-
Frontiers in Public Health 2023The provincial malaria diagnosis reference laboratories review and assess malaria cases diagnosed in health facilities for supporting the malaria elimination efforts and...
INTRODUCTION
The provincial malaria diagnosis reference laboratories review and assess malaria cases diagnosed in health facilities for supporting the malaria elimination efforts and preventing re-transmission of imported malaria. The study aimed to evaluate the detection capability of malaria diagnosis in China from 2014 to 2021.
METHODS
Data on malaria cases reported in the provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, Guangxi, and Zhejiang from 2014 to 2021 were collected and analyzed.
RESULTS
In total, 5,770 malaria cases were reported from 2014 to 2021, and 99.05% (5,715/5,770) were submitted to the provincial malaria diagnosis reference laboratories. The median time between malaria cases being reported and the samples being received by reference laboratories was 6 days (Interquartile range, IQR:3-12 days) from 2017 to 2021. Diagnosis of 5,680 samples in the laboratory were confirmed by provincial reference laboratories, including 3,970 cases of , 414 of , 1,055 of , 158 of , 1 of , and 82 of mixed infections. species of 5,141 confirmed cases were consistent with the initial diagnosis, with a species accuracy rate of 90.53% (5,141/5,679). The accuracy of diagnosis in health facilities was higher than that of non-falciparum species. The inconsistency between microscopy and nested polymerase chain reaction (nPCR) results of confirmatory diagnosis was mainly in malaria-positive versus malaria-negative cases, as well as in mixed versus single infection cases.
CONCLUSION
The provincial malaria diagnosis reference laboratories have played an important role in ensuring the accuracy and reliability of diagnosis in health facilities. However, the results of this study imply that capacity training for the identification of species in health facilities is warranted.
Topics: Humans; Laboratories; Reproducibility of Results; China; Malaria; Plasmodium
PubMed: 37841716
DOI: 10.3389/fpubh.2023.1243642 -
Proceedings (Baylor University. Medical... 2023is a genus of parasites that comprises different species. The species and are known to cause a vector-borne illness called malaria, and among these, is known to... (Review)
Review
is a genus of parasites that comprises different species. The species and are known to cause a vector-borne illness called malaria, and among these, is known to cause major complications. The vector, the Anopheles mosquito, is commonly found in warmer regions close to the equator, and hence transmission and numbers of cases tend to be higher in Sub-Saharan Africa, South Asia, and Central America. The number of cases of malaria in the United States has remained stable over the years with low transmission rates, and the disease is mostly seen in the population with a recent travel history to endemic regions. The main reason behind this besides the weather conditions is that economically developed countries have eliminated mosquitos. However, there have been reports of locally reported cases with in areas such as Florida and Texas in patients with no known travel history. This paper aims to familiarize US physicians with the pathophysiology, clinical features, and diagnostic modalities of malaria, as well as available treatment options.
PubMed: 37829240
DOI: 10.1080/08998280.2023.2255514 -
Health Science Reports Oct 2023Malaria is a parasitic infection primarily caused by four main species of the genus , that is, , , , and . It is transmitted through the bite of the female mosquito. It...
BACKGROUND
Malaria is a parasitic infection primarily caused by four main species of the genus , that is, , , , and . It is transmitted through the bite of the female mosquito. It holds the status of one of the leading causes of death in the developing world. Malaria is endemic to Pakistan, and the country experienced the worst floods in its history from April to October 2022. The stagnant flood water served as a breeding ground for mosquitoes, culminating in an alarming spike in malaria cases. According to the World Health Organization (WHO), the number of cases reported till August 2022 was more than in the whole year of 2021. There was more than a twofold rise in cumulative cases in 62 high-burden Pakistani Districts in August 2022 as compared to August 2021.
AIMS
This commentary aims to bring this emerging issue to notice and highlight the most effective probable measures to help eliminate and prevent the hazards the current outbreak poses.
RESULTS
Rapid planning and execution are needed to ensure the most efficient and rapid elimination of malaria. To educate the general public, the national government must start public awareness efforts in electronic, print, and social media and deploy solar-powered mobile healthcare units to far-flung areas. Prophylactic and postexposure treatments should be planned because larvicidal preventive measures are less practical in flood-affected vicinities.
