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Jeyaprakasam NK, Phang WK, Shahari S, Vythilingam I. Plasmodium cynomolgi: potential emergence of new zoonotic malaria in Southeast Asia. Parasit Vectors 2025; 18:151. [PMID: 40270022 PMCID: PMC12020267 DOI: 10.1186/s13071-025-06784-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Accepted: 03/28/2025] [Indexed: 04/25/2025] Open
Abstract
The reported cases of Plasmodium cynomolgi in Southeast Asia pose a significant public health concern. Sporadic reports of human Plasmodium cynomolgi infections have increased in the past few years, raising attention regarding its potential impact on human populations. Further compounding this issue are the morphological similarities between P. cynomolgi and the human malaria parasite Plasmodium vivax, which may lead to misdiagnosis and underreporting of P. cynomolgi infections. Both in vitro and in vivo studies have shown that P. cynomolgi can effectively invade human reticulocytes using mechanisms like those employed by P. vivax, underscoring its capacity to infect human hosts if given the opportunity. These studies collectively highlight the parasite's potential to establish infections in humans and emphasize the need for molecular diagnostic tools to accurately detect P. cynomolgi. Additionally, challenges in accurate diagnosis and surveillance systems may underestimate the true extent of their impact, making it imperative for healthcare authorities to bolster monitoring efforts and deploy targeted interventions. Strengthening surveillance, improving diagnostic capabilities, and developing targeted vector control strategies are crucial to mitigating the risk of P. cynomolgi becoming a major zoonotic disease like its counterpart, Plasmodium knowlesi. Thus, this review aims to highlight the current understanding of P. cynomolgi infections in human, vector, and macaque hosts based on collated data from previous studies while underscoring the urgent need for enhanced surveillance, accurate diagnostic tools, and effective vector control strategies to mitigate its potential as a significant zoonotic threat in Southeast Asia.
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Affiliation(s)
- Nantha Kumar Jeyaprakasam
- Biomedical Science Programme, Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Wei Kit Phang
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shahhaziq Shahari
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Soulama A, Sogore F, Ansah F, Diakite O, Chirawurah JD, Maiga FO, Maiga M, Danwonno HA, Campo B, Djimde AA, Awandare GA, Amenga-Etego LN, Dembele L, Aniweh Y. Differential ex vivo susceptibility of Plasmodium malariae and Plasmodium falciparum clinical isolates from Ghana and Mali to current and lead discovery candidate antimalarial drugs. Microbiol Spectr 2025; 13:e0217624. [PMID: 40062863 PMCID: PMC11960124 DOI: 10.1128/spectrum.02176-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 02/09/2025] [Indexed: 04/03/2025] Open
Abstract
Non-falciparum species causing malaria in humans are considered neglected in the fight toward malaria elimination. Recent data highlight the increasing contribution of Plasmodium malariae to malaria morbidity and mortality. In this study, the susceptibility of P. malariae and Plasmodium falciparum to current antimalarial drugs was compared to advanced lead candidate drugs using field isolates. The blood samples were collected from the Central region of Ghana and Faladje and Kati in Mali. Following this, an ex vivo drug efficacy assay was conducted by screening mono-infected isolates against a panel of antimalarials. In Ghana, the susceptibility of the two species to most of the current antimalarial drugs was comparable, except for artemether, sulfadoxine, and atovaquone, for which the drugs were less potent against P. malariae than P. falciparum (7.12 vs 2.15 nM, 25.72 vs 7.86 nM, and 10.38 vs 2.51 nM, respectively). In Mali, quinine was significantly more potent against P. malariae than P. falciparum (18.35 and 26.84 nM), and tafenoquine was less potent against P. malariae than P. falciparum (5.50 and 2.85 nM). Among the candidate drugs, except INE963, whose inhibitory potency was comparable between both species, the other compounds significantly inhibited P. malariae more than P. falciparum. The data showed that current drugs investigated against the isolates from Ghana may be suitable for curing P. malariae infections. However, in Mali, chloroquine resistance appeared to have affected the suitability of quinine-based compounds for non-falciparum malaria treatment. Therefore, additional studies are required to establish the efficacy of artemether-lumefantrine for the treatment of P. malariae infections. IMPORTANCE One major hurdle to research in the community is our inability to have continuous culture for parasites such as Plasmodium malariae and Plasmodium ovale. These two are common in the West African region and co-occur with Plasmodium falciparum in driving both clinical or asymptomatic infections as either mono-infections or mixed infections. This manuscript is a buildup of our efforts at using ex vivo methods to study the susceptibility of P. malariae and P. falciparum to conventional and lead compounds, comparing the isolates from Ghana and Mali. This is necessary to facilitate drug discovery efforts in combating malaria holistically. The community will greatly see this work as a step in the right direction, stimulating more research into these other parasites causing malaria.
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Affiliation(s)
- Alamissa Soulama
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Fanta Sogore
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Ousmaila Diakite
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Jersley D. Chirawurah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Fatoumata O. Maiga
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Mohamed Maiga
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Harry A. Danwonno
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Brice Campo
- Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | - Abdoulaye A. Djimde
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Gordon A. Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Lucas N. Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Laurent Dembele
- Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Malaria Research and Training Centre (MRTC), Bamako, Mali
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
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Murdiyarso LS, Rajahram GS, Tan AF, Piera KA, William T, Oyong DA, Sakam SSB, Jelip J, Dony J, Jantim A, Teo R, Manah AM, Barber BE, Anstey NM, Grigg MJ. Plasmodium cynomolgi Infections Not Found in Microscopy-Diagnosed Malaria Cases across Sabah, Malaysia. Am J Trop Med Hyg 2025; 112:85-88. [PMID: 39531730 PMCID: PMC11720798 DOI: 10.4269/ajtmh.24-0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/02/2024] [Indexed: 11/16/2024] Open
Abstract
Zoonotic malaria presents a major public health challenge in Southeast Asia. Plasmodium cynomolgi coinfects the same macaque hosts and mosquito vectors as the most common cause of zoonotic malaria, Plasmodium knowlesi. Plasmodium cynomolgi appears morphologically similar to Plasmodium vivax on microscopy and can amplify P. vivax polymerase chain reaction (PCR) assays, confounding transmission estimates. We screened 2,103 samples for P. cynomolgi across all 26 districts in Sabah, Malaysia, from 2010 to 2021. Samples comprised 1,425 P. knowlesi, 256 P. vivax, 293 P. falciparum, and 31 Plasmodium malariae PCR-confirmed malaria cases and 100 malaria microscopy-positive and species-specific PCR-negative samples. A nested PCR assay targeting P. cynomolgi-specific 18S small subunit ribosomal ribonucleic acid with a detection limit of ∼2 parasites/µL was conducted on whole blood samples. No P. cynomolgi infections were detected. Symptomatic P. cynomolgi co-infections appear rare in Malaysia, although prevalence may be underestimated owing to the absence of routine molecular screening and the sensitivity of available assays.
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Affiliation(s)
- Lydia S. Murdiyarso
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Giri S. Rajahram
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Malaysia
- Queen Elizabeth Hospital II, Kota Kinabalu, Malaysia
| | - Angelica F. Tan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Kim A. Piera
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Timothy William
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Malaysia
| | | | - Sitti Saimah Binti Sakam
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Jenarun Jelip
- Vector Borne Disease Sector, Ministry of Health, Putrajaya, Malaysia
| | - Jiloris Dony
- Kota Kinabalu Public Health Laboratory, Ministry of Health, Kota Kinabalu, Malaysia
| | - Anisah Jantim
- Kota Kinabalu Public Health Laboratory, Ministry of Health, Kota Kinabalu, Malaysia
| | - Roddy Teo
- Public Health Research Section, Sabah State Department of Health, Kota Kinabalu, Malaysia
| | - Abdul Marsudi Manah
- Vector Borne Disease Unit, Sabah State Department of Health, Kota Kinabalu, Malaysia
| | - Bridget E. Barber
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Nicholas M. Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Matthew J. Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Disease Society Kota Kinabalu Sabah – Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
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Vythilingam I, Jeyaprakasam NK. Deforestation and non-human primate malarias will be a threat to malaria elimination in the future: Insights from Southeast Asia. Acta Trop 2024; 257:107280. [PMID: 38908421 DOI: 10.1016/j.actatropica.2024.107280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/24/2024]
Abstract
Malaria continues to be a global public health problem although it has been eliminated from many countries. Sri Lanka and China are two countries that recently achieved malaria elimination status, and many countries in Southeast Asia are currently in the pipeline for achieving the same goal by 2030. However, Plasmodium knowlesi, a non-human primate malaria parasite continues to pose a threat to public health in this region, infecting many humans in all countries in Southeast Asia except for Timor-Leste. Besides, other non-human primate malaria parasite such as Plasmodium cynomolgi and Plasmodium inui are infecting humans in the region. The non-human primates, the long-tailed and pig-tailed macaques which harbour these parasites are now increasingly prevalent in farms and forest fringes close by to the villages. Additionally, the Anopheles mosquitoes belonging to the Lecuosphyrus Group are also present in these areas which makes them ideal for transmitting the non-human primate malaria parasites. With changing landscape and deforestation, non-human primate malaria parasites will affect more humans in the coming years with the elimination of human malaria. Perhaps due to loss of immunity, more humans will be infected as currently being demonstrated in Malaysia. Thus, control measures need to be instituted rapidly to achieve the malaria elimination status by 2030. However, the zoonotic origin of the parasite and the changes of the vectors behaviour to early biting seems to be the stumbling block to the malaria elimination efforts in this region. In this review, we discuss the challenges faced in malaria elimination due to deforestation and the serious threat posed by non-human primate malaria parasites.
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Affiliation(s)
- Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Nantha Kumar Jeyaprakasam
- Biomedical Science Program, Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Muh F, Erwina A, Fitriana F, Syahada JH, Cahya AD, Choe S, Jun H, Garjito TA, Siregar JE, Han JH. Plasmodium cynomolgi: What Should We Know? Microorganisms 2024; 12:1607. [PMID: 39203449 PMCID: PMC11356028 DOI: 10.3390/microorganisms12081607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 09/03/2024] Open
Abstract
Even though malaria has markedly reduced its global burden, it remains a serious threat to people living in or visiting malaria-endemic areas. The six Plasmodium species (Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale curtisi, Plasmodium ovale wallikeri and Plasmodium knowlesi) are known to associate with human malaria by the Anopheles mosquito. Highlighting the dynamic nature of malaria transmission, the simian malaria parasite Plasmodium cynomolgi has recently been transferred to humans. The first human natural infection case of P. cynomolgi was confirmed in 2011, and the number of cases is gradually increasing. It is assumed that it was probably misdiagnosed as P. vivax in the past due to its similar morphological features and genome sequences. Comprehensive perspectives that encompass the relationships within the natural environment, including parasites, vectors, humans, and reservoir hosts (macaques), are required to understand this zoonotic malaria and prevent potential unknown risks to human health.
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Affiliation(s)
- Fauzi Muh
- Department of Epidemiology and Tropical Diseases, Faculty of Public Health, Universitas Diponegoro, Semarang 50275, Indonesia; (F.M.); (A.E.); (F.F.); (J.H.S.)
| | - Ariesta Erwina
- Department of Epidemiology and Tropical Diseases, Faculty of Public Health, Universitas Diponegoro, Semarang 50275, Indonesia; (F.M.); (A.E.); (F.F.); (J.H.S.)
| | - Fadhila Fitriana
- Department of Epidemiology and Tropical Diseases, Faculty of Public Health, Universitas Diponegoro, Semarang 50275, Indonesia; (F.M.); (A.E.); (F.F.); (J.H.S.)
| | - Jadidan Hada Syahada
- Department of Epidemiology and Tropical Diseases, Faculty of Public Health, Universitas Diponegoro, Semarang 50275, Indonesia; (F.M.); (A.E.); (F.F.); (J.H.S.)
| | - Angga Dwi Cahya
- Department of Environmental Health, Faculty of Public Health, Universitas Diponegoro, Semarang 50275, Indonesia;
| | - Seongjun Choe
- Department of Parasitology, School of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea;
| | - Hojong Jun
- Department of Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea;
| | - Triwibowo Ambar Garjito
- Vector-Borne and Zoonotic Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency Indonesia, Salatiga 50721, Indonesia;
| | - Josephine Elizabeth Siregar
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Jalan Raya Bogor Km. 46, Cibinong, Bogor 16911, Indonesia;
| | - Jin-Hee Han
- Department of Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea;
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Lai MY, Abdullah ML, Lau YL. Real-time fluorescence loop-mediated isothermal amplification assays for detection of zoonotic malaria Plasmodium parasites. Acta Trop 2024; 255:107249. [PMID: 38740319 DOI: 10.1016/j.actatropica.2024.107249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Natural human infections by Plasmodium cynomolgi and P. inui have been reported recently and gain the substantial attention from Southeast Asian countries. Zoonotic transmission of non-human malaria parasites to humans from macaque monkeys occurred through the bites of the infected mosquitoes. The objective of this study is to establish real-time fluorescence loop-mediated isothermal amplification (LAMP) assays for the detection of zoonotic malaria parasites by combining real-time fluorescent technology with the isothermal amplification technique. METHODS By using 18S rRNA as the target gene, the primers for P. cynomolgi, P. coatneyi and P. inui were newly designed in the present study. Four novel real-time fluorescence LAMP assays were developed for the detection of P. cynomolgi, P. coatneyi, P. inui and P. knowlesi. The entire amplification process was completed in 60 min, with the assays performed at 65 °C. By using SYTO-9 as the nucleic acid intercalating dye, the reaction was monitored via real-time fluorescence signal. RESULTS There was no observed cross-reactivity among the primers from different species. All 70 field-collected monkey samples were successfully amplified by real-time fluorescence LAMP assays. The detection limit for P. cynomolgi, P. coatneyi and P. knowlesi was 5 × 109 copies/µL. Meanwhile, the detection limit of P. inui was 5 × 1010 copies/µL. CONCLUSION This is the first report of the detection of four zoonotic malaria parasites by real-time fluorescence LAMP approaches. It is an effective, rapid and simple-to-use technique. This presented platform exhibits considerable potential as an alternative detection for zoonotic malaria parasites.
