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Millat-Martínez P, Baro B, Kasian B, Lorry L, Sanz S, Wali C, Raulo S, Elizah A, Koleala T, Kaius-Ome M, Karl S, Mitjà O, Laman M, Pomat W, Bassat Q. A cross-sectional study to ascertain malaria prevalence among asymptomatic travellers arriving on the Lihir Group of Islands, Papua New Guinea: implications for elimination efforts. Malar J 2023; 22:364. [PMID: 38031175 PMCID: PMC10688477 DOI: 10.1186/s12936-023-04804-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation. METHODS In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity. RESULTS 398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066). CONCLUSIONS Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.
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Affiliation(s)
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | - Bernadine Kasian
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Lina Lorry
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Sergi Sanz
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Chilaka Wali
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Sylvia Raulo
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Arthur Elizah
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Tamarah Koleala
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Maria Kaius-Ome
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Stephan Karl
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Oriol Mitjà
- Fight Infectious Diseases Foundation, Hospital Germans Trias I Pujol, Badalona, Spain
- School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Vic, Catalonia, Spain
- Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea
| | - Moses Laman
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - William Pomat
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Huang F, Cui Y, Huang Z, Wang S, Li S, Guo X, Guo X, Xia ZG. Serological surveillance on potential Plasmodium vivax exposure risk in a post-elimination setting. Front Cell Infect Microbiol 2023; 13:1132917. [PMID: 36968112 PMCID: PMC10034364 DOI: 10.3389/fcimb.2023.1132917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
China was declared malaria free in June of 2021. In the post-elimination setting, vigilant surveillance is essential to sustain malaria free status. Serological surveillance has been recognized as an efficient tool for assessing the immunity levels and exposure risk in a population. In this study, a cross-sectional serological survey was conducted in Yingjiang County, China, in August–September, 2021. The study sites were villages along the borders with Myanmar, which have no local transmission since the last indigenous case registered in 2016. A total of 923 participants from six villages were enrolled. The majority was aged > 36 years (56.12%) and 12.46% (115/923) participants had experienced malaria infection at least once. A magnetic- bead-based assay was used to test antibodies against Plasmodium vivax antigen PvMSP-119 to evaluate the prevalence of antibody positive subjects. A reversible catalytic model was used to assess the risk of exposure. The prevalence of anti-PvMSP-119 IgG was 12.84% [95% confidence interval (CI): 9.22%–16.47%], 13.93% (95% CI: 10.11%–17.74%), and 3.57% (95% CI: 1.40%–5.75%) in three different line-of-defense areas, which differed significantly (P < 0.0001). The prevalence of anti-PvMSP-119 IgG increased with age and no statistically significant difference was detected between the sexes. The reversible catalytic model indicated that the seropositive conversion rate and seronegative reversion rate were 0.0042, 0.0034, 0.0032 and 0.0024, 0.0004, 0.0065 in the first-, second-line-of-defense area and total areas, respectively, and the fitted value did not differ significantly from the observed value (P > 0.1). Although this study found the prevalence of antibody-positive subjects and the seroconversion rate in this post-elimination setting were lower than that in transmission setting, the population still had an exposure risk. Serological surveillance should be considered in post-elimination settings to provide valuable information with which to evaluate the risk of malaria re-establishment.