CONCLUSION
The most effective preventive strategy is drug prophylaxis, followed by insecticide-treated nets, indoor residual spraying, and untreated nets. Scientists should intensify their investigations for effective medications to alleviate the malaria burden in Pakistan.
PubMed: 37822844
DOI: 10.1002/hsr2.1620 -
MedRxiv : the Preprint Server For... Sep 2023Recent data indicate that non- species may be more prevalent than previously realized in sub-Saharan Africa, the region where 95% of the world's malaria cases occur....
Recent data indicate that non- species may be more prevalent than previously realized in sub-Saharan Africa, the region where 95% of the world's malaria cases occur. Although spp., and are generally less severe than , treatment and control are more challenging, and their geographic distributions are not well characterized. In order to characterize the distribution of malaria species in Mainland Tanzania (which has a high burden and geographically heterogeneous transmission levels), we randomly selected 3,284 samples from 12,845 samples to determine presence and parasitemia of different malaria species. The samples were collected from cross-sectional surveys in 100 health facilities across ten regions and analyzed via quantitative real-time PCR to characterize regional positivity rates for each species. was most prevalent, but and were found in all regions except Dar es Salaam, with high levels (>5%) of in seven regions (70%). The highest positivity rate of was 4.5% in Mara region and eight regions (80%) had positivity rates ≥1%. We also detected three infections in the very low-transmission Kilimanjaro region. While most samples that tested positive for non-falciparum malaria were co-infected with , 23.6% (n = 13/55) of and 14.7% (n = 24/163) of spp. samples were mono-infections. 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 non-falciparum species.
PubMed: 37790396
DOI: 10.1101/2023.09.19.23295562 -
MedRxiv : the Preprint Server For... Apr 2023Increasing reports suggest that non-falciparum species are an underappreciated cause of malaria in sub-Saharan Africa, but their epidemiology is not well-defined. This...
BACKGROUND
Increasing reports suggest that non-falciparum species are an underappreciated cause of malaria in sub-Saharan Africa, but their epidemiology is not well-defined. This is particularly true in regions of high endemicity such as the Democratic Republic of Congo (DRC), where 12% of the world's malaria cases and 13% of deaths occur.
METHODS AND FINDINGS
The cumulative incidence and prevalence of and spp. infection detected by real-time PCR were estimated among children and adults within a longitudinal study conducted in seven rural, peri-urban, and urban sites from 2015-2017 in Kinshasa Province, DRC. Participants were sampled at biannual household survey visits (asymptomatic) and during routine health facility visits (symptomatic). Participant-level characteristics associated with non-falciparum infections were estimated for single- and mixed-species infections. Among 9,089 samples collected from 1,565 participants over a 3-year period, the incidence of and spp. infection was 11% (95% CI: 9%-12%) and 7% (95% CI: 5%-8%) by one year, respectively, compared to a 67% (95% CI: 64%-70%) one-year cumulative incidence of infection. Incidence continued to rise in the second year of follow-up, reaching 26% and 15% in school-age children (5-14yo) for and spp., respectively. Prevalence of spp., and infections during household visits were 3% (95% CI: 3%-4%), 1% (95% CI: 1%-2%), and 35% (95% CI: 33%-36%), respectively. Non-falciparum malaria was more prevalent in rural and peri-urban vs. urban sites, in school-age children, and among those with P. falciparum co-infection. A crude association was detected between and any anemia in the symptomatic clinic population, although this association did not hold when stratified by anemia severity. No crude associations were detected between non-falciparum infection and fever prevalence.
CONCLUSIONS
remains the primary driver of malaria morbidity and mortality in the DRC. However, non-falciparum species also pose an infection risk across sites of varying urbanicity and malaria endemicity within Kinshasa, DRC, particularly among children under 15 years of age. As interventions gain traction in high-burden settings like the DRC, continued surveillance and improved understanding of non-falciparum infections are warranted.