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Affiliation(s)
- Meng Yee Lai
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohd Lutfi Abdullah
- National Wildlife Forensic Laboratory, Ex-Situ Conservation Division Department of Wildlife and National Parks Peninsular Malaysia, Jalan Cheras, 56100 Kuala Lumpur, Malaysia
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.
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Sánchez KL, Baird JK, Nielsen A, Nurillah A, Agustina F, Komara, Fadilah F, Prameswari W, Nugraha RTP, Saputra S, Nurkanto A, Dharmayanthi AB, Pratama R, Exploitasia I, Greenwood AD. Naturally acquired immunity to Plasmodium pitheci in Bornean orangutans ( Pongo pygmaeus). Parasitology 2024; 151:380-389. [PMID: 38361461 PMCID: PMC11044065 DOI: 10.1017/s0031182024000155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 01/17/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
Naturally acquired immunity to the different types of malaria in humans occurs in areas of endemic transmission and results in asymptomatic infection of peripheral blood. The current study examined the possibility of naturally acquired immunity in Bornean orangutans, Pongo pygmaeus, exposed to endemic Plasmodium pitheci malaria. A total of 2140 peripheral blood samples were collected between January 2017 and December 2022 from a cohort of 135 orangutans housed at a natural forested Rescue and Rehabilitation Centre in West Kalimantan, Indonesia. Each individual was observed for an average of 4.3 years during the study period. Blood samples were examined by microscopy and polymerase chain reaction for the presence of plasmodial parasites. Infection rates and parasitaemia levels were measured among age groups and all 20 documented clinical malaria cases were reviewed to estimate the incidence of illness and risk ratios among age groups. A case group of all 17 individuals that had experienced clinical malaria and a control group of 34 individuals having an event of >2000 parasites μL−1 blood but with no outward or clinical sign of illness were studied. Immature orangutans had higher-grade and more frequent parasitaemia events, but mature individuals were more likely to suffer from clinical malaria than juveniles. The case orangutans having patent clinical malaria were 256 times more likely to have had no parasitaemia event in the prior year relative to asymptomatic control orangutans. The findings are consistent with rapidly acquired immunity to P. pitheci illness among orangutans that wanes without re-exposure to the pathogen.
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Affiliation(s)
- Karmele Llano Sánchez
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
- International Animal Rescue, Uckfield, UK
- School of Veterinary Medicine, Freie Universität, Berlin, Germany
| | - John Kevin Baird
- Oxford University Clinical Research Unit-Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Aileen Nielsen
- Center for Law and Economics, ETH Zurich, Zurich, Switzerland
| | - Andini Nurillah
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
| | - Fitria Agustina
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
| | - Komara
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
| | - Fina Fadilah
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
| | - Wendi Prameswari
- IAR Indonesia Foundation, Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Sinarwangi, Bogor, West Java, Indonesia
| | | | - Sugiyono Saputra
- Research Center for Applied Zoology, National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Arif Nurkanto
- Research Center for Biosystematics and Evolution, National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Anik Budhi Dharmayanthi
- Research Center for Biosystematics and Evolution, National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Rahadian Pratama
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Indra Exploitasia
- Biodiversity Conservation Directorate of the General Director of Natural Resources and Ecosystem Conservation, Ministry of Environment and Forestry of the Republic of Indonesia, Jakarta, Indonesia
| | - Alex D. Greenwood
- School of Veterinary Medicine, Freie Universität, Berlin, Germany
- Department of Wildlife Diseases, Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
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8
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Shahari S, Bin Abdullah ML, Binti Isman Rohimly AA, Binti Ashrat N, Amir A, Atroosh WMM, Fong MY, Lau YL. The prevalence of simian malaria in wild long-tailed macaques throughout Peninsular Malaysia. Sci Rep 2024; 14:6023. [PMID: 38472278 PMCID: PMC10933401 DOI: 10.1038/s41598-024-54981-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The parasite Plasmodium knowlesi has been the sole cause of malaria in Malaysia from 2018 to 2022. The persistence of this zoonotic species has hampered Malaysia's progress towards achieving the malaria-free status awarded by the World Health Organisation (WHO). Due to the zoonotic nature of P. knowlesi infections, it is important to study the prevalence of the parasite in the macaque host, the long-tailed macaque (Macaca fascicularis). Apart from P. knowlesi, the long-tailed macaque is also able to harbour Plasmodium cynomolgi, Plasmodium inui, Plasmodium caotneyi and Plasmodium fieldi. Here we report the prevalence of the 5 simian malaria parasites in the wild long-tailed macaque population in 12 out of the 13 states in Peninsular Malaysia using a nested PCR approach targeting the 18s ribosomal RNA (18s rRNA) gene. It was found that all five Plasmodium species were widely distributed throughout Peninsular Malaysia except for states with major cities such as Kuala Lumpur and Putrajaya. Of note, Pahang reported a malaria prevalence of 100% in the long-tailed macaque population, identifying it as a potential hotspot for zoonotic transmission. Overall, this study shows the distribution of the 5 simian malaria parasite species throughout Peninsular Malaysia, the data of which could be used to guide future malaria control interventions to target zoonotic malaria.
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Affiliation(s)
- Shahhaziq Shahari
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohd Lutfi Bin Abdullah
- National Wildlife Forensic Laboratory, Ex-Situ Conservation Division, Department of Wildlife and National Parks Peninsular Malaysia, 56100, Kuala Lumpur, Malaysia
| | - Anis Adlina Binti Isman Rohimly
- National Wildlife Forensic Laboratory, Ex-Situ Conservation Division, Department of Wildlife and National Parks Peninsular Malaysia, 56100, Kuala Lumpur, Malaysia
| | - Norsharina Binti Ashrat
- National Wildlife Forensic Laboratory, Ex-Situ Conservation Division, Department of Wildlife and National Parks Peninsular Malaysia, 56100, Kuala Lumpur, Malaysia
| | - Amirah Amir
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Mun Yik Fong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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9
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Latif ENM, Noordin NR, Shahari S, Amir A, Lau YL, Cheong FW, Abdullah ML, Fong MY. Genetic polymorphism and clustering of the Plasmodium cynomolgi Duffy binding protein 1 region II of recent macaque isolates from Peninsular Malaysia. Parasitol Res 2024; 123:105. [PMID: 38240877 DOI: 10.1007/s00436-024-08125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
Plasmodium cynomolgi is a simian malaria parasite that has been increasingly infecting humans. It is naturally present in the long-tailed and pig-tailed macaques in Southeast Asia. The P. cynomolgi Duffy binding protein 1 region II [PcDBP1(II)] plays an essential role in the invasion of the parasite into host erythrocytes. This study investigated the genetic polymorphism, natural selection and haplotype clustering of PcDBP1(II) from wild macaque isolates in Peninsular Malaysia. The genomic DNA of 50 P. cynomolgi isolates was extracted from the macaque blood samples. Their PcDBP1(II) gene was amplified using a semi-nested PCR, cloned into a plasmid vector and subsequently sequenced. The polymorphism, natural selection and haplotypes of PcDBP1(II) were analysed using MEGA X and DnaSP ver.6.12.03 programmes. The analyses revealed high genetic polymorphism of PcDBP1(II) (π = 0.026 ± 0.004; Hd = 0.996 ± 0.001), and it was under purifying (negative) selection. A total of 106 haplotypes of PcDBP1(II) were identified. Phylogenetic and haplotype analyses revealed two groups of PcDBP1(II). Amino acid length polymorphism was observed between the groups, which may lead to possible phenotypic difference between them.
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Affiliation(s)
| | - Naqib Rafieqin Noordin
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahhaziq Shahari
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amirah Amir
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yee-Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Fei-Wen Cheong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Lutfi Abdullah
- National Wildlife Forensic Laboratory, Ex-Situ Conservation Division Department of Wildlife and National Parks Peninsular Malaysia, Kuala Lumpur, Malaysia
| | - Mun Yik Fong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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10
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Fornace KM, Zorello Laporta G, Vythilingham I, Chua TH, Ahmed K, Jeyaprakasam NK, de Castro Duarte AMR, Amir A, Phang WK, Drakeley C, Sallum MAM, Lau YL. Simian malaria: a narrative review on emergence, epidemiology and threat to global malaria elimination. THE LANCET. INFECTIOUS DISEASES 2023; 23:e520-e532. [PMID: 37454671 DOI: 10.1016/s1473-3099(23)00298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 07/18/2023]
Abstract
Simian malaria from wild non-human primate populations is increasingly recognised as a public health threat and is now the main cause of human malaria in Malaysia and some regions of Brazil. In 2022, Malaysia became the first country not to achieve malaria elimination due to zoonotic simian malaria. We review the global distribution and drivers of simian malaria and identify priorities for diagnosis, treatment, surveillance, and control. Environmental change is driving closer interactions between humans and wildlife, with malaria parasites from non-human primates spilling over into human populations and human malaria parasites spilling back into wild non-human primate populations. These complex transmission cycles require new molecular and epidemiological approaches to track parasite spread. Current methods of malaria control are ineffective, with wildlife reservoirs and primarily outdoor-biting mosquito vectors urgently requiring the development of novel control strategies. Without these, simian malaria has the potential to undermine malaria elimination globally.
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Affiliation(s)
- Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Gabriel Zorello Laporta
- Graduate Research and Innovation Program, Centro Universitario FMABC, Santo André, São Paulo, Brazil
| | | | | | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia; Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nantha K Jeyaprakasam
- Biomedical Science Programme, Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ana Maria Ribeiro de Castro Duarte
- Laboratory of Protozoology, Institute of Tropical Medicine of São Paulo, Universidade de São Paulo, São Paulo, Brazil; Instituto Pasteur, Secretaria de Estado da Saude de São Paulo, São Paulo, Brazil
| | - Amirah Amir
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wei Kit Phang
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Anice M Sallum
- Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de São Paulo, São Paulo, Brazil
| | - Yee Ling Lau
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
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11
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Narapakdeesakul D, Pengsakul T, Kaewparuehaschai M, Thongsahuan S, Moonmake S, Lekcharoen P, Thanee S, Pattaradilokrat S, Kaewthamasorn M. Zoonotic simian malaria parasites in free-ranging Macaca fascicularis macaques and human malaria patients in Thailand, with a note on genetic characterization of recent isolates. Acta Trop 2023; 248:107030. [PMID: 37742788 DOI: 10.1016/j.actatropica.2023.107030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023]
Abstract
Despite the natural occurrences of human infections by Plasmodium knowlesi, P. cynomolgi, P. inui, and P. fieldi in Thailand, investigating the prevalence and genetic diversity of the zoonotic simian malaria parasites in macaque populations has been limited to certain areas. To address this gap, a total of 560 long-tailed macaques (Macaca fascicularis) and 20 southern pig-tailed macaques (M. nemestrina) were captured from 15 locations across 10 provinces throughout Thailand between 2018 and 2021 for investigation of malaria, as were 15 human samples residing in two simian-malaria endemic provinces, namely Songkhla and Satun, who exhibited malaria-like symptoms. Using PCR techniques targeting the mitochondrial cytb and cox1 genes coupled with DNA sequencing, 40 long-tailed macaques inhabiting five locations had mono-infections with one of the three simian malaria species. Most of the positive cases of macaque were infected with P. inui (32/40), while infections with P. cynomolgi (6/40) and P. knowlesi (2/40) were less common and confined to specific macaque populations. Interestingly, all 15 human cases were mono-infected with P. knowlesi, with one of them residing in an area with two P. knowlesi-infected macaques. Nucleotide sequence analysis showed a high level of genetic diversity in P. inui, while P. cynomolgi and P. knowlesi displayed limited genetic diversity. Phylogenetic and haplotype network analyses revealed that P. inui in this study was closely related to simian and Anopheles isolates from Peninsular Malaysia, while P. cynomolgi clustered with simian and human isolates from Asian countries. P. knowlesi, which was found in both macaques and humans in this study, was closely related to isolates from macaques, humans, and An. hackeri in Peninsular Malaysia, suggesting a sylvatic transmission cycle extending across these endemic regions. This study highlights the current hotspots for zoonotic simian malaria and sheds light on the genetic characteristics of recent isolates in both macaques and human residents in Thailand.
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Affiliation(s)
- Duriyang Narapakdeesakul
- Veterinary Pathobiology Graduate Program, Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; Veterinary Parasitology Research Unit, Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Theerakamol Pengsakul
- Health and Environmental Research Center, Faculty of Environmental Management, Prince of Songkla University, Songkhla 90110, Thailand
| | - Mutchamon Kaewparuehaschai
- Department of National Parks, Wildlife and Plant Conservation, Ministry of Natural Resources and Environment, Bangkok 10900, Thailand
| | - Salintorn Thongsahuan
- Department of National Parks, Wildlife and Plant Conservation, Ministry of Natural Resources and Environment, Bangkok 10900, Thailand
| | - Sopavadee Moonmake
- The Office of Disease Prevention and Control Region 12 Songkhla, Department of Disease Control, Ministry of Public Health, Songkhla 90000, Thailand
| | - Paisin Lekcharoen
- Veterinary Public Health Graduate Program, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Suchansa Thanee
- Veterinary Parasitology Research Unit, Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | | | - Morakot Kaewthamasorn
- Veterinary Parasitology Research Unit, Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand.
