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Malaria Journal Jan 2017Expanded malaria control efforts in Sénégal have resulted in increased use of rapid diagnostic tests (RDT) to identify the primary disease-causing Plasmodium species,...
BACKGROUND
Expanded malaria control efforts in Sénégal have resulted in increased use of rapid diagnostic tests (RDT) to identify the primary disease-causing Plasmodium species, Plasmodium falciparum. However, the type of RDT utilized in Sénégal does not detect other malaria-causing species such as Plasmodium ovale spp., Plasmodium malariae, or Plasmodium vivax. Consequently, there is a lack of information about the frequency and types of malaria infections occurring in Sénégal. This study set out to better determine whether species other than P. falciparum were evident among patients evaluated for possible malaria infection in Kédougou, Sénégal.
METHODS
Real-time polymerase chain reaction speciation assays for P. vivax, P. ovale spp., and P. malariae were developed and validated by sequencing and DNA extracted from 475 Plasmodium falciparum-specific HRP2-based RDT collected between 2013 and 2014 from a facility-based sample of symptomatic patients from two health clinics in Kédougou, a hyper-endemic region in southeastern Sénégal, were analysed.
RESULTS
Plasmodium malariae (n = 3) and P. ovale wallikeri (n = 2) were observed as co-infections with P. falciparum among patients with positive RDT results (n = 187), including one patient positive for all three species. Among 288 negative RDT samples, samples positive for P. falciparum (n = 24), P. ovale curtisi (n = 3), P. ovale wallikeri (n = 1), and P. malariae (n = 3) were identified, corresponding to a non-falciparum positivity rate of 2.5%.
CONCLUSIONS
These findings emphasize the limitations of the RDT used for malaria diagnosis and demonstrate that non-P. falciparum malaria infections occur in Sénégal. Current RDT used for routine clinical diagnosis do not necessarily provide an accurate reflection of malaria transmission in Kédougou, Sénégal, and more sensitive and specific methods are required for diagnosis and patient care, as well as surveillance and elimination activities. These findings have implications for other malaria endemic settings where species besides P. falciparum may be transmitted and overlooked by control or elimination activities.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Diagnostic Tests, Routine; Female; Humans; Infant; Malaria; Male; Middle Aged; Plasmodium malariae; Plasmodium ovale; Plasmodium vivax; Prevalence; Real-Time Polymerase Chain Reaction; Senegal; Sensitivity and Specificity; Young Adult
PubMed: 28049489
DOI: 10.1186/s12936-016-1661-3 -
MedRxiv : the Preprint Server For... Dec 2023Recent studies point to the need to incorporate non-falciparum species detection into malaria surveillance activities in sub-Saharan Africa, where 95% of malaria cases...
Recent studies point to the need to incorporate non-falciparum species detection into malaria surveillance activities in sub-Saharan Africa, where 95% of malaria cases occur. Although infection is typically more severe, diagnosis, treatment, and control for , spp., and may be more challenging. The prevalence of these species throughout sub-Saharan Africa is poorly defined. Tanzania has geographically heterogeneous transmission levels but an overall high malaria burden. In order to estimate the prevalence of malaria species in Mainland Tanzania, 1,428 samples were randomly selected from 6,005 asymptomatic isolates collected in cross-sectional community surveys across four regions and analyzed via qPCR to detect each species. was most prevalent, with and spp. detected at lower prevalence (<5%) in all four regions. was not detected. Malaria elimination efforts in Tanzania will need to account for these non-falciparum species.
PubMed: 38234751
DOI: 10.1101/2023.12.28.23300584 -
Malaria Journal Jul 2023Malaria is a major public health problem, particularly in the tropical regions of America, Africa and Asia. Plasmodium falciparum is not only the most widespread but...
BACKGROUND
Malaria is a major public health problem, particularly in the tropical regions of America, Africa and Asia. Plasmodium falciparum is not only the most widespread but also the most deadly species. The share of Plasmodium infections caused by the other species (Plasmodium ovale and Plasmodium malariae) is clearly underestimated. The objective of the study was to determine the molecular epidemiology of plasmodial infection due to P. malariae and P. ovale in Côte d'Ivoire.
METHODS
The study was cross-sectional. The study participants were recruited from Abengourou, San Pedro and Grand-Bassam. Sample collection took place from May 2015 to April 2016. Questionnaires were administered and filter paper blood samples were collected for parasite DNA extraction. The molecular analysis was carried out from February to March 2021. A nested PCR was used for species diagnosis. The data was presented in frequencies and proportions.