PubMed: 37790376
DOI: 10.1101/2023.04.20.23288826 -
Malaria Journal Oct 2023Since 2018, no indigenous human malaria cases has been reported in Malaysia. However, during the recent COVID-19 pandemic the World Health Organization is concerned that...
BACKGROUND
Since 2018, no indigenous human malaria cases has been reported in Malaysia. However, during the recent COVID-19 pandemic the World Health Organization is concerned that the pandemic might erode the success of malaria control as there are reports of increase malaria cases in resource limited countries. Little is known how the COVID-19 pandemic has impacted malaria in middle-income countries like Malaysia. Here the public health response to a Plasmodium malariae outbreak occurred in a village in Sabah state, Malaysia, during a COVID-19 movement control order is reported.
METHODS
An outbreak was declared following the detection of P. malariae in July 2020 and active case detection for malaria was performed by collecting blood samples from residents residing within 2 km radius of Moyog village. Vector prevalence and the efficacy of residual insecticides were determined. Health awareness programmes were implemented to prevent future outbreaks. A survey was conducted among villagers to understand risk behaviour and beliefs concerning malaria.
RESULTS
A total of 5254 blood samples collected from 19 villages. Among them, 19 P. malariae cases were identified, including the index case, which originated from a man who returned from Indonesia. His return from Indonesia and healthcare facilities visit coincided with the movement control order during COVID-19 pandemic when the healthcare facilities stretched its capacity and only serious cases were given priority. Despite the index case being a returnee from a malaria endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. All cases were symptomatic and uncomplicated except for a pregnant woman with severe malaria. There were no deaths; all patients recovered following treatment with artemether-lumefantrine combination therapy. Anopheles balabacensis and Anopheles barbirostris were detected in ponds, puddles and riverbeds. The survey revealed that fishing and hunting during night, and self-treatment for mild symptoms contributed to the outbreak. Despite the index case being a returnee from a malaria-endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities.
CONCLUSION
The outbreak occurred during a COVID-19 movement control order, which strained healthcare facilities, prioritizing only serious cases. Healthcare workers need to be more aware of the risk of malaria from individuals who return from malaria endemic areas. To achieve malaria elimination and prevention of disease reintroduction, new strategies that include multisectoral agencies and active community participation are essential for a more sustainable malaria control programme.
Topics: Male; Animals; Female; Humans; Malaysia; Plasmodium malariae; Antimalarials; Public Health; Pandemics; Mosquito Vectors; Plasmodium knowlesi; Artemether; Artemether, Lumefantrine Drug Combination; COVID-19; Malaria; Disease Outbreaks; Anopheles
PubMed: 37789320
DOI: 10.1186/s12936-023-04693-1 -
Tropical Medicine and Infectious Disease Sep 2023Up-to-date knowledge of key epidemiological aspects of each species is necessary for making informed decisions on targeted interventions and control strategies to...
Up-to-date knowledge of key epidemiological aspects of each species is necessary for making informed decisions on targeted interventions and control strategies to eliminate each of them. This study aims to describe the epidemiology of plasmodial species in Mali, where malaria is hyperendemic and seasonal. Data reports collected during high-transmission season over six consecutive years were analyzed to summarize malaria epidemiology. Malaria species and density were from blood smear microscopy. Data from 6870 symptomatic and 1740 asymptomatic participants were analyzed. The median age of participants was 12 years, and the sex ratio (male/female) was 0.81. Malaria prevalence from all species was 65.20% (95% CI: 60.10-69.89%) and 22.41% (CI: 16.60-28.79%) for passive and active screening, respectively. was the most prevalent species encountered in active and passive screening (59.33%, 19.31%). This prevalence was followed by (1.50%, 1.15%) and (0.32%, 0.06%). Regarding frequency, was more frequent in symptomatic individuals (96.77% vs. 93.24%, = 0.014). In contrast, was more frequent in asymptomatic individuals (5.64% vs. 2.45%, < 0.001). remained the least frequent species (less than 1%), and no was detected. The most frequent coinfections were and (0.56%). Children aged 5-9 presented the highest frequency of infections (41.91%). Non- species were primarily detected in adolescents (10-14 years) with frequencies above 50%. Only infections had parasitemias greater than 100,000 parasites per µL of blood. gametocytes were found with variable prevalence across age groups. Our data highlight that represented the first burden, but other non- species were also important. Increasing attention to and is essential if malaria elimination is to be achieved.