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12
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Chaturvedi R, Biswas S, Bisht K, Sharma A. The threat of increased transmission of non- knowlesi zoonotic malaria in humans: a systematic review. Parasitology 2023; 150:1167-1177. [PMID: 37929579 PMCID: PMC10801384 DOI: 10.1017/s003118202300077x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 11/07/2023]
Abstract
Of the 5 human malarial parasites, Plasmodium falciparum and Plasmodium vivax are the most prevalent species globally, while Plasmodium malariae, Plasmodium ovale curtisi and Plasmodium ovale wallikeri are less prevalent and typically occur as mixed-infections. Plasmodium knowlesi, previously considered a non-human primate (NHP) infecting species, is now a cause of human malaria in Malaysia. The other NHP Plasmodium species, Plasmodium cynomolgi, Plasmodium brasilianum, Plasmodium inui, Plasmodium simium, Plasmodium coatneyi and Plasmodium fieldi cause malaria in primates, which are mainly reported in southeast Asia and South America. The non-knowlesi NHP Plasmodium species also emerged and were found to cross-transmit from their natural hosts (NHP) – to human hosts in natural settings. Here we have reviewed and collated data from the literature on the NHPs-to-human-transmitting non-knowlesi Plasmodium species. It was observed that the natural transmission of these NHP parasites to humans had been reported from 2010 onwards. This study shows that: (1) the majority of the non-knowlesi NHP Plasmodium mixed species infecting human cases were from Yala province of Thailand; (2) mono/mixed P. cynomolgi infections with other human-infecting Plasmodium species were prevalent in Malaysia and Thailand and (3) P. brasilianum and P. simium were found in Central and South America.
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Affiliation(s)
- Rini Chaturvedi
- Molecular Medicine Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
| | - Shibani Biswas
- Molecular Medicine Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
- Host–Parasite Biology, ICMR-National Institute of Malaria Research, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Kanika Bisht
- Host–Parasite Biology, ICMR-National Institute of Malaria Research, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Amit Sharma
- Molecular Medicine Group, International Centre for Genetic Engineering & Biotechnology, New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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13
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Ruengket P, Roytrakul S, Tongthainan D, Taruyanon K, Sangkharak B, Limudomporn P, Pongsuchart M, Udom C, Fungfuang W. Serum proteomic profile of wild stump-tailed macaques (Macaca arctoides) infected with malaria parasites in Thailand. PLoS One 2023; 18:e0293579. [PMID: 37910477 PMCID: PMC10619813 DOI: 10.1371/journal.pone.0293579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
The number of patients infected with simian malaria is gradually increasing in many countries of Southeast Asia and South America. The most important risk factor for a zoonotic spillover event of malarial infection is mostly influenced by the interaction between humans, monkeys, and vectors. In this study, we determine the protein expression profile of a wild stump-tailed macaque (Macaca arctoides) from a total of 32 blood samples collected from Prachuap Kiri Khan Province, Thailand. The malarial parasite was analyzed using nested polymerase chain reaction (PCR) assays by dividing the samples into three groups: non-infected, mono-infected, and multiple-infected. The identification and differential proteomic expression profiles were determined using liquid chromatography with tandem mass spectrometry (LC-MS/MS) and bioinformatics tools. A total of 9,532 proteins (total proteins) were identified with the filter-based selection methods analysis, and a subset of 440 proteins were found to be different between each group. Within these proteins, the GhostKOALA functional enrichment analysis indicated that 142 important proteins were associated with either of the organismal system (28.87%), genetic information processing (23.24%), environmental information processing (16.20%), metabolism (13.38%), cellular processes (11.97%), or causing human disease (6.34%). Additionally, using interaction network analysis, nine potential reporter proteins were identified. Here, we report the first study on the protein profiles differentially expressed in the serum of wild stump-tailed macaques between non, mono, and multiple malarial infected living in a natural transmission environment. Our findings demonstrate that differentially expressed proteins implicated in host defense through lipid metabolism, involved with TGF pathway were suppressed, while those with the apoptosis pathway, such as cytokines and proinflammation signals were increased. Including the parasite's response via induced hemolysis and disruption of myeloid cells. A greater understanding of the fundamental processes involved in a malarial infection and host response can be crucial for developing diagnostic tools, medication development, and therapies to improve the health of those affected by the disease.
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Affiliation(s)
- Pakorn Ruengket
- Genetic Engineering and Bioinformatics Program, Graduate School, Kasetsart University, Bangkok, Thailand
| | - Sittiruk Roytrakul
- Functional Ingredients and Food Innovation Research Group, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Daraka Tongthainan
- Faculty of Veterinary Medicine, Rajamongala University of Technology Tawan-ok, Chonburi, Thailand
| | - Kanokwan Taruyanon
- Department of National Parks, Wildlife Conservation Division Protected Areas Regional Office, Wildlife and Plant Conservation, Ratchaburi, Thailand
| | - Bencharong Sangkharak
- Department of National Parks, Wildlife Conservation Division, Wildlife and Plant Conservation, Bangkok, Thailand
| | - Paviga Limudomporn
- Faculty of Science, Department of Zoology, Kasetsart University, Bangkok, Thailand
| | - Mongkol Pongsuchart
- Faculty of Science, Department of Zoology, Kasetsart University, Bangkok, Thailand
| | - Chanya Udom
- Faculty of Science, Department of Zoology, Kasetsart University, Bangkok, Thailand
| | - Wirasak Fungfuang
- Faculty of Science, Department of Zoology, Kasetsart University, Bangkok, Thailand
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14
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Dao F, Dembele L, Diarra B, Sogore F, Marin-Menendez A, Goita S, Haidara AS, Barre YN, Sangare CPO, Kone A, Ouologuem DT, Dara A, Tekete MM, Talman AM, Djimde AA. The Prevalence of Human Plasmodium Species during Peak Transmission Seasons from 2016 to 2021 in the Rural Commune of Ntjiba, Mali. Trop Med Infect Dis 2023; 8:438. [PMID: 37755899 PMCID: PMC10535850 DOI: 10.3390/tropicalmed8090438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
Up-to-date knowledge of key epidemiological aspects of each Plasmodium 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 Plasmodium species was 65.20% (95% CI: 60.10-69.89%) and 22.41% (CI: 16.60-28.79%) for passive and active screening, respectively. P. falciparum was the most prevalent species encountered in active and passive screening (59.33%, 19.31%). This prevalence was followed by P. malariae (1.50%, 1.15%) and P. ovale (0.32%, 0.06%). Regarding frequency, P. falciparum was more frequent in symptomatic individuals (96.77% vs. 93.24%, p = 0.014). In contrast, P. malariae was more frequent in asymptomatic individuals (5.64% vs. 2.45%, p < 0.001). P. ovale remained the least frequent species (less than 1%), and no P. vivax was detected. The most frequent coinfections were P. falciparum and P. malariae (0.56%). Children aged 5-9 presented the highest frequency of P. falciparum infections (41.91%). Non-falciparum species were primarily detected in adolescents (10-14 years) with frequencies above 50%. Only P. falciparum infections had parasitemias greater than 100,000 parasites per µL of blood. P. falciparum gametocytes were found with variable prevalence across age groups. Our data highlight that P. falciparum represented the first burden, but other non-falciparum species were also important. Increasing attention to P. malariae and P. ovale is essential if malaria elimination is to be achieved.
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Affiliation(s)
- Francois Dao
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
- MIVEGEC, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (A.M.-M.); (A.M.T.)
| | - Laurent Dembele
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Bakoroba Diarra
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Fanta Sogore
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | | | - Siaka Goita
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Aboubacrin S. Haidara
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Yacouba N. Barre
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Cheick P. O. Sangare
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Aminatou Kone
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Dinkorma T. Ouologuem
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Antoine Dara
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Mamadou M. Tekete
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
| | - Arthur M. Talman
- MIVEGEC, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (A.M.-M.); (A.M.T.)
| | - Abdoulaye A. Djimde
- Malaria Research and Training Center, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques, and Technologies of Bamako, Bamako 1805, Mali; (F.D.); (B.D.); (F.S.); (S.G.); (A.S.H.); (Y.N.B.); (C.P.O.S.); (A.K.); (D.T.O.); (A.D.); (M.M.T.)
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15
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Mewara A, Sreenivasan P, Khurana S. Primate malaria of human importance. Trop Parasitol 2023; 13:73-83. [PMID: 37860614 PMCID: PMC10583777 DOI: 10.4103/tp.tp_79_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/10/2023] [Indexed: 10/21/2023] Open
Abstract
Nonhuman primate (NHP) malaria poses a major threat to the malaria control programs. The last two decades have witnessed a paradigm shift in our understanding of the malaria caused by species other than the traditionally known human Plasmodium species - Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale. The emergence of the malaria parasite of long-tailed macaque monkeys, Plasmodium knowlesi, as the fifth malaria species of humans has made the scientific community consider the risk of other zoonotic malaria, such as Plasmodium cynomolgi, Plasmodium simium, Plasmodium inui, and others, to humans. The development of knowledge about P. knowlesi as a pathogen which was earlier only known to experimentally cause malaria in humans and rarely cause natural infection, toward its acknowledgment as a significant cause of human malaria and a threat of malaria control programs has been made possible by the use of advanced molecular techniques such as polymerase chain reaction and gene sequencing. This review explores the various aspects of NHP malaria, and the association of various factors with their emergence and potential to cause human malaria which are important to understand to be able to control these emerging infections.
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Affiliation(s)
- Abhishek Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Priya Sreenivasan
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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16
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Doum D, Mclver DJ, Hustedt J, Hii J, Sovannaroth S, Lek D, Richardson JH, Tatarsky A, Lobo NF. An active and targeted survey reveals asymptomatic malaria infections among high-risk populations in Mondulkiri, Cambodia. Malar J 2023; 22:193. [PMID: 37353790 DOI: 10.1186/s12936-023-04630-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/20/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Malaria is a mosquito-borne disease that is one of the most serious public health issues globally and a leading cause of mortality in many developing countries worldwide. Knowing the prevalence of both symptomatic and asymptomatic malaria on a subnational scale allows for the estimation of the burden of parasitaemia present in the transmission system, enabling targeting and tailoring of resources towards greater impact and better use of available capacity. This study aimed to determine the PCR-based point prevalence of malaria infection, by parasite species, among three high-risk populations in Mondulkiri province, Cambodia: forest rangers, forest dwellers, and forest goers. METHODS A cross-sectional survey was performed during the transmission season in November and December 2021. Blood samples collected on filter paper from participants (n = 1301) from all target groups were screened for Plasmodium spp using PCR. RESULTS Malaria prevalence among all study participants was 6.7% for any Plasmodium species. Malaria prevalence in the forest ranger group was 8.1%, was 6.8% in forest goers, and 6.4% in forest dwellers; all infections were asymptomatic. Plasmodium vivax was detected in all participant groups, while the few Plasmodium falciparum infections were found in goers and dwellers. 81% of all infections were due to P. vivax, 9% were due to P. falciparum, 3% due to Plasmodium cynomolgi, and the rest (7%) remained undefined. Gender was associated with malaria infection prevalence, with male participants having higher odds of malaria infection than female participants (OR = 1.69, 95% CI 1.08-2.64). Passively collected malaria incidence data from the Cambodian government were also investigated. Health facility-reported malaria cases, based on rapid diagnostic tests, for the period Jan-Dec 2021 were 521 Plasmodium vivax (0.89% prevalence), 34 P. falciparum (0.06%) and four P. falciparum + mixed (0.01%)-a total of 559 cases (0.95%) for all of Mondulkiri. CONCLUSION This reservoir of asymptomatic parasitaemia may be perpetuating low levels of transmission, and thus, new strategies are required to realize the goal of eliminating malaria in Cambodia by 2025.
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Affiliation(s)
- Dyna Doum
- Health Forefront Organization, Phnom Penh, Cambodia
| | - David J Mclver
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA.
| | - John Hustedt
- Health Forefront Organization, Phnom Penh, Cambodia
| | - Jeffrey Hii
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
| | - Siv Sovannaroth
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Dysoley Lek
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | - Allison Tatarsky
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
| | - Neil F Lobo
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
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17
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DeBarry JD, Nural MV, Pakala SB, Nayak V, Warrenfeltz S, Humphrey J, Lapp SA, Cabrera-Mora M, Brito CFA, Jiang J, Saney CL, Hankus A, Stealey HM, DeBarry MB, Lackman N, Legall N, Lee K, Tang Y, Gupta A, Trippe ED, Bridger RR, Weatherly DB, Peterson MS, Jiang X, Tran V, Uppal K, Fonseca LL, Joyner CJ, Karpuzoglu E, Cordy RJ, Meyer EVS, Wells LL, Ory DS, Lee FEH, Tirouvanziam R, Gutiérrez JB, Ibegbu C, Lamb TJ, Pohl J, Pruett ST, Jones DP, Styczynski MP, Voit EO, Moreno A, Galinski MR, Kissinger JC. MaHPIC malaria systems biology data from Plasmodium cynomolgi sporozoite longitudinal infections in macaques. Sci Data 2022; 9:722. [PMID: 36433985 PMCID: PMC9700667 DOI: 10.1038/s41597-022-01755-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/10/2022] [Indexed: 11/27/2022] Open
Abstract
Plasmodium cynomolgi causes zoonotic malarial infections in Southeast Asia and this parasite species is important as a model for Plasmodium vivax and Plasmodium ovale. Each of these species produces hypnozoites in the liver, which can cause relapsing infections in the blood. Here we present methods and data generated from iterative longitudinal systems biology infection experiments designed and performed by the Malaria Host-Pathogen Interaction Center (MaHPIC) to delve deeper into the biology, pathogenesis, and immune responses of P. cynomolgi in the Macaca mulatta host. Infections were initiated by sporozoite inoculation. Blood and bone marrow samples were collected at defined timepoints for biological and computational experiments and integrative analyses revolving around primary illness, relapse illness, and subsequent disease and immune response patterns. Parasitological, clinical, haematological, immune response, and -omic datasets (transcriptomics, proteomics, metabolomics, and lipidomics) including metadata and computational results have been deposited in public repositories. The scope and depth of these datasets are unprecedented in studies of malaria, and they are projected to be a F.A.I.R., reliable data resource for decades.