RESULTS
A total of 360 patients were recruited, including 179 men (49,7%) for 181 women (50,3%). The overall Plasmodium positive rate was 72.5% (261/360). The specific index was 77.4% and 1.5% for P. falciparum and P. malariae in mono-infection, respectively. There was also 15% P. falciparum and P. malariae co-infection, 3.4% P. falciparum and P. ovale co-infection and 2.3% P. falciparum, P. malariae and P. ovale triple-infection. Typing of P. ovale subspecies showed a significant predominance of P. ovale curtisi (81.2% of cases).
CONCLUSION
Plasmodium falciparum remains the most prevalent malaria species in Côte d'Ivoire, but P. malariae and P. ovale are also endemic mostly in co-infection. Malaria elimination requires a better understanding of the specific epidemiological characteristics of P. malariae and P. ovale with a particular emphasis on the identification of asymptomatic carriers.
Topics: Male; Humans; Female; Plasmodium falciparum; Cote d'Ivoire; Molecular Epidemiology; Coinfection; Cross-Sectional Studies; Prevalence; Malaria, Falciparum; Malaria; Plasmodium ovale; Plasmodium malariae
PubMed: 37468917
DOI: 10.1186/s12936-023-04639-7 -
Parasites & Vectors Jan 2022Clinical presentations of malaria in Ghana are primarily caused by infections containing microscopic densities of Plasmodium falciparum, with a minor contribution...
BACKGROUND
Clinical presentations of malaria in Ghana are primarily caused by infections containing microscopic densities of Plasmodium falciparum, with a minor contribution from Plasmodium malariae and Plasmodium ovale. However, infections containing submicroscopic parasite densities can result in clinical disease. In this study, we used PCR to determine the prevalence of three human malaria parasite species harboured by suspected malaria patients attending healthcare facilities across the country.
METHODS
Archived dried blood spots on filter paper that had been prepared from whole blood collected from 5260 patients with suspected malaria attending healthcare facilities across the country in 2018 were used as experimental material. Plasmodium species-specific PCR was performed on DNA extracted from the dried blood spots. Demographic data and microscopy data for the subset of samples tested were available from the original study on these specimens.
RESULTS
The overall frequency of P. falciparum, P. malariae and P. ovale detected by PCR was 74.9, 1.4 and 0.9%, respectively. Of the suspected symptomatic P. falciparum malaria cases, 33.5% contained submicroscopic densities of parasites. For all regions, molecular diagnosis of P. falciparum, P. malariae and P. ovale was significantly higher than diagnosis using microscopy: up to 98.7% (75/76) of P. malariae and 97.8% (45/46) of P. ovale infections detected by PCR were missed by microscopy.
CONCLUSION
Plasmodium malariae and P. ovale contributed to clinical malaria infections, with children aged between 5 and 15 years harbouring a higher frequency of P. falciparum and P. ovale, whilst P. malariae was more predominant in individuals aged between 10 and 20 years. More sensitive point-of-care tools are needed to detect the presence of low-density (submicroscopic) Plasmodium infections, which may be responsible for symptomatic infections.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cross-Sectional Studies; Dried Blood Spot Testing; Female; Ghana; Humans; Infant; Malaria; Male; Middle Aged; Molecular Epidemiology; Plasmodium; Young Adult
PubMed: 35090545
DOI: 10.1186/s13071-022-05153-6 -
Malaria Journal Apr 2021Plasmodium knowlesi is recognized as the fifth Plasmodium species causing malaria in humans. It is morphologically similar to the human malaria parasite Plasmodium...
BACKGROUND
Plasmodium knowlesi is recognized as the fifth Plasmodium species causing malaria in humans. It is morphologically similar to the human malaria parasite Plasmodium malariae, so molecular detection should be used to clearly discriminate between these Plasmodium species. This study aimed to quantify the rate at which P. knowlesi is misidentified as P. malariae by microscopy in endemic and non-endemic areas.
METHODS
The protocol of this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID = CRD42020204770). Studies reporting the misidentification of P. knowlesi as P. malariae by microscopy and confirmation of this by molecular methods in MEDLINE, Web of Science and Scopus were reviewed. The risk of bias in the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). The pooled prevalence and 95% confidence interval (CI) of the misidentification of P. knowlesi as P. malariae by microscopy were estimated using a random effects model. Subgroup analysis of the study sites was performed to demonstrate any differences in the misidentification rates in different areas. Heterogeneity across the included studies was assessed and quantified using Cochran's Q and I statistics, respectively. Publication bias in the included studies was assessed using the funnel plot, Egger's test and contour-enhanced funnel plot.