PubMed: 37755899
DOI: 10.3390/tropicalmed8090438 -
Malaria Journal Sep 2023The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy...
BACKGROUND
The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures.
METHODS
In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined.
RESULTS AND DISCUSSION
The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment.
CONCLUSION
Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques.
Topics: Child; Humans; Ghana; Malaria; Artemisinins; Malaria, Falciparum; Plasmodium malariae; Nucleic Acids
PubMed: 37710288
DOI: 10.1186/s12936-023-04712-1 -
Malaria Journal Aug 2023Anopheles funestus, which is considered as secondary vector of malaria in Ethiopia, is known to have several morphologically indistinguishable (sibling) species....
BACKGROUND
Anopheles funestus, which is considered as secondary vector of malaria in Ethiopia, is known to have several morphologically indistinguishable (sibling) species. Accurate identification of sibling species is crucial to understand their biology, behaviour and vector competence. In this study, molecular identification was conducted on the Ethiopian An. funestus populations. Moreover, insecticide resistance mechanism markers were detected, including ace N485I, kdr L1014F, L1014S, and CYP6P9a TaqMan qPCR was used to detect the infective stage of the parasite from field collected adult female An. funestus populations.
METHODS
Adult female mosquito collection was conducted from Lare, Gambella Regional State of Ethiopia between June 2018 to July 2020 using CDC light traps and HLC. Sub-samples of the morphologically identified An. funestus mosquitoes were molecularly identified using species-specific PCR, and the possible presence of insecticide resistance alleles was investigated using TaqMan qPCR (N485I-Ace-1), PCR-Sanger sequencing (L1014F-kdr), and PCR-RFLP (CYP6P9a resistance allele). Following head/thorax dissection, the TaqMan qPCR assay was used to investigate the presence of the infective stage Plasmodium parasite species.
RESULTS
A total of 1086 adult female An. funestus mosquitoes were collected during the study period. All sub-samples (N = 20) that were morphologically identified as An. funestus sensu lato (s.l.) were identified as An. funestus sensu stricto (s.s.) using species- specific PCR assay. The PCR-RFLP assay that detects the CYP6P9a resistance allele that confers pyrethroid resistance in An. funestus was applied in N = 30 randomly selected An. funestus s.l.
SPECIMENS
None of the specimens showed a digestion pattern consistent with the presence of the CYP6P9a resistance allele in contrast to what was observed in the positive control. Consequently, all samples were characterized as wild type. The qPCR TaqMan assay that detects the N485I acetylcholinesterase-1 mutation conferring resistance to organophosphates/carbamates in An. funestus was used in (N = 144) samples. All samples were characterized as wild type. The kdr L1014F and L1014S mutations in the VGSC gene that confer resistance to pyrethroids and DDT were analysed with direct Sanger sequencing after PCR and clean-up of the PCR products were also characterized as wild type. None of the samples (N = 169) were found positive for Plasmodium (P. falciparum/ovale/malariae/vivax) detection.
CONCLUSION
All An. funestus s.l. samples from Lare were molecularly identified as An. funestus s.s. No CYP6P9, N485I acetylcholinesterase 1, kdr L1014F or L1014S mutations were detected in the An. funestus samples. None of the An. funestus samples were positive for Plasmodium. Although the current study did not detect any insecticide resistant mechanism, it provides a reference for future vector monitoring programmes. Regular monitoring of resistance mechanisms covering wider geographical areas of Ethiopia where this vector is distributed is important for improving the efficacy of vector control programs.
Topics: Animals; Female; Anopheles; Acetylcholinesterase; Alleles; Ethiopia; Mosquito Vectors; Insecticides; Pyrethrins; Insecticide Resistance; Malaria
PubMed: 37573300
DOI: 10.1186/s12936-023-04667-3