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Affiliation(s)
- Jeremy D DeBarry
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
| | - Mustafa V Nural
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
| | - Suman B Pakala
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Vishal Nayak
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Cancer Data Science Initiatives, Frederick National Laboratory for Cancer Research, Post Office Box B, Frederick, MD, 21702, USA
| | - Susanne Warrenfeltz
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, 30602, USA
| | - Jay Humphrey
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, 30602, USA
| | - Stacey A Lapp
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Monica Cabrera-Mora
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Cristiana F A Brito
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Laboratório de Malária, Instituto René Rachou/Fiocruz Minas, Av. Augusto de Lima 1715, Belo Horizonte, MG, 30190 009, Brazil
| | - Jianlin Jiang
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
| | - Celia L Saney
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, 30605, USA
| | - Allison Hankus
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Senior Public Health Informaticist, MITRE Corp, Atlanta, GA, 30345, USA
| | - Hannah M Stealey
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, 78712, USA
| | - Megan B DeBarry
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
| | - Nicolas Lackman
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
| | - Noah Legall
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Interdisciplinary Disease Ecology Across Scales Research Traineeship Program, Institute of Bioinformatics, Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, 30602, USA
| | - Kevin Lee
- Center for Integrative Genomics, School of Biology, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Yan Tang
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Anuj Gupta
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
- Valted Seq, 704 Quince Orchard Rd, Gaithersburg, MD, 20878, USA
| | - Elizabeth D Trippe
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Federal Drug Administration, Silver Spring, MD, 20993, USA
| | - Robert R Bridger
- Complex Carbohydrate Research Center, Department of Biochemistry, University of Georgia, Athens, GA, 30602, USA
| | - Daniel Brent Weatherly
- Complex Carbohydrate Research Center, Department of Biochemistry, University of Georgia, Athens, GA, 30602, USA
| | - Mariko S Peterson
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
| | - Xuntian Jiang
- Division of Endocrinology, Metabolism & Lipid Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - ViLinh Tran
- Division of Pulmonary, Allergy, Critical Care, & Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Karan Uppal
- Division of Pulmonary, Allergy, Critical Care, & Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Luis L Fonseca
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, 32603, USA
| | - Chester J Joyner
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Center for Tropical and Emerging Global Disease, University of Georgia, Athens, GA, 30602, USA
- Center for Vaccines and Immunology, Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | - Ebru Karpuzoglu
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Department of Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | - Regina J Cordy
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Department of Biology, Wake Forest University, Winston Salem, NC, 27103, USA
| | - Esmeralda V S Meyer
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Institutional Animal Care and Use Committee, Research Compliance and Research Integrity Office, Emory University, Atlanta, GA, 30322, USA
| | - Lance L Wells
- Complex Carbohydrate Research Center, Department of Biochemistry, University of Georgia, Athens, GA, 30602, USA
| | - Daniel S Ory
- Division of Endocrinology, Metabolism & Lipid Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Casma Therapeutics, Cambridge, MA, 02139, USA
| | - F Eun-Hyung Lee
- Division of Pulmonary, Allergy, Critical Care, & Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Lowance Center for Human Immunology, Emory University, Atlanta, GA, 30322, USA
| | - Rabindra Tirouvanziam
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Juan B Gutiérrez
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- Department of Mathematics, Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA
- University of Texas at San Antonio, San Antonio, TX, 78249, USA
| | - Chris Ibegbu
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
| | - Tracey J Lamb
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Department of Pathology, University of Utah, Salt Lake City, UT, 84112, USA
| | - Jan Pohl
- Biotechnology Core Facility Branch, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Sarah T Pruett
- Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- University of Tennessee, Knoxville, TN, 37996, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, Critical Care, & Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Mark P Styczynski
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Eberhard O Voit
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Alberto Moreno
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Mary R Galinski
- Emory Vaccine Center, Yerkes/Emory National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Jessica C Kissinger
- Institute of Bioinformatics, University of Georgia, Athens, GA, 30602, USA.
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, 30602, USA.
- Department of Genetics, University of Georgia, Athens, GA, 30602, USA.
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18
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Plasmodium cynomolgi in humans: current knowledge and future directions of an emerging zoonotic malaria parasite. Infection 2022; 51:623-640. [PMID: 36401673 PMCID: PMC9676733 DOI: 10.1007/s15010-022-01952-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Plasmodium cynomolgi (Pcy), a simian malaria parasite, is a recent perfect example of emerging zoonotic transfer in human. This review summarizes the current knowledge on the epidemiology of natural Pcy infections in humans, mosquitoes and monkeys, along with its biological, clinical and drug sensitivity patterns. Knowledge gaps and further studies on Pcy in humans are also discussed. This parasite currently seems to be geographically limited in South-East Asia (SEA) with a global prevalence in human ranging from 0 to 1.4%. The Pcy infections were reported in local SEA populations and European travelers, and range from asymptomatic carriage to mild/moderate attacks with no evidence of pathognomonic clinical and laboratory patterns but with Pcy strain-shaped clinical differences. Geographical distribution and competence of suitable mosquito vectors and non-primate hosts, globalization, climate change, and increased intrusion of humans into the habitat of monkeys are key determinants to emergence of Pcy parasites in humans, along with its expansion outside SEA. Sensitization/information campaigns coupled with training and assessment sessions of microscopists and clinicians on Pcy are greatly needed to improve data on the epidemiology and management of human Pcy infection. There is a need for development of sensitive and specific molecular tools for individual diagnosis and epidemiological studies. The development of safe and efficient anti-hypnozoite drugs is the main therapeutic challenge for controlling human relapsing malaria parasites. Experience gained from P. knowlesi malaria, development of integrated measures and strategies—ideally with components related to human, monkeys, mosquito vectors, and environment—could be very helpful to prevent emergence of Pcy malaria in humans through disruption of transmission chain from monkeys to humans and ultimately contain its expansion in SEA and potential outbreaks in a context of malaria elimination.
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19
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Sanchez KL, Greenwood AD, Nielsen A, Nugraha RTP, Prameswari W, Nurillah A, Agustina F, Campbell-Smith G, Dharmayanthi AB, Pratama R, Exploitasia I, Baird JK. Plasmodium pitheci malaria in Bornean orang-utans at a rehabilitation centre in West Kalimantan, Indonesia. Malar J 2022; 21:280. [PMID: 36184593 PMCID: PMC9528059 DOI: 10.1186/s12936-022-04290-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasmodial species naturally infecting orang-utans, Plasmodium pitheci and Plasmodium silvaticum, have been rarely described and reportedly cause relatively benign infections. Orang-utans at Rescue Rehabilitation Centres (RRC) across the orang-utan natural range suffer from malaria illness. However, the species involved and clinical pathology of this illness have not been described in a systematic manner. The objective of the present study was to identify the Plasmodium species infecting orang-utans under our care, define the frequency and character of malaria illness among the infected, and establish criteria for successful diagnosis and treatment. METHODS During the period 2017-2021, prospective active surveillance of malaria among 131 orang-utans resident in a forested RRC in West Kalimantan (Indonesia) was conducted. A total of 1783 blood samples were analysed by microscopy and 219 by nucleic acid based (PCR) diagnostic testing. Medical records of inpatient orang-utans at the centre from 2010 to 2016 were also retrospectively analysed for instances of symptomatic malaria. RESULTS Active surveillance revealed 89 of 131 orang-utans were positive for malaria at least once between 2017 and 2021 (period prevalence = 68%). During that period, 14 cases (affecting 13 orang-utans) developed clinical malaria (0.027 attacks/orang-utan-year). Three other cases were found to have occurred from 2010-2016. Sick individuals presented predominantly with fever, anaemia, thrombocytopenia, and leukopenia. All had parasitaemias in excess of 4000/μL and as high as 105,000/μL, with severity of illness correlating with parasitaemia. Illness and parasitaemia quickly resolved following administration of artemisinin-combined therapies. High levels of parasitaemia also sometimes occurred in asymptomatic cases, in which case, parasitaemia cleared spontaneously. CONCLUSIONS This study demonstrated that P. pitheci very often infected orang-utans at this RRC. In about 14% of infected orang-utans, malaria illness occurred and ranged from moderate to severe in nature. The successful clinical management of acute pitheci malaria is described. Concerns are raised about this infection potentially posing a threat to this endangered species in the wild.
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Affiliation(s)
- Karmele Llano Sanchez
- IAR Indonesia Foundation - Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Ketapang, West Kalimantan, Indonesia.
- International Animal Rescue, Uckfield, UK.
- Department of Veterinary Medicine, Frei Universität, Berlin, Germany.
| | - Alex D Greenwood
- Department of Veterinary Medicine, Frei Universität, Berlin, Germany
- Department of Wildlife Diseases, Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Aileen Nielsen
- Center for Law and Economics, ETH Zurich, Zurich, Switzerland
| | - R Taufiq P Nugraha
- Research Center for Applied Zoology, National Research and Innovation Agency, Republic of Indonesia (BRIN), Cibinong, Indonesia
| | - Wendi Prameswari
- IAR Indonesia Foundation - Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Ketapang, West Kalimantan, Indonesia
| | - Andini Nurillah
- IAR Indonesia Foundation - Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Ketapang, West Kalimantan, Indonesia
| | - Fitria Agustina
- IAR Indonesia Foundation - Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Ketapang, West Kalimantan, Indonesia
| | - Gail Campbell-Smith
- IAR Indonesia Foundation - Yayasan Inisiasi Alam Rehabilitasi Indonesia (YIARI), Ketapang, West Kalimantan, Indonesia
- International Animal Rescue, Uckfield, UK
| | - Anik Budhi Dharmayanthi
- Research Center for Biosystematics and Evolution, National Research and Innovation Agency, Republic of Indonesia (BRIN), Cibinong, Indonesia
| | - Rahadian Pratama
- Department of Biochemistry, Faculty of Mathematics and Natural Sciences, IPB University, Bogor, Indonesia
| | - Indra Exploitasia
- Biodiversity Conservation Directorate of the General Director of Natural Resources and Ecosystem Conservation, Ministry of Environment and Forestry of the Republic of Indonesia, Jakarta, Indonesia
| | - J Kevin Baird
- Clinical Research Unit-Indonesia, Faculty of Medicine, Oxford University, Universitas Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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20
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Brashear AM, Cui L. Population genomics in neglected malaria parasites. Front Microbiol 2022; 13:984394. [PMID: 36160257 PMCID: PMC9493318 DOI: 10.3389/fmicb.2022.984394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Malaria elimination includes neglected human malaria parasites Plasmodium vivax, Plasmodium ovale spp., and Plasmodium malariae. Biological features such as association with low-density infection and the formation of hypnozoites responsible for relapse make their elimination challenging. Studies on these parasites rely primarily on clinical samples due to the lack of long-term culture techniques. With improved methods to enrich parasite DNA from clinical samples, whole-genome sequencing of the neglected malaria parasites has gained increasing popularity. Population genomics of more than 2200 P. vivax global isolates has improved our knowledge of parasite biology and host-parasite interactions, identified vaccine targets and potential drug resistance markers, and provided a new way to track parasite migration and introduction and monitor the evolutionary response of local populations to elimination efforts. Here, we review advances in population genomics for neglected malaria parasites, discuss how the rich genomic information is being used to understand parasite biology and epidemiology, and explore opportunities for the applications of malaria genomic data in malaria elimination practice.
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21
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Sam J, Shamsusah NA, Ali AH, Hod R, Hassan MR, Agustar HK. Prevalence of simian malaria among macaques in Malaysia (2000–2021): A systematic review. PLoS Negl Trop Dis 2022; 16:e0010527. [PMID: 35849568 PMCID: PMC9292078 DOI: 10.1371/journal.pntd.0010527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background The aim of Malaysia to eliminate malaria nationwide by 2020 seems need to be prolonged. Whilst Malaysia has successfully eliminated human malaria transmission, simian malaria parasites such as Plasmodium knowlesi, P. cynomolgi, P. inui and P. cynomolgi are the emerging cause of malaria in humans. The epidemiological study of simian malaria in primates provides useful information in identifying the risk of human-macaques Plasmodium infection. Methodology/Principal findings This study was performed to gather all available data in terms of simian malaria epidemiology study among macaques in Malaysia over the last two decades. This systematic review was conducted according to the PRISMA guidelines to select appropriate articles as references. Data searches were performed through international databases such as Google Scholar, PubMed, CrossRef, Scopus, Web of Science and Science Direct for original articles published from 2000 until 2021. The review identified seven simian malaria epidemiology studies in Malaysia over the 20-year study period. Most studies were conducted in Peninsular Malaysia (5/7; 71%) followed by East Malaysia (2/7; 29%). All studies showed positive detection of Plasmodium parasites in macaques. The most prevalent Plasmodium species in macaques was P. inui (49.27%) and the least prevalent was P. fieldi (4.76%). The prevalence of simian malaria was higher in East Malaysia compared to Peninsular Malaysia. The mono, dual and triple infection types were the most common among macaques. Conclusion/Significance The non-human primates like macaques are the reservoir of simian plasmodium in Malaysia. Hence, the study of host epidemiology is an important insight to public health management as there is a high occurrence of simian malaria in Malaysia. The right measurement can be taken as well to prevent the transmission of simian malaria from macaques to humans. Macaques are the most abundant primates in south east Asia including Malaysia. Due to deforestation, macaques came closer to human settlements searching for food. Macaques like the long-tailed and pig-tailed harbouring several Plasmodium species that can cause zoonotic malaria in humans. Close contact of human and macaques cause zoonotic transmission of simian malaria. The simian plasmodium such as P. knowlesi, P. inui and P. cynomolgi have been found infecting humans in Malaysia; mainly in East Malaysia (Borneo). Zoonotic malaria poses great risk to public health as prolonged in treatment often lead to fatal outcomes. Hence the knowledge of prevalence and diversity is important to access, this can therefore enlighten the authorities to plan a control strategy that will minimize the zoonotic transmission between non-human primate host to human. This systematic review has summarised all publish data of macaques-plasmodium infection from the year 2000–2021 by using PRISMA guidelines. Our result showed that P. inui (49.27%) is the most prevalent Plasmodium species found in macaques, followed by P. cynomolgi (33.05%) and P. knowlesi (26.86%). Simian plasmodium prevalent was also found higher in East Malaysia (97.0%) compared to Peninsular Malaysia (45.18%). The significant increase of simian malaria incidences in human have jeopardized the national malaria elimination programme. Hence, this study provides a compact insight into the plasmodium epidemiology of macaques in Malaysia.