RESULTS
Among 375 reviewed studies, 11 studies with a total of 1569 confirmed P. knowlesi cases in humans were included. Overall, the pooled prevalence of the misidentification of P. knowlesi as P. malariae by microscopy was estimated at 57% (95% CI 37-77%, I: 99.3%). Subgroup analysis demonstrated the highest rate of misidentification in Sawarak, Malaysia (87%, 95% CI 83-90%, I: 95%), followed by Sabah, Malaysia (85%, 95% CI 79-92%, I: 85.1%), Indonesia (16%, 95% CI 6-38%), and then Thailand (4%, 95% CI 2-9%, I: 95%).
CONCLUSION
Although the World Health Organization (WHO) recommends that all P. malariae-positive diagnoses made by microscopy in P. knowlesi endemic areas be reported as P. malariae/P. knowlesi malaria, the possibility of microscopists misidentifying P. knowlesi as P. malariae is a diagnostic challenge. The use of molecular techniques in cases with malariae-like Plasmodium with high parasite density as determined by microscopy could help identify human P. knowlesi cases in non-endemic countries.
Topics: Humans; Malaria; Microscopy; Plasmodium knowlesi; Plasmodium malariae; Prevalence
PubMed: 33836773
DOI: 10.1186/s12936-021-03714-1 -
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 -
International Journal For Parasitology Oct 2016Malaria in humans is caused by six species of Plasmodium parasites, of which the nuclear genome sequences for the two Plasmodium ovale spp., P. ovale curtisi and P.... (Comparative Study)
Comparative Study
Malaria in humans is caused by six species of Plasmodium parasites, of which the nuclear genome sequences for the two Plasmodium ovale spp., P. ovale curtisi and P. ovale wallikeri, and Plasmodium malariae have not yet been analyzed. Here we present an analysis of the nuclear genome sequences of these three parasites, and describe gene family expansions therein. Plasmodium ovale curtisi and P. ovale wallikeri are genetically distinct but morphologically indistinguishable and have sympatric ranges through the tropics of Africa, Asia and Oceania. Both P. ovale spp. show expansion of the surfin variant gene family, and an amplification of the Plasmodium interspersed repeat (pir) superfamily which results in an approximately 30% increase in genome size. For comparison, we have also analyzed the draft nuclear genome of P. malariae, a malaria parasite causing mild malaria symptoms with a quartan life cycle, long-term chronic infections, and wide geographic distribution. Plasmodium malariae shows only a moderate level of expansion of pir genes, and unique expansions of a highly diverged transmembrane protein family with over 550 members and the gamete P25/27 gene family. The observed diversity in the P. ovale wallikeri and P. ovale curtisi surface antigens, combined with their phylogenetic separation, supports consideration that the two parasites be given species status.
Topics: Adult; Africa, Western; Animals; Antigens, Protozoan; Antigens, Surface; China; Chromobox Protein Homolog 5; Genetic Variation; Genome, Protozoan; Humans; Interspersed Repetitive Sequences; Male; Membrane Proteins; Multigene Family; Phylogeny; Plasmodium falciparum; Plasmodium knowlesi; Plasmodium malariae; Plasmodium ovale; Plasmodium vivax; Young Adult
PubMed: 27392654
DOI: 10.1016/j.ijpara.2016.05.009 -
Malaria Journal Mar 2019The Belgian Reference Laboratory for Plasmodium offers a free-of-charge reference testing of malaria-positive or doubtful samples to clinical laboratories.
BACKGROUND
The Belgian Reference Laboratory for Plasmodium offers a free-of-charge reference testing of malaria-positive or doubtful samples to clinical laboratories.
METHODS
The final malaria diagnosis from the Reference Laboratory (microscopy, rapid diagnostic tests (RDTs) and Plasmodium species-specific PCR) were compared with the final diagnosis from peripheral Belgian laboratories. The Reference Laboratory reports were analysed for all samples submitted between 2013 and 2017. Criteria assessed included the diagnosis of malaria, Plasmodium species identification including mixed infections, and in case of Plasmodium falciparum, the parasite density and the presence of sexual and asexual stages.
RESULTS
A total of 947 non-duplicate samples were included. Reference testing confirmed 96.3% (893/927) and 90.0% (18/20) samples submitted as positive and negative, respectively, the two missed diagnoses were samples with Plasmodium ovale and Plasmodium malariae. Submitting laboratories had correctly identified P. falciparum in 95.1% (508/534) samples with P. falciparum single infection. They had correctly diagnosed the species in 62.9% (95/151) single non-falciparum samples and had reported 'non-falciparum' in another 26 (17.2%) samples; most errors occurred among P. malariae (n = 8/21, 38.1%) and P. ovale (n = 14/51, 27.5%). Only one of the 21 mixed Plasmodium species infections had been diagnosed as such by the submitting laboratories; in three of them, P. falciparum had been overlooked. Taken single and mixed infections together, P. falciparum was diagnosed in 98.6% (546/554) samples. Among 471 single P. falciparum samples available for comparison, laboratories had correctly reported parasite densities above 2% in 87.5% (70/80) samples; they had incorrectly reported parasite densities > 2% in an extra 52 (8.9%) samples. Laboratories had correctly reported P. falciparum schizonts and gametocytes in 25.6% (11/43) and 56.7% (17/30) samples, respectively.
