all four regions; P. vivax was not detected in any sample.
CONCLUSIONS
The results of this study indicate that malaria elimination efforts in Tanzania will need to account for and enhance surveillance of these non-falciparum species.
Topics: Humans; Asymptomatic Infections; Cross-Sectional Studies; Malaria; Malaria, Falciparum; Malaria, Vivax; Plasmodium falciparum; Plasmodium malariae; Prevalence; Tanzania
PubMed: 38519992
DOI: 10.1186/s13071-024-06242-4 -
Genome Biology and Evolution Feb 2024Plasmodium species causing malaria in humans are not monophyletic, sharing common ancestors with nonhuman primate parasites. Plasmodium gonderi is one of the few known...
Plasmodium species causing malaria in humans are not monophyletic, sharing common ancestors with nonhuman primate parasites. Plasmodium gonderi is one of the few known Plasmodium species infecting African old-world monkeys that are not found in apes. This study reports a de novo assembled P. gonderi genome with complete chromosomes. The P. gonderi genome shares codon usage, syntenic blocks, and other characteristics with the human parasites Plasmodium ovale s.l. and Plasmodium malariae, also of African origin, and the human parasite Plasmodium vivax and species found in nonhuman primates from Southeast Asia. Using phylogenetically aware methods, newly identified syntenic blocks were found enriched with conserved metabolic genes. Regions outside those blocks harbored genes encoding proteins involved in the vertebrate host-Plasmodium relationship undergoing faster evolution. Such genome architecture may have facilitated colonizing vertebrate hosts. Phylogenomic analyses estimated the common ancestor between P. vivax and an African ape parasite P. vivax-like, within the Asian nonhuman primates parasites clade. Time estimates incorporating P. gonderi placed the P. vivax and P. vivax-like common ancestor in the late Pleistocene, a time of active migration of hominids between Africa and Asia. Thus, phylogenomic and time-tree analyses are consistent with an Asian origin for P. vivax and an introduction of P. vivax-like into Africa. Unlike other studies, time estimates for the clade with Plasmodium falciparum, the most lethal human malaria parasite, coincide with their host species radiation, African hominids. Overall, the newly assembled genome presented here has the quality to support comparative genomic investigations in Plasmodium.
Topics: Animals; Humans; Parasites; Plasmodium; Malaria; Plasmodium vivax; Plasmodium falciparum; Primates; Hominidae
PubMed: 38376987
DOI: 10.1093/gbe/evae027 -
Travel Medicine and Infectious Disease 2023
Topics: Humans; Antimalarials; Plasmodium malariae; Chloroquine; Artemisinins; Plasmodium falciparum; Malaria, Falciparum
PubMed: 38016529
DOI: 10.1016/j.tmaid.2023.102671 -
Infection, Genetics and Evolution :... Mar 2024Malaria parasites are known to infect a variety of vertebrate hosts, including ungulates. However, ungulates of Amazonia have not been investigated. We report for the...
Malaria parasites are known to infect a variety of vertebrate hosts, including ungulates. However, ungulates of Amazonia have not been investigated. We report for the first time, the presence of parasite lineages closely related to Plasmodium odocoilei clade 1 and clade 2 in free-ranging South American red-brocket deer (Mazama americana; 44.4%, 4/9) and gray-brocket deer (Mazama nemorivaga; 50.0%, 1/2). We performed PCR-based analysis of blood samples from 47 ungulates of five different species collected during subsistence hunting by an indigenous community in the Peruvian Amazon. We detected Plasmodium malariae/brasilianum lineage in a sample from red-brocket deer. However, no parasite DNA was detected in collared peccary (Pecari tajacu; 0.0%, 0/10), white-lipped peccary (Tayassu pecari; 0.0%, 0/15), and tapir (Tapirus terrestris; 0.0%, 0/11). Concordant phylogenetic analyses suggested a possible co-evolutionary relationship between the Plasmodium lineages found in American deer and their hosts.
Topics: Animals; Phylogeny; Deer; Peru; Plasmodium; Perissodactyla
PubMed: 38246398
DOI: 10.1016/j.meegid.2024.105554 -
Cureus May 2024Background In parallel with the eradication of indigenous malaria since 2005 and the certification of Morocco as a malaria-free country by the World Health Organization...
Background In parallel with the eradication of indigenous malaria since 2005 and the certification of Morocco as a malaria-free country by the World Health Organization in 2010, imported malaria cases are still being notified in Morocco. This study aims to describe the epidemiological profile and characterize the demographic, clinical, and biological profile of imported malaria cases diagnosed at the Central Laboratory of Parasitology-Mycology of the Ibn Sina University Hospital in Rabat, Morocco. Methodology This retrospective study analyzed 81 cases of imported malaria at Ibn Sina University Hospital's Central Laboratory of Parasitology-Mycology in Rabat, Morocco from January 2015 to December 2023. Patients meeting the inclusion criteria had contracted malaria in endemic regions, confirmed through parasitological evidence on blood smears. Results Among the 81 positive cases, 55 (63%) were male, resulting in a male-to-female ratio of approximately 3:1. The imported cases came from 15 countries in sub-Saharan Africa, mainly from Ivory Coast (31 patients, 31%) and Guinea (16 patients, 16%). The main clinical sign was fever (79 patients, 97.53%). The majority of patients (70 patients, 86%) suffered from anemia, while thrombocytopenia was present in 76% of patients (62 patients). was the most common species found in 77 (95%) cases and in two (2.5%) cases. However, was isolated in only one (1.23%) case. Only one case of co-infection by and (1.23%) was found. Parasitemia values due to were between 0.1% and 30%. On the other hand, those of other species did not exceed 2%. Conclusions In summary, among 81 imported malaria cases, 55 (63%) were men, imported mainly from 15 sub-Saharan African countries. was the predominant species. Fever was the most common clinical sign, accompanied by high rates of anemia and thrombocytopenia.
PubMed: 38872642
DOI: 10.7759/cureus.60253