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Affiliation(s)
- Janeeca Sam
- Department of Bioscience and Biotechnology, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Nadia Aqilla Shamsusah
- Department of Earth Sciences and Environment, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Amatul Hamizah Ali
- Department of Chemical Sciences, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail: (HKA); (RH)
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hani Kartini Agustar
- Department of Earth Sciences and Environment, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
- * E-mail: (HKA); (RH)
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22
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Non-Human Primate Malaria Infections: A Review on the Epidemiology in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137888. [PMID: 35805545 PMCID: PMC9265734 DOI: 10.3390/ijerph19137888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/01/2023]
Abstract
Malaria remains a public health problem in many parts of the world, including Malaysia. Although Malaysia has been recognized as one of the countries free from indigenous human malaria since 2018, the rising trend of zoonotic malaria, particularly Plasmodium knowlesi cases, poses a threat to public health and is of great concern to the country’s healthcare system. We reviewed previously scattered information on zoonotic malaria infections in both Peninsular Malaysia and Malaysian Borneo to determine the epidemiology and distribution of emerging zoonotic malaria infections. Given the high prevalence of zoonotic malaria in Malaysia, efforts should be made to detect zoonotic malaria in humans, mosquito vectors, and natural hosts to ensure the success of the National Malaria Elimination Strategic Plan.
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23
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Nada-Raja T, Kadir KA, Divis PCS, Mohamad DSA, Matusop A, Singh B. Macaca fascicularis and Macaca nemestrina infected with zoonotic malaria parasites are widely distributed in Sarawak, Malaysian Borneo. Sci Rep 2022; 12:10476. [PMID: 35729212 PMCID: PMC9213397 DOI: 10.1038/s41598-022-14560-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022] Open
Abstract
Human infections with Plasmodium knowlesi, a malaria parasite of Macaca fascicularis and Macaca nemestrina (long-tailed and pig-tailed macaques respectively), occur throughout Southeast Asia, especially Malaysian Borneo. Other naturally-acquired human infections with malaria parasites from macaques in Southeast Asia are P. cynomolgi, P. inui-like, P. coatneyi and P. simiovale. In Sarawak, Malaysian Borneo, M. fascicularis and M. nemestrina from only the Kapit Division have been examined previously for malaria parasites. In order to determine the distribution of P. knowlesi and other zoonotic malaria parasites, 73 macaque blood samples derived from 7 other administrative divisions in Sarawak were studied. Of 45 blood samples from M. fascicularis and 28 from M. nemestrina tested by nested PCR assays, 23 (51.1%) M. fascicularis and 15 (53.6%) M. nemestrina samples were positive for Plasmodium DNA. Thirty-two of these macaques from 7 divisions sampled, harboured either single (n = 12), double (n = 9), triple (n = 7) or quadruple (n = 4) infections of P. knowlesi, P. inui, P. cynomolgi and P. coatneyi, while the infecting species of Plasmodium could not be identified for 6 samples. P. knowlesi was detected in 15.5% (7/45) M. fascicularis and in 7.1% (2/28) M. nemestrina sampled. Despite the small number of samples analysed from each administrative division, the current study indicates that macaques infected with the zoonotic malaria parasites P. knowlesi, P. cynomolgi, P. inui and P. coatneyi are widely distributed throughout Sarawak, Malaysian Borneo. Travelers to forested areas in Sarawak should be made aware of the potential risk of acquiring zoonotic malaria.
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Affiliation(s)
- Thamayanthi Nada-Raja
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Khamisah A Kadir
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Paul C S Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Dayang S A Mohamad
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Asmad Matusop
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia.,Sarawak State Health Department, 93050, Kuching, Sarawak, Malaysia
| | - Balbir Singh
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia.
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Yusuf NM, Zulkefli J, Jiram AI, Vythilingam I, Hisam S, Devi R, Salehhuddin A, Ali NM, Isa M, Alias N, Ogu salim N, Aziz AA, Sulaiman LH. Plasmodium spp. in macaques, Macaca fascicularis, in Malaysia, and their potential role in zoonotic malaria transmission. Parasite 2022; 29:32. [PMID: 35674419 PMCID: PMC9175634 DOI: 10.1051/parasite/2022032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/22/2022] [Indexed: 11/14/2022] Open
Abstract
Macaques, Macaca fascicularis, are a known reservoir of Plasmodium knowlesi, the agent of simian malaria which is the predominant zoonotic species affecting humans in Malaysia and other Southeast Asian countries. Recently, a naturally acquired human infection of another simian malaria parasite, P. cynomolgi has been reported. Thus, it is crucial to study the distribution of simian Plasmodium infections with particular attention to the macaques. Four hundred and nineteen (419) long-tailed macaques (Macaca fascicularis) were trapped in selected areas where human cases of P. knowlesi and P. cynomolgi have been reported. Nested polymerase chain reaction (PCR) was conducted to identify the Plasmodium spp., and circumsporozoite protein (CSP) genes of P. knowlesi samples were sequenced. Plasmodium cynomolgi infection was shown to be the most prevalent among the macaque population (68.4%). Although 50.6% of analyzed samples contained single infections either with P. knowlesi, P. cynomolgi, P. inui, P. coatneyi, or P. fieldi, mixed infections with double, triple, quadruple, and all 5 species were also detected. Infection with P. cynomolgi and P. knowlesi were the highest among Malaysian macaques in areas where humans and macaques are in close contact. The risk of zoonotic infection in these areas needs to be addressed since the number of zoonotic malaria cases is on the rise. With the elimination of human malaria, the risk of humans being infected with simian malaria is very high and steps should be taken to mitigate this issue.
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Affiliation(s)
- Noorazian Md Yusuf
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Corresponding author: ,
| | - Jannah Zulkefli
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Adela Ida Jiram
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Indra Vythilingam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Department of Parasitology, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur Malaysia
| | - Shamilah Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Renuka Devi
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Afiqah Salehhuddin
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Nurulshuhada Md Ali
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Maccallyster Isa
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Norwahida Alias
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Nurhainis Ogu salim
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Adli Abd Aziz
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- School of Biology, Faculty of Applied Sciences, Universiti Teknologi MARA Cawangan Negeri Sembilan Kampus Kuala Pilah, Pekan Parit Tinggi 72000 Kuala Pilah Negeri Sembilan Malaysia
| | - Lokman Hakim Sulaiman
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Centre for Environmental and Population Health, Institute for Research, Development, and Innovation, and Department of Community Medicine, School of Medicine, International Medical University No. 126, Jalan Jalil Perkasa 19, Bukit Jalil 57000 Kuala Lumpur Malaysia
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Abstract
"The Primate Malarias" book has been a uniquely important resource for multiple generations of scientists, since its debut in 1971, and remains pertinent to the present day. Indeed, nonhuman primates (NHPs) have been instrumental for major breakthroughs in basic and pre-clinical research on malaria for over 50 years. Research involving NHPs have provided critical insights and data that have been essential for malaria research on many parasite species, drugs, vaccines, pathogenesis, and transmission, leading to improved clinical care and advancing research goals for malaria control, elimination, and eradication. Whilst most malaria scientists over the decades have been studying Plasmodium falciparum, with NHP infections, in clinical studies with humans, or using in vitro culture or rodent model systems, others have been dedicated to advancing research on Plasmodium vivax, as well as on phylogenetically related simian species, including Plasmodium cynomolgi, Plasmodium coatneyi, and Plasmodium knowlesi. In-depth study of these four phylogenetically related species over the years has spawned the design of NHP longitudinal infection strategies for gathering information about ongoing infections, which can be related to human infections. These Plasmodium-NHP infection model systems are reviewed here, with emphasis on modern systems biological approaches to studying longitudinal infections, pathogenesis, immunity, and vaccines. Recent discoveries capitalizing on NHP longitudinal infections include an advanced understanding of chronic infections, relapses, anaemia, and immune memory. With quickly emerging new technological advances, more in-depth research and mechanistic discoveries can be anticipated on these and additional critical topics, including hypnozoite biology, antigenic variation, gametocyte transmission, bone marrow dysfunction, and loss of uninfected RBCs. New strategies and insights published by the Malaria Host-Pathogen Interaction Center (MaHPIC) are recapped here along with a vision that stresses the importance of educating future experts well trained in utilizing NHP infection model systems for the pursuit of innovative, effective interventions against malaria.
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Affiliation(s)
- Mary R Galinski
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University, Atlanta, GA, USA.
- Emory National Primate Research Center (Yerkes National Primate Research Center), Emory University, Atlanta, GA, USA.
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Santos NAC, Andrade AO, Santos TC, Martinez LN, Ferreira AS, Bastos AS, Martins MM, Pontual JDC, Teles CBG, Medeiros JF, Araújo MS. Evaluation of sustainable susceptibility to Plasmodium vivax infection among colonized Anopheles darlingi and Anopheles deaneorum. Malar J 2022; 21:163. [PMID: 35658964 PMCID: PMC9164182 DOI: 10.1186/s12936-022-04204-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The colonization of mosquitoes susceptible to Plasmodium vivax via direct membrane feeding assay (DMFA) has the potential to significantly advance our knowledge of P. vivax biology, vector-parasite interaction and transmission-blocking vaccine research. Anopheles darlingi and Anopheles deaneorum are important vectors of malaria in the Western Brazilian Amazon. Since 2018, well-established colonies of these species have been maintained in order to mass produce mosquitoes destined for P. vivax infection. Plasmodium susceptibility was confirmed when the colonies were established, but susceptibility needs to be maintained for these colonies to remain good models for pathogen transmission. Thus, the susceptibility was assessed of colonized mosquitoes to P. vivax isolates circulating in the Western Amazon. METHODS Laboratory-reared mosquitoes from F10-F25 generations were fed on P. vivax blood isolates via DMFA. Susceptibility was determined by prevalence and intensity of infection as represented by oocyst load seven days after blood feeding, and sporozoite load 14 days after blood feeding. The effect of infection on mosquito survival was evaluated from initial blood feeding until sporogonic development and survival rates were compared between mosquitoes fed on infected and uninfected blood. Correlation was calculated between gametocytaemia and prevalence/intensity of infection, and between oocyst and sporozoite load. RESULTS Significant differences were found in prevalence and intensity of infection between species. Anopheles darlingi showed a higher proportion of infected mosquitoes and higher oocyst and sporozoite intensity than An. deaneorum. Survival analysis showed that An. deaneorum survival decreased drastically until 14 days post infection (dpi). Plasmodium vivax infection decreased survival in both species relative to uninfected mosquitoes. No correlation was observed between gametocytaemia and prevalence/intensity of infection, but oocyst and sporozoite load had a moderate to strong correlation. CONCLUSIONS Colonized An. darlingi make excellent subjects for modelling pathogen transmission. On the other hand, An. deaneorum could serve as a model for immunity studies due the low susceptibility under current colonized conditions. In the application of DMFA, gametocyte density is not a reliable parameter for predicting mosquito infection by P. vivax, but oocyst intensity should be used to schedule sporozoite experiments.
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Affiliation(s)
- Najara A C Santos
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, FIOCRUZ Rondônia, Porto Velho, Rondônia, Brazil
| | - Alice O Andrade
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - Thais C Santos
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - Leandro N Martinez
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, FIOCRUZ Rondônia, Porto Velho, Rondônia, Brazil
- Plataforma de Bioensaios de Malária e Leishmaniose da Fiocruz (PBML), Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Instituto Nacional de Epidemiologia na Amazônia Ocidental, INCT-EpiAmO, Porto Velho, Rondônia, Brazil
| | - Amália S Ferreira
- Plataforma de Bioensaios de Malária e Leishmaniose da Fiocruz (PBML), Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Instituto Nacional de Epidemiologia na Amazônia Ocidental, INCT-EpiAmO, Porto Velho, Rondônia, Brazil
| | - Alessandra S Bastos
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, FIOCRUZ Rondônia, Porto Velho, Rondônia, Brazil
| | - Mirilene M Martins
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - José D C Pontual
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - Carolina B G Teles
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, FIOCRUZ Rondônia, Porto Velho, Rondônia, Brazil
- Plataforma de Bioensaios de Malária e Leishmaniose da Fiocruz (PBML), Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Instituto Nacional de Epidemiologia na Amazônia Ocidental, INCT-EpiAmO, Porto Velho, Rondônia, Brazil
| | - Jansen F Medeiros
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, FIOCRUZ Rondônia, Porto Velho, Rondônia, Brazil
- Instituto Nacional de Epidemiologia na Amazônia Ocidental, INCT-EpiAmO, Porto Velho, Rondônia, Brazil
| | - Maisa S Araújo
- Plataforma de Produção e Infecção de Vetores da Malária (PIVEM), Laboratório de Entomologia, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil.
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Case series of three malaria patients from Thailand infected with the simian parasite, Plasmodium cynomolgi. Malar J 2022; 21:142. [PMID: 35524255 PMCID: PMC9074209 DOI: 10.1186/s12936-022-04167-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While human cases of Plasmodium knowlesi are now regularly recognized in Southeast Asia, infections with other simian malaria species, such as Plasmodium cynomolgi, are still rare. There has been a handful of clinical cases described, all from Malaysia, and retrospective studies of archived blood samples in Thailand and Cambodia have discovered the presence P. cynomolgi in isolates using polymerase chain reaction (PCR) assays. CASE PRESENTATION In Thailand, an ongoing malaria surveillance study enrolled two patients from Yala Province diagnosed with Plasmodium vivax by blood smear, but who were subsequently found to be negative by PCR. Expanded PCR testing of these isolates detected mono-infection with P. cynomolgi, the first time this has been reported in Thailand. Upon re-testing of 60 isolates collected from Yala, one other case was identified, a co-infection of P. cynomolgi and P. vivax. The clinical course for all three was relatively mild, with symptoms commonly seen in malaria: fever, chills and headaches. All infections were cured with a course of chloroquine and primaquine. CONCLUSION In malaria-endemic areas with macaque populations, cases of simian malaria in humans are being reported at an increasing rate, although still comprise a very small percentage of total cases. Plasmodium cynomolgi and P. vivax are challenging to distinguish by blood smear; therefore, PCR can be employed when infections are suspected or as part of systematic malaria surveillance. As Thai MoPH policy schedules regular follow-up visits after each malaria infection, identifying those with P. cynomolgi will allow for monitoring of treatment efficacy, although at this time P. cynomolgi appears to have an uncomplicated clinical course and good response to commonly used anti-malarials.