CONCLUSION
Diagnostic laboratories in a malaria non-endemic setting provided excellent diagnosis of malaria and P. falciparum, reasonably good diagnosis of non-falciparum infections and acceptable calculation of P. falciparum parasite density.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Belgium; Child; Child, Preschool; Clinical Laboratory Techniques; Female; Humans; Infant; Laboratory Proficiency Testing; Malaria; Male; Middle Aged; Parasite Load; Plasmodium; Young Adult
PubMed: 30922316
DOI: 10.1186/s12936-019-2731-0 -
Tropical Biomedicine Dec 2009Light microscopy, the mainstay of malaria diagnosis in epidemiologic studies, exhibits limited sensitivity for detecting low level infections and often under-estimates...
Light microscopy, the mainstay of malaria diagnosis in epidemiologic studies, exhibits limited sensitivity for detecting low level infections and often under-estimates the frequency of mixed Plasmodium species infections. To overcome these shortcomings we performed the PCR method for detection and identification of Plasmodium species in blood specimens from 242 individuals collected during the peak season of malaria incidence (July-October). Malaria prevalence was 81.4% and 43.4% by PCR and microscopy respectively. Moreover, while PCR detected Plasmodium malariae DNA in 108 (44.6%), microscopic examination detected only 20 (8.3%) individuals parasitized with this species. Further data analysis revealed an independent random distribution pattern of parasites irrespective of age groups (0-5 yrs, chi-square7df=2.77, P>0.95; 6-15 yrs, chi-square7df=4.82, P>0.50; >15 yrs, chi-square7df=4.4, P>0.70) and sexes (for male chi-square7df=2.48, P>0.95; for female, chi-square7df=1.85, P>0.95). However, although the parasite distribution is random irrespective of sex, females had more P. malariae infections (P=0.004, OR=2.312, 95% CI=1.3-4.1). Our study demonstrates that the parasite distribution in Orissa is random with substantially higher prevalence of P.malariae than previously suspected and this may be seasonal. A study of the bionomics of vector(s) responsible for P. malariae transmission in Orissa is needed to provide information for the control of malaria in the state.
Topics: Adolescent; Age Factors; Child; Child, Preschool; Cross-Sectional Studies; DNA, Protozoan; Female; Humans; Incidence; India; Infant; Malaria; Male; Parasitemia; Plasmodium malariae; Polymerase Chain Reaction; Prevalence; Sex Factors; Species Specificity
PubMed: 20237447
DOI: No ID Found -
Parasitology International Feb 2014Animal models of malaria, mainly mice, have made a large contribution to our knowledge of host-pathogen interactions and immune responses, and to drug and vaccine... (Review)
Review
Animal models of malaria, mainly mice, have made a large contribution to our knowledge of host-pathogen interactions and immune responses, and to drug and vaccine design. Non-human primate (NHP) models for malaria are admittedly under-used, although they are probably closer models than mice for human malaria; in particular, NHP models allow the use of human pathogens (Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium knowlesi). NHPs, whether natural hosts or experimentally challenged with a simian Plasmodium, can also serve as robust pre-clinical models. Some simian parasites are closely related to a human counterpart, with which they may share a common ancestor, and display similar major features with the human infection and pathology. NHP models allow longitudinal studies, from the early events following sporozoite inoculation to the later events, including analysis of organs and tissues, particularly liver, spleen, brain and bone marrow. NHP models have one other significant advantage over mouse models: NHPs are our closest relatives and thus their biology is very similar to ours. Recently developed in vivo imaging tools have provided insight into malaria parasite infection and disease in mouse models. One advantage of these tools is that they limit the need for invasive procedures, such as tissue biopsies. Many such technologies are now available for NHP studies and provide new opportunities for elucidating host/parasite interactions. The aim of this review is to bring the malaria community up to date on what is currently possible and what soon will be, in terms of in vivo imaging in NHP models of malaria, to consider the pros and the cons of the various techniques, and to identify challenges.
Topics: Animals; Diagnostic Imaging; Disease Models, Animal; Humans; Malaria; Primates
PubMed: 24042056
DOI: 10.1016/j.parint.2013.09.001