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Escalante AA, Cepeda AS, Pacheco MA. Why Plasmodium vivax and Plasmodium falciparum are so different? A tale of two clades and their species diversities. Malar J 2022; 21:139. [PMID: 35505356 PMCID: PMC9066883 DOI: 10.1186/s12936-022-04130-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
The global malaria burden sometimes obscures that the genus Plasmodium comprises diverse clades with lineages that independently gave origin to the extant human parasites. Indeed, the differences between the human malaria parasites were highlighted in the classical taxonomy by dividing them into two subgenera, the subgenus Plasmodium, which included all the human parasites but Plasmodium falciparum that was placed in its separate subgenus, Laverania. Here, the evolution of Plasmodium in primates will be discussed in terms of their species diversity and some of their distinct phenotypes, putative molecular adaptations, and host–parasite biocenosis. Thus, in addition to a current phylogeny using genome-level data, some specific molecular features will be discussed as examples of how these parasites have diverged. The two subgenera of malaria parasites found in primates, Plasmodium and Laverania, reflect extant monophyletic groups that originated in Africa. However, the subgenus Plasmodium involves species in Southeast Asia that were likely the result of adaptive radiation. Such events led to the Plasmodium vivax lineage. Although the Laverania species, including P. falciparum, has been considered to share “avian characteristics,” molecular traits that were likely in the common ancestor of primate and avian parasites are sometimes kept in the Plasmodium subgenus while being lost in Laverania. Assessing how molecular traits in the primate malaria clades originated is a fundamental science problem that will likely provide new targets for interventions. However, given that the genus Plasmodium is paraphyletic (some descendant groups are in other genera), understanding the evolution of malaria parasites will benefit from studying “non-Plasmodium” Haemosporida.
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Affiliation(s)
- Ananias A Escalante
- Biology Department/Institute of Genomics and Evolutionary Medicine [iGEM], Temple University, Philadelphia, PA, 19122-1801, USA.
| | - Axl S Cepeda
- Biology Department/Institute of Genomics and Evolutionary Medicine [iGEM], Temple University, Philadelphia, PA, 19122-1801, USA
| | - M Andreína Pacheco
- Biology Department/Institute of Genomics and Evolutionary Medicine [iGEM], Temple University, Philadelphia, PA, 19122-1801, USA
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Lempang MEP, Dewayanti FK, Syahrani L, Permana DH, Malaka R, Asih PBS, Syafruddin D. Primate malaria: An emerging challenge of zoonotic malaria in Indonesia. One Health 2022; 14:100389. [PMID: 35686151 PMCID: PMC9171520 DOI: 10.1016/j.onehlt.2022.100389] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 12/23/2022] Open
Abstract
The emergence of zoonotic malaria in different parts of the world, including Indonesia poses a challenge to the current malaria control and elimination program that target global malaria elimination at 2030. The reported cases in human include Plasmodium knowlesi, P. cynomolgi and P. inui, in South and Southeast Asian region and P. brazilianum and P. simium in Latin America. All are naturally found in the Old and New-world monkeys, macaques spp. This review focuses on the currently available data that may represent primate malaria as an emerging challenge of zoonotic malaria in Indonesia, the distribution of non-human primates and the malaria parasites it carries, changes in land use and deforestation that impact the habitat and intensifies interaction between the non-human primate and the human which facilitate spill-over of the pathogens. Although available data in Indonesia is very limited, a growing body of evidence indicate that the challenge of zoonotic malaria is immense and alerts to the need to conduct mitigation efforts through multidisciplinary approach involving environmental management, non-human primates conservation, disease management and vector control.
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Affiliation(s)
| | - Farahana Kresno Dewayanti
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia
| | - Lepa Syahrani
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia
| | - Dendi Hadi Permana
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia
| | - Ratmawati Malaka
- Faculty of Animal Husbandry, Hasanuddin University, Makassar, Indonesia
| | - Puji Budi Setia Asih
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia
| | - Din Syafruddin
- Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia
- Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Corresponding author at: Eijkman Institute for Molecular Biology, National Research and Innovation Agency, Jakarta, Indonesia.
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Ruiz Cuenca P, Key S, Lindblade KA, Vythilingam I, Drakeley C, Fornace K. Is there evidence of sustained human-mosquito-human transmission of the zoonotic malaria Plasmodium knowlesi? A systematic literature review. Malar J 2022; 21:89. [PMID: 35300703 PMCID: PMC8929260 DOI: 10.1186/s12936-022-04110-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background The zoonotic malaria parasite Plasmodium knowlesi has emerged across Southeast Asia and is now the main cause of malaria in humans in Malaysia. A critical priority for P. knowlesi surveillance and control is understanding whether transmission is entirely zoonotic or is also occurring through human-mosquito-human transmission. Methods A systematic literature review was performed to evaluate existing evidence which refutes or supports the occurrence of sustained human-mosquito-human transmission of P. knowlesi. Possible evidence categories and study types which would support or refute non-zoonotic transmission were identified and ranked. A literature search was conducted on Medline, EMBASE and Web of Science using a broad search strategy to identify any possible published literature. Results were synthesized using the Synthesis Without Meta-analysis (SWiM) framework, using vote counting to combine the evidence within specific categories. Results Of an initial 7,299 studies screened, 131 studies were included within this review: 87 studies of P. knowlesi prevalence in humans, 14 studies in non-human primates, 13 studies in mosquitoes, and 29 studies with direct evidence refuting or supporting non-zoonotic transmission. Overall, the evidence showed that human-mosquito-human transmission is biologically possible, but there is limited evidence of widespread occurrence in endemic areas. Specific areas of research were identified that require further attention, notably quantitative analyses of potential transmission dynamics, epidemiological and entomological surveys, and ecological studies into the sylvatic cycle of the disease. Conclusion There are key questions about P. knowlesi that remain within the areas of research that require more attention. These questions have significant implications for malaria elimination and eradication programs. This paper considers limited but varied research and provides a methodological framework for assessing the likelihood of different transmission patterns for emerging zoonotic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04110-z.
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Affiliation(s)
- Pablo Ruiz Cuenca
- Centre for Health Informatics, Computing, and Statistics (CHICAS), Lancaster University Medical School, Lancaster, UK. .,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Stephanie Key
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kim A Lindblade
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kimberly Fornace
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
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Gupta A, Galinski MR, Voit EO. Dynamic Control Balancing Cell Proliferation and Inflammation is Crucial for an Effective Immune Response to Malaria. Front Mol Biosci 2022; 8:800721. [PMID: 35242812 PMCID: PMC8886244 DOI: 10.3389/fmolb.2021.800721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Malaria has a complex pathology with varying manifestations and symptoms, effects on host tissues, and different degrees of severity and ultimate outcome, depending on the causative Plasmodium pathogen and host species. Previously, we compared the peripheral blood transcriptomes of two macaque species (Macaca mulatta and Macaca fascicularis) in response to acute primary infection by Plasmodium knowlesi. Although these two species are very closely related, the infection in M. mulatta is fatal, unless aggressively treated, whereas M. fascicularis develops a chronic, but tolerable infection in the blood. As a reason for this stark difference, our analysis suggests delayed pathogen detection in M. mulatta followed by extended inflammation that eventually overwhelms this monkey’s immune response. By contrast, the natural host M. fascicularis detects the pathogen earlier and controls the inflammation. Additionally, M. fascicularis limits cell proliferation pathways during the log phase of infection, presumably in an attempt to control inflammation. Subsequent cell proliferation suggests a cell-mediated adaptive immune response. Here, we focus on molecular mechanisms underlying the key differences in the host and parasite responses and their coordination. SICAvar Type 1 surface antigens are highly correlated with pattern recognition receptor signaling and important inflammatory genes for both hosts. Analysis of pathogen detection pathways reveals a similar signaling mechanism, but with important differences in the glutamate G-protein coupled receptor (GPCR) signaling pathway. Furthermore, differences in inflammasome assembly processes suggests an important role of S100 proteins in balancing inflammation and cell proliferation. Both differences point to the importance of Ca2+ homeostasis in inflammation. Additionally, the kynurenine-to-tryptophan ratio, a known inflammatory biomarker, emphasizes higher inflammation in M. mulatta during log phase. Transcriptomics-aided metabolic modeling provides a functional method for evaluating these changes and understanding downstream changes in NAD metabolism and aryl hydrocarbon receptor (AhR) signaling, with enhanced NAD metabolism in M. fascicularis and stronger AhR signaling in M. mulatta. AhR signaling controls important immune genes like IL6, IFNγ and IDO1. However, direct changes due to AhR signaling could not be established due to complicated regulatory feedback mechanisms associated with the AhR repressor (AhRR). A complete understanding of the exact dynamics of the immune response is difficult to achieve. Nonetheless, our comparative analysis provides clear suggestions of processes that underlie an effective immune response. Thus, our study identifies multiple points of intervention that are apparently responsible for a balanced and effective immune response and thereby paves the way toward future immune strategies for treating malaria.
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Affiliation(s)
- Anuj Gupta
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Mary R. Galinski
- Emory Vaccine Center, Yerkes National Primate Research Center, Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, United States
| | - Eberhard O. Voit
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- *Correspondence: Eberhard O. Voit,
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Voinson M, Nunn CL, Goldberg A. Primate malarias as a model for cross-species parasite transmission. eLife 2022; 11:e69628. [PMID: 35086643 PMCID: PMC8798051 DOI: 10.7554/elife.69628] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 01/14/2022] [Indexed: 12/16/2022] Open
Abstract
Parasites regularly switch into new host species, representing a disease burden and conservation risk to the hosts. The distribution of these parasites also gives insight into characteristics of ecological networks and genetic mechanisms of host-parasite interactions. Some parasites are shared across many species, whereas others tend to be restricted to hosts from a single species. Understanding the mechanisms producing this distribution of host specificity can enable more effective interventions and potentially identify genetic targets for vaccines or therapies. As ecological connections between human and local animal populations increase, the risk to human and wildlife health from novel parasites also increases. Which of these parasites will fizzle out and which have the potential to become widespread in humans? We consider the case of primate malarias, caused by Plasmodium parasites, to investigate the interacting ecological and evolutionary mechanisms that put human and nonhuman primates at risk for infection. Plasmodium host switching from nonhuman primates to humans led to ancient introductions of the most common malaria-causing agents in humans today, and new parasite switching is a growing threat, especially in Asia and South America. Based on a wild host-Plasmodium occurrence database, we highlight geographic areas of concern and potential areas to target further sampling. We also discuss methodological developments that will facilitate clinical and field-based interventions to improve human and wildlife health based on this eco-evolutionary perspective.
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Affiliation(s)
- Marina Voinson
- Department of Evolutionary Anthropology, Duke UniversityDurhamUnited States
| | - Charles L Nunn
- Department of Evolutionary Anthropology, Duke UniversityDurhamUnited States
- Duke Global Health, Duke UniversityDurhamUnited States
| | - Amy Goldberg
- Department of Evolutionary Anthropology, Duke UniversityDurhamUnited States
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Idris Z, Dian N, Rahim MFA. Plasmodium cynomolgi: An emerging threat of zoonotic malaria species in Malaysia? ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.335698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Peterson MS, Joyner CJ, Brady JA, Wood JS, Cabrera-Mora M, Saney CL, Fonseca LL, Cheng WT, Jiang J, Lapp SA, Soderberg SR, Nural MV, Humphrey JC, Hankus A, Machiah D, Karpuzoglu E, DeBarry JD, Tirouvanziam R, Kissinger JC, Moreno A, Gumber S, Voit EO, Gutiérrez JB, Cordy RJ, Galinski MR. Clinical recovery of Macaca fascicularis infected with Plasmodium knowlesi. Malar J 2021; 20:486. [PMID: 34969401 PMCID: PMC8719393 DOI: 10.1186/s12936-021-03925-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Kra monkeys (Macaca fascicularis), a natural host of Plasmodium knowlesi, control parasitaemia caused by this parasite species and escape death without treatment. Knowledge of the disease progression and resilience in kra monkeys will aid the effective use of this species to study mechanisms of resilience to malaria. This longitudinal study aimed to define clinical, physiological and pathological changes in kra monkeys infected with P. knowlesi, which could explain their resilient phenotype. METHODS Kra monkeys (n = 15, male, young adults) were infected intravenously with cryopreserved P. knowlesi sporozoites and the resulting parasitaemias were monitored daily. Complete blood counts, reticulocyte counts, blood chemistry and physiological telemetry data (n = 7) were acquired as described prior to infection to establish baseline values and then daily after inoculation for up to 50 days. Bone marrow aspirates, plasma samples, and 22 tissue samples were collected at specific time points to evaluate longitudinal clinical, physiological and pathological effects of P. knowlesi infections during acute and chronic infections. RESULTS As expected, the kra monkeys controlled acute infections and remained with low-level, persistent parasitaemias without anti-malarial intervention. Unexpectedly, early in the infection, fevers developed, which ultimately returned to baseline, as well as mild to moderate thrombocytopenia, and moderate to severe anaemia. Mathematical modelling and the reticulocyte production index indicated that the anaemia was largely due to the removal of uninfected erythrocytes and not impaired production of erythrocytes. Mild tissue damage was observed, and tissue parasite load was associated with tissue damage even though parasite accumulation in the tissues was generally low. CONCLUSIONS Kra monkeys experimentally infected with P. knowlesi sporozoites presented with multiple clinical signs of malaria that varied in severity among individuals. Overall, the animals shared common mechanisms of resilience characterized by controlling parasitaemia 3-5 days after patency, and controlling fever, coupled with physiological and bone marrow responses to compensate for anaemia. Together, these responses likely minimized tissue damage while supporting the establishment of chronic infections, which may be important for transmission in natural endemic settings. These results provide new foundational insights into malaria pathogenesis and resilience in kra monkeys, which may improve understanding of human infections.
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Affiliation(s)
- Mariko S Peterson
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | - Chester J Joyner
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Center for Vaccines and Immunology, Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Center for Vaccines and Immunology, Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jessica A Brady
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, GA, USA
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Jennifer S Wood
- Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Monica Cabrera-Mora
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Celia L Saney
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Luis L Fonseca
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Wayne T Cheng
- Center for Vaccines and Immunology, Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Jianlin Jiang
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Stacey A Lapp
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Stephanie R Soderberg
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Thermo Fisher Scientific, South San Francisco, CA, USA
| | - Mustafa V Nural
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
| | - Jay C Humphrey
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Center for Tropical & Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Allison Hankus
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- The MITRE Corporation, Atlanta, GA, USA
| | - Deepa Machiah
- Division of Pathology, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Ebru Karpuzoglu
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Department of Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jeremy D DeBarry
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Center for Topical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | | | - Jessica C Kissinger
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Department of Genetics, University of Georgia, Athens, GA, USA
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Alberto Moreno
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanjeev Gumber
- Division of Pathology, Yerkes National Primate Research Center, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory School of Medicine, Atlanta, GA, USA
- Pathology, Drug Safety, and DMPK, Boehringer Ingelheim Animal Health USA, Inc., Athens, GA, USA
| | - Eberhard O Voit
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Juan B Gutiérrez
- Department of Mathematics, University of Georgia, Athens, GA, USA
- Department of Mathematics, University of Texas at San Antonio, San Antonio, TX, USA
| | - Regina Joice Cordy
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Department of Biology, Wake Forest University, Winston-Salem, NC, USA
| | - Mary R Galinski
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University, Atlanta, GA, USA.
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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van Schalkwyk DA, Moon RW, Duffey M, Leroy D, Sutherland CJ. Ex vivo susceptibility to new antimalarial agents differs among human-infecting Plasmodium species. Int J Parasitol Drugs Drug Resist 2021; 17:5-11. [PMID: 34315108 PMCID: PMC8327131 DOI: 10.1016/j.ijpddr.2021.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
Several promising antimalarial drugs are currently being tested in human trials, such as artefenomel, cipargamin, ferroquine and ganaplacide. Many of these compounds were identified using high throughput screens against a single species of human malaria, Plasmodium falciparum, under the assumption that effectiveness against all malaria species will be similar, as has been observed for other antimalarial drugs. However, using our in vitro adapted line, we demonstrated recently that P. knowlesi is significantly less susceptible than P. falciparum to some new antimalarial drugs (e.g., cipargamin and DSM265), and more susceptible to others (e.g., ganaplacide). There is, therefore, an urgent need to determine the susceptibility profile of all human malaria species to the current generation of antimalarial compounds. We obtained ex vivo malaria samples from travellers returning to the United Kingdom and, using the [3H]hypoxanthine incorporation method, compared susceptibility to select established and experimental antimalarial agents among all major human infective Plasmodium species. We demonstrate that P. malariae and P. ovale spp. are significantly less susceptible than P. falciparum to cipargamin, DSM265 and AN13762, but are more susceptible to ganaplacide. Preliminary ex vivo data from single isolates of P. knowlesi and P. vivax demonstrate a similar profile. Our findings highlight the need to ensure cross species susceptibility profiles are determined early in the drug development pipeline. Our data can also be used to inform further drug development, and illustrate the utility of the P. knowlesi in vitro model as a scalable approach for predicting the drug susceptibility of non-falciparum malaria species in general.
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Affiliation(s)
- Donelly A van Schalkwyk
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Robert W Moon
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Maëlle Duffey
- Medicines for Malaria Venture, 20 rte de Pré Bois, Geneva, CH 1215, Switzerland
| | - Didier Leroy
- Medicines for Malaria Venture, 20 rte de Pré Bois, Geneva, CH 1215, Switzerland
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK; Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London, WC1E 6JB, UK
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36
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Progress in understanding the phylogeny of the Plasmodium vivax lineage. Parasitol Int 2021; 87:102507. [PMID: 34781012 DOI: 10.1016/j.parint.2021.102507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022]
Abstract
There has been some controversy about the evolutionary origin of Plasmodium vivax, particularly whether it is of Asian or African origin. Recently, a new malaria species which closely related to ape P. vivax was found in chimpanzees, in addition, the host switches of P. vivax from ape to human was confirmed. These findings support the African origin of P. vivax. Previous phylogenetic analyses have shown the position of P. vivax within the Asian primate malaria parasite clade. This suggested an Asian origin of P. vivax. Recent analyses using massive gene data, however, positioned P. vivax after the branching of the African Old World monkey parasite P. gonderi, and before the branching of the common ancestor of Asian primate malaria parasites. This position is consistent with an African origin of P. vivax. We here review the history of phylogenetic analyses on P. vivax, validate previous analyses, and finally present a definitive analysis using currently available data that indicate a tree in which P. vivax is positioned at the base of the Asian primate malaria parasite clade, and thus that is consistent with an African origin of P. vivax.
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Cuenca PR, Key S, Jumail A, Surendra H, Ferguson HM, Drakeley CJ, Fornace K. Epidemiology of the zoonotic malaria Plasmodium knowlesi in changing landscapes. ADVANCES IN PARASITOLOGY 2021; 113:225-286. [PMID: 34620384 DOI: 10.1016/bs.apar.2021.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Within the past two decades, incidence of human cases of the zoonotic malaria Plasmodium knowlesi has increased markedly. P. knowlesi is now the most common cause of human malaria in Malaysia and threatens to undermine malaria control programmes across Southeast Asia. The emergence of zoonotic malaria corresponds to a period of rapid deforestation within this region. These environmental changes impact the distribution and behaviour of the simian hosts, mosquito vector species and human populations, creating new opportunities for P. knowlesi transmission. Here, we review how landscape changes can drive zoonotic disease emergence, examine the extent and causes of these changes across Southeast and identify how these mechanisms may be impacting P. knowlesi dynamics. We review the current spatial epidemiology of reported P. knowlesi infections in people and assess how these demographic and environmental changes may lead to changes in transmission patterns. Finally, we identify opportunities to improve P. knowlesi surveillance and develop targeted ecological interventions within these landscapes.
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Affiliation(s)
- Pablo Ruiz Cuenca
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephanie Key
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Henry Surendra
- Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia; Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Chris J Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kimberly Fornace
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom.
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Vythilingam I, Chua TH, Liew JWK, Manin BO, Ferguson HM. The vectors of Plasmodium knowlesi and other simian malarias Southeast Asia: challenges in malaria elimination. ADVANCES IN PARASITOLOGY 2021; 113:131-189. [PMID: 34620382 DOI: 10.1016/bs.apar.2021.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Plasmodium knowlesi, a simian malaria parasite of great public health concern has been reported from most countries in Southeast Asia and exported to various countries around the world. Currently P. knowlesi is the predominant species infecting humans in Malaysia. Besides this species, other simian malaria parasites such as P. cynomolgi and P. inui are also infecting humans in the region. The vectors of P. knowlesi and other Asian simian malarias belong to the Leucosphyrus Group of Anopheles mosquitoes which are generally forest dwelling species. Continual deforestation has resulted in these species moving into forest fringes, farms, plantations and human settlements along with their macaque hosts. Limited studies have shown that mosquito vectors are attracted to both humans and macaque hosts, preferring to bite outdoors and in the early part of the night. We here review the current status of simian malaria vectors and their parasites, knowledge of vector competence from experimental infections and discuss possible vector control measures. The challenges encountered in simian malaria elimination are also discussed. We highlight key knowledge gaps on vector distribution and ecology that may impede effective control strategies.
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Affiliation(s)
- Indra Vythilingam
- Department of Parasitology, University of Malaya, Kuala Lumpur, Malaysia.
| | - Tock Hing Chua
- Department of Pathobiology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia.
| | - Jonathan Wee Kent Liew
- Department of Parasitology, University of Malaya, Kuala Lumpur, Malaysia; Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Benny O Manin
- Department of Pathobiology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
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Gupta A, Styczynski MP, Galinski MR, Voit EO, Fonseca LL. Dramatic transcriptomic differences in Macaca mulatta and Macaca fascicularis with Plasmodium knowlesi infections. Sci Rep 2021; 11:19519. [PMID: 34593836 PMCID: PMC8484567 DOI: 10.1038/s41598-021-98024-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/30/2021] [Indexed: 12/02/2022] Open
Abstract
Plasmodium knowlesi, a model malaria parasite, is responsible for a significant portion of zoonotic malaria cases in Southeast Asia and must be controlled to avoid disease severity and fatalities. However, little is known about the host-parasite interactions and molecular mechanisms in play during the course of P. knowlesi malaria infections, which also may be relevant across Plasmodium species. Here we contrast P. knowlesi sporozoite-initiated infections in Macaca mulatta and Macaca fascicularis using whole blood RNA-sequencing and transcriptomic analysis. These macaque hosts are evolutionarily close, yet malaria-naïve M. mulatta will succumb to blood-stage infection without treatment, whereas malaria-naïve M. fascicularis controls parasitemia without treatment. This comparative analysis reveals transcriptomic differences as early as the liver phase of infection, in the form of signaling pathways that are activated in M. fascicularis, but not M. mulatta. Additionally, while most immune responses are initially similar during the acute stage of the blood infection, significant differences arise subsequently. The observed differences point to prolonged inflammation and anti-inflammatory effects of IL10 in M. mulatta, while M. fascicularis undergoes a transcriptional makeover towards cell proliferation, consistent with its recovery. Together, these findings suggest that timely detection of P. knowlesi in M. fascicularis, coupled with control of inflammation while initiating the replenishment of key cell populations, helps contain the infection. Overall, this study points to specific genes and pathways that could be investigated as a basis for new drug targets that support recovery from acute malaria.
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Affiliation(s)
- Anuj Gupta
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Mark P Styczynski
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Mary R Galinski
- Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Eberhard O Voit
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
| | - Luis L Fonseca
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Laboratory for Systems Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
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40
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Yap NJ, Hossain H, Nada-Raja T, Ngui R, Muslim A, Hoh BP, Khaw LT, Kadir KA, Simon Divis PC, Vythilingam I, Singh B, Lim YAL. Natural Human Infections with Plasmodium cynomolgi, P. inui, and 4 other Simian Malaria Parasites, Malaysia. Emerg Infect Dis 2021; 27:2187-2191. [PMID: 34287122 PMCID: PMC8314832 DOI: 10.3201/eid2708.204502] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We detected the simian malaria parasites Plasmodium knowlesi, P. cynomolgi, P. inui, P. coatneyi, P. inui–like, and P. simiovale among forest fringe–living indigenous communities from various locations in Malaysia. Our findings underscore the importance of using molecular tools to identify newly emergent malaria parasites in humans.
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Wilairatana P, Mala W, Rattaprasert P, Kotepui KU, Kotepui M. Prevalence of Malaria and Leptospirosis Co-Infection among Febrile Patients: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2021; 6:tropicalmed6030122. [PMID: 34287366 PMCID: PMC8293407 DOI: 10.3390/tropicalmed6030122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 06/29/2021] [Indexed: 12/28/2022] Open
Abstract
Malaria and leptospirosis are important cosmopolitan infections that have emerged with overlapping geographic distribution, especially in tropical and subtropical regions. Therefore, co-infection with malaria and leptospirosis may occur in overlapping areas. The present study aimed to quantify the prevalence of malaria and leptospirosis co-infection among febrile patients. The association between malaria and leptospirosis infections was also investigated. Relevant studies that had reported malaria and leptospirosis co-infection were identified from PubMed, Scopus, and Web of Science. The risk of bias of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The pooled prevalence of malaria and leptospirosis co-infections among febrile patients and the pooled prevalence of leptospirosis infection among malaria patients were estimated using random effect models. The association between malaria and leptospirosis infection among febrile patients was estimated using random effect models. The outcomes of each study were shown in a forest plot in point estimate and 95% confidence interval (CI). Heterogeneity among the included studies was assessed using Cochran’s Q and quantified using I-squared statistics. For leptospirosis, subgroup analyses of countries, diagnostic tests, and participants’ age groups were performed to specify prevalence in each subgroup. Publication bias was assessed by funnel-plot visualization. Of the 2370 articles identified from the databases, 15 studies met the eligibility criteria and were included for qualitative and quantitative syntheses. Most of the included studies were conducted in India (5/15, 33.3%), Thailand (3/15, 20%), and Cambodia (2/15, 13.3%). Most of the enrolled cases were febrile patients (5838 cases) and malaria-positive patients (421 cases). The meta-analysis showed that the pooled prevalence of malaria and leptospirosis co-infection (86 cases) among febrile patients was 1% (95% CI: 1–2%, I2: 83.3%), while the pooled prevalence of leptospirosis infection (186 cases) among malaria patients was 13% (95% CI: 9–18%, I2: 90.3%). The meta-analysis showed that malaria and leptospirosis co-infections occurred by chance (p: 0.434, OR: 1.4, 95% CI: 0.6–3.28, I2: 85.2%). The prevalence of malaria in leptospirosis co-infection among febrile patients in the included studies was low. Co-infection was likely to occur by chance. However, as clinical symptoms of leptospirosis patients were non-specific and not distinguishable from symptoms of malaria patients, clinicians caring for febrile patients in an area where those two diseases are endemic should maintain a high index of suspicion for both diseases and whether mono-infections or co-infections are likely. Recognition of this co-infection may play an important role in reducing disease severity and treatment duration.
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Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
| | - Pongruj Rattaprasert
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
- Correspondence: ; Tel.: +66-954392469
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Laboratory Detection of Malaria Antigens: a Strong Tool for Malaria Research, Diagnosis, and Epidemiology. Clin Microbiol Rev 2021; 34:e0025020. [PMID: 34043447 DOI: 10.1128/cmr.00250-20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The identification and characterization of proteins produced during human infection with Plasmodium spp. have guided the malaria community in research, diagnosis, epidemiology, and other efforts. Recently developed methods for the detection of these proteins (antigens) in the laboratory have provided new types of data that can inform the evaluation of malaria diagnostics, epidemiological investigations, and overall malaria control strategies. Here, the focus is primarily on antigens that are currently known to be detectable in human specimens and on their impact on the understanding of malaria in human populations. We highlight historical and contemporary laboratory assays for malaria antigen detection, the concept of an antigen profile for a biospecimen, and ways in which binary results for a panel of antigens could be interpreted and utilized for different analyses. Particular emphasis is given to the direct comparison of field-level malaria diagnostics and laboratory antigen detection for the development of an external evaluation scheme. The current limitations of laboratory antigen detection are considered, and the future of this developing field is discussed.
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Ooi CH, Phang WK, Kent Liew JW, Lau YL. Spatial and Temporal Patterns of Plasmodium knowlesi Malaria in Sarawak from 2008 to 2017. Am J Trop Med Hyg 2021; 104:1814-1819. [PMID: 33755585 PMCID: PMC8103491 DOI: 10.4269/ajtmh.20-1304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/22/2021] [Indexed: 12/16/2022] Open
Abstract
Zoonotic knowlesi malaria has replaced human malaria as the most prevalent malaria disease in Malaysia. The persistence of knowlesi malaria in high-risk transmission areas or hotspots can be discouraging to existing malaria elimination efforts. In this study, retrospective data of laboratory-confirmed knowlesi malaria cases were obtained from the Sarawak Health Department to investigate the spatiotemporal patterns and clustering of knowlesi malaria in the state of Sarawak from 2008 to 2017. Purely spatial, purely temporal, and spatiotemporal analyses were performed using SaTScan software to define clustering of knowlesi malaria incidence. Purely spatial and spatiotemporal analyses indicated most likely clusters of knowlesi malaria in the northern region of Sarawak, along the Sarawak-Kalimantan border, and the inner central region of Sarawak between 2008 and 2017. Temporal cluster was detected between September 2016 and December 2017. This study provides evidence of the existence of statistically significant Plasmodium knowlesi malaria clusters in Sarawak, Malaysia. The analysis approach applied in this study showed potential in establishing surveillance and risk management system for knowlesi malaria control as Malaysia approaches human malaria elimination.
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Affiliation(s)
- Choo Huck Ooi
- Vector Borne Disease Section, Sarawak Health Department, Ministry of Health Malaysia, Kuching, Malaysia;,Address correspondence to Choo Huck Ooi, Vector Borne Disease Section, Sarawak Health Department, Ministry of Health Malaysia, Diplomatik Rd., Off Bako Rd., Kuching 93050, Malaysia, E-mail: or Yee Ling Lau, Department of Parasitology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia, E-mail:
| | - Wei Kit Phang
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jonathan Wee Kent Liew
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,Address correspondence to Choo Huck Ooi, Vector Borne Disease Section, Sarawak Health Department, Ministry of Health Malaysia, Diplomatik Rd., Off Bako Rd., Kuching 93050, Malaysia, E-mail: or Yee Ling Lau, Department of Parasitology, Faculty of Medicine, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia, E-mail:
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Munajat MB, Rahim MAFA, Wahid W, Seri Rakna MIM, Divis PCS, Chuangchaiya S, Lubis IND, Osman E, Mohd Kasri MR, Idris ZM. Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia. Malar J 2021; 20:202. [PMID: 33906645 PMCID: PMC8077949 DOI: 10.1186/s12936-021-03741-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community's knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia. METHODS A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Community members aged six years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics. RESULTS Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bed net ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% were aware that bed nets were used to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their houses and 20.1% reported entering nearby forests within the last 6 months. CONCLUSION This study found that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices concerning managing malaria require marked improvement.
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Affiliation(s)
- Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Amirul Fitri A Rahim
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Wathiqah Wahid
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | | | - Paul C S Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Sriwipa Chuangchaiya
- Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, 47000, Thailand
| | - Inke Nadia D Lubis
- Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, 20154, Indonesia
| | - Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | | | - Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia.
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The New Zoonotic Malaria: Plasmodium cynomolgi. Trop Med Infect Dis 2021; 6:tropicalmed6020046. [PMID: 33916448 PMCID: PMC8167800 DOI: 10.3390/tropicalmed6020046] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/02/2021] [Accepted: 04/03/2021] [Indexed: 12/04/2022] Open
Abstract
Plasmodium cynomolgi is a simian malaria parasite that has been a central model parasite since it was first described in 1907. Recently it has made the zoonotic jump and started naturally infecting humans. In this paper, the interactions between Plasmodium cynomolgi and humans, the environment and the non-human animal intermediates or definitive host will be discussed, with a particular focus on the clinical implications of infection and approaches to management of this novel zoonotic parasite.
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46
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Kotepui M, Masangkay FR, Kotepui KU, Milanez GDJ. Preliminary review on the prevalence, proportion, geographical distribution, and characteristics of naturally acquired Plasmodium cynomolgi infection in mosquitoes, macaques, and humans: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:259. [PMID: 33711940 PMCID: PMC7953546 DOI: 10.1186/s12879-021-05941-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/28/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Plasmodium cynomolgi is a simian malaria parasite that has been reported as a naturally acquired human infection. The present study aims to systematically review reports on naturally acquired P. cynomolgi in humans, mosquitoes, and macaques to provide relevant data for pre-emptive surveillance and preparation in the event of an outbreak of zoonotic malaria in Southeast Asia. METHODS The protocol of the systematic review was registered at PROSPERO with approval ID CRD42020203046. Three databases (Web of Science, Scopus, and MEDLINE) were searched for studies reporting the prevalence of P. cynomolgi infections in Southeast Asian countries between 1946 and 2020. The pooled prevalence or pooled proportion of P. cynomolgi parasitemia in humans, mosquitoes, and macaques was estimated using a random-effects model. Differences in the clinical characteristics of P. cynomolgi infections were also estimated using a random-effects model and presented as pooled odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs). RESULTS Thirteen studies reporting on the prevalence of naturally acquired P. cynomolgi in humans (3 studies, 21 cases), mosquitoes (3 studies, 28 cases), and macaques (7 studies, 334 cases) were included. The results demonstrated that the pooled proportion of naturally acquired P. cynomolgi in humans was 1% (95% CI, 0.1%, I2, 0%), while the pooled proportion of P. cynomolgi infecting mosquitoes was 18% (95% CI, 10-26%, I2, 32.7%). The pooled prevalence of naturally acquired P. cynomolgi in macaques was 47% (95% CI, 27-67%, I2, 98.3%). Most of the cases of naturally acquired P. cynomolgi in humans were reported in Cambodia (62%) and Malaysia (38%), while cases of P. cynomolgi in macaques were reported in Malaysia (35.4%), Singapore (23.2%), Indonesia (17.3%), Philippines (8.5%), Laos (7.93%), and Cambodia (7.65%). Cases of P. cynomolgi in mosquitoes were reported in Vietnam (76.9%) and Malaysia (23.1%). CONCLUSIONS This study demonstrated the occurrence of naturally acquired P. cynomolgi infection in humans, mosquitoes, and macaques. Further studies of P. cynomolgi in asymptomatic human cases in areas where vectors and natural hosts are endemic are extensively needed if human infections with P. cynomolgi do become public health problems.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Frederick Ramirez Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
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Oresegun DR, Daneshvar C, Cox-Singh J. Plasmodium knowlesi - Clinical Isolate Genome Sequencing to Inform Translational Same-Species Model System for Severe Malaria. Front Cell Infect Microbiol 2021; 11:607686. [PMID: 33738266 PMCID: PMC7960762 DOI: 10.3389/fcimb.2021.607686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/27/2021] [Indexed: 12/03/2022] Open
Abstract
Malaria is responsible for unacceptably high morbidity and mortality, especially in Sub-Saharan African Nations. Malaria is caused by member species' of the genus Plasmodium and despite concerted and at times valiant efforts, the underlying pathophysiological processes leading to severe disease are poorly understood. Here we describe zoonotic malaria caused by Plasmodium knowlesi and the utility of this parasite as a model system for severe malaria. We present a method to generate long-read third-generation Plasmodium genome sequence data from archived clinical samples using the MinION platform. The method and technology are accessible, affordable and data is generated in real-time. We propose that by widely adopting this methodology important information on clinically relevant parasite diversity, including multiple gene family members, from geographically distinct study sites will emerge. Our goal, over time, is to exploit the duality of P. knowlesi as a well-used laboratory model and human pathogen to develop a representative translational model system for severe malaria that is informed by clinically relevant parasite diversity.
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Affiliation(s)
| | | | - Janet Cox-Singh
- Division of Infection, School of Medicine, University of St Andrews, St Andrews, United Kingdom
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Fornace KM, Diaz AV, Lines J, Drakeley CJ. Achieving global malaria eradication in changing landscapes. Malar J 2021; 20:69. [PMID: 33530995 PMCID: PMC7856737 DOI: 10.1186/s12936-021-03599-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Land use and land cover changes, such as deforestation, agricultural expansion and urbanization, are one of the largest anthropogenic environmental changes globally. Recent initiatives to evaluate the feasibility of malaria eradication have highlighted impacts of landscape changes on malaria transmission and the potential of these changes to undermine malaria control and elimination efforts. Multisectoral approaches are needed to detect and minimize negative impacts of land use and land cover changes on malaria transmission while supporting development aiding malaria control, elimination and ultimately eradication. Pathways through which land use and land cover changes disrupt social and ecological systems to increase or decrease malaria risks are outlined, identifying priorities and opportunities for a global malaria eradication campaign. The impacts of land use and land cover changes on malaria transmission are complex and highly context-specific, with effects changing over time and space. Landscape changes are only one element of a complex development process with wider economic and social dimensions affecting human health and wellbeing. While deforestation and other landscape changes threaten to undermine malaria control efforts and have driven the emergence of zoonotic malaria, most of the malaria elimination successes have been underpinned by agricultural development and land management. Malaria eradication is not feasible without addressing these changing risks while, conversely, consideration of malaria impacts in land management decisions has the potential to significantly accelerate progress towards eradication. Multisectoral cooperation and approaches to linking malaria control and environmental science, such as conducting locally relevant ecological monitoring, integrating landscape data into malaria surveillance systems and designing environmental management strategies to reduce malaria burdens, are essential to achieve malaria eradication.
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Affiliation(s)
- Kimberly M Fornace
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. .,Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Adriana V Diaz
- Pathology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Jo Lines
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris J Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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Li MI, Mailepessov D, Vythilingam I, Lee V, Lam P, Ng LC, Tan CH. Prevalence of simian malaria parasites in macaques of Singapore. PLoS Negl Trop Dis 2021; 15:e0009110. [PMID: 33493205 PMCID: PMC7861519 DOI: 10.1371/journal.pntd.0009110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/04/2021] [Accepted: 01/06/2021] [Indexed: 02/04/2023] Open
Abstract
Plasmodium knowlesi is a simian malaria parasite currently recognized as the fifth causative agent of human malaria. Recently, naturally acquired P. cynomolgi infection in humans was also detected in Southeast Asia. The main reservoir of both parasites is the long-tailed and pig-tailed macaques, which are indigenous in this region. Due to increased urbanization and changes in land use, there has been greater proximity and interaction between the long-tailed macaques and the general population in Singapore. As such, this study aims to determine the prevalence of simian malaria parasites in local macaques to assess the risk of zoonosis to the general human population. Screening for the presence of malaria parasites was conducted on blood samples from 660 peridomestic macaques collected between Jan 2008 and Mar 2017, and 379 wild macaques collected between Mar 2009 and Mar 2017, using a Pan-Plasmodium-genus specific PCR. Positive samples were then screened using a simian Plasmodium species-specific nested PCR assay to identify the species of parasites (P. knowlesi, P. coatneyi, P. fieldi, P. cynomolgi, and P. inui) present. All the peridomestic macaques sampled were tested negative for malaria, while 80.5% of the 379 wild macaques were infected. All five simian Plasmodium species were detected; P. cynomolgi being the most prevalent (71.5%), followed by P. knowlesi (47.5%), P. inui (42.0%), P. fieldi (32.5%), and P. coatneyi (28.5%). Co-infection with multiple species of Plasmodium parasites was also observed. The study revealed that Singapore's wild long-tailed macaques are natural hosts of the five simian malaria parasite species, while no malaria was detected in all peridomestic macaques tested. Therefore, the risk of simian malaria transmission to the general human population is concluded to be low. However, this can be better demonstrated with the incrimination of the vectors of simian malaria parasites in Singapore.
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Affiliation(s)
- Meizhi Irene Li
- Environmental Health Institute, National Environment Agency, Singapore
| | - Diyar Mailepessov
- Environmental Health Institute, National Environment Agency, Singapore
| | - Indra Vythilingam
- Parasitology Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vernon Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Patrick Lam
- Biodefence Centre, Force Medical Protection Command, Headquarters Medical Corps, Singapore Armed Forces, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Cheong Huat Tan
- Environmental Health Institute, National Environment Agency, Singapore
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Su XZ, Wu J. Zoonotic Transmissions and Host Switches of Malaria Parasites. ZOONOSES (BURLINGTON, MASS.) 2021; 1. [PMID: 35282332 DOI: 10.15212/zoonoses-2021-0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Malaria is a deadly disease that affects the health of hundreds of millions of people annually. There are five Plasmodium parasite species that can naturally infect humans, including Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium knowlesi. Some of the parasites can also infect various non-human primates. Parasites mainly infecting monkeys such as Plasmodium cynomolgi (in fact P. knowlesi was considered as a parasite of monkeys for years) can also be transmitted to human hosts. Recently, many new Plasmodium species were discovered in African apes, and it is possible that some of the parasites can be transmitted to humans in the future. Here, we searched PubMed and the internet via Google and selected articles concerning zoonotic transmission and evolution of selected malaria parasite species. We reviewed the current advances in the relevant topics emphasizing on transmissions of malaria parasites between humans and non-human primates. We also briefly discuss the transmissions of some avian malaria parasites between wild birds and domestic fowls. Zoonotic malaria transmissions are widespread, which poses a threat to public health. More studies on parasite species identification in non-human primates, transmission, and evolution are needed to reduce or prevent transmission of malaria parasites from non-human primates to humans.
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Affiliation(s)
- Xin-Zhuan Su
- Malaria Functional Genomics Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD 20892-8132, USA
| | - Jian Wu
- Malaria Functional Genomics Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD 20892-8132, USA
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