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Affiliation(s)
- Fang Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yanwen Cui
- Division of Tuberculosis Control and Prevention, Shanghai Pudong Center for Disease Control and Prevention, Shanghai, China
| | - Zhuoying Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Siqi Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
- Department of Malaria, Chinese Center for Tropical Diseases Research, Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
- WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Shigang Li
- Division of Endemic Disease Control and Prevention, Yingjiang County Center for Disease Control and Prevention, Yingjiang, China
| | - Xiangrui Guo
- Division of Endemic Disease Control and Prevention, Yingjiang County Center for Disease Control and Prevention, Yingjiang, China
| | - Xiang Guo
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- *Correspondence: Xiang Guo, ; Zhi-Gui Xia,
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
- Department of Malaria, Chinese Center for Tropical Diseases Research, Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
- WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
- *Correspondence: Xiang Guo, ; Zhi-Gui Xia,
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Sun XD, Zhao YL, Lin ZR, Zhao Y, Zhou YW, Li SG, Guo XR, Tian P, Duan KX, Ding CL, Chen QY, Sui Y, Lu SN, Cotter C, Wang DQ, Zheng Z. Implementing a novel capture and ligation probe-PCR method in mass screen and treatment to support malaria elimination efforts in the China-Myanmar border region. Malar J 2023; 22:21. [PMID: 36658578 PMCID: PMC9854064 DOI: 10.1186/s12936-023-04449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Mass screening and treatment (MSAT) for malaria elimination lacks an ideal diagnostic tool to allow sensitive and affordable test of the target population in the field. This study evaluated whether Capture and Ligation Probe-PCR (CLIP-PCR) could be used in a field MSAT in Laiza City, Myanmar. METHODS On day 0, two dried blood spots were collected from each participant. On day 1, all samples were screened for Plasmodium in a 20 m2 laboratory with workbench, a biosafety cabinet, a refrigerator, a benchtop shaking incubator and a qPCR machine, by four technicians using CLIP-PCR with sample pooling, at a health clinic of the Chinese bordering town of Nabang. On day 2, all positives were followed up and treated. RESULTS Of 15,038 persons (65% of the total population) screened, 204 (1.36%) were CLIP-PCR positives. Among them, 188, 14, and 2 were infected with Plasmodium vivax, Plasmodium falciparum, and P. vivax/P. falciparum mix, respectively. The testing capacity was 538 persons/day, with a cost of US$0.92 /person. The proportion of submicroscopic infection was 64.7%. All positive individuals received treatment within 72 h after blood collection. CONCLUSION Using CLIP-PCR in MSAT in low transmission settings can support the malaria elimination efforts in the China-Myanmar border region.
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Affiliation(s)
- Xiao-dong Sun
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Ya-ling Zhao
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
| | - Zu-rui Lin
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Ye Zhao
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
| | - Yao-wu Zhou
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Shi-gang Li
- Yingjiang Centre for Disease Control and Prevention, Yingjiang, 679300 China
| | - Xiang-rui Guo
- Yingjiang Centre for Disease Control and Prevention, Yingjiang, 679300 China
| | - Peng Tian
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Kai-xia Duan
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Chun-li Ding
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Qi-yan Chen
- grid.464500.30000 0004 1758 1139Yunnan Institute of Parasitic Diseases, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Provincial Centre of Malaria Research, Puer, 665000 China
| | - Yuan Sui
- grid.4367.60000 0001 2355 7002Brown School, Washington University, St. Louis, MO USA
| | - Shen-ning Lu
- grid.508378.1WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Science and Technology, Ministry of Health, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, 200025 China
| | - Chris Cotter
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, Institute for Global Health Sciences, University of California, San Francisco, CA USA ,grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Duo-quan Wang
- grid.4367.60000 0001 2355 7002Brown School, Washington University, St. Louis, MO USA
| | - Zhi Zheng
- grid.506261.60000 0001 0706 7839Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
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Huang F, Li S, Tian P, Pu LJS, Cui Y, Liu H, Yang L, Bi DY. Genetic polymorphisms in genes associated with drug resistance in Plasmodium vivax parasites from northeastern Myanmar. Malar J 2022; 21:66. [PMID: 35241080 PMCID: PMC8892751 DOI: 10.1186/s12936-022-04084-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Anti-malarial drug resistance is still a major threat to malaria elimination in the Great Mekong Sub-region. Plasmodium vivax parasites resistant to anti-malarial drugs are now found in Myanmar. Molecular surveillance on drug resistance genes in P. vivax parasites from northeastern Myanmar was aimed at estimating the underlying drug resistance in this region. Methods Blood samples from patients with vivax malaria were collected from Laiza city in northeastern Myanmar in 2020. Drug resistance genes including Pvcrt-o, Pvmdr1, Pvdhfr and Pvdhps were amplified and sequenced. Genetic polymorphisms and haplotypes were analysed to evaluate the prevalence of mutant alleles associated with drug resistance. Results A total of 149 blood samples from P. vivax patients were collected. The prevalence of Pvmdr1 mutations at codons 958 and 1076 was 100.0% and 52.0%, respectively, whereas no single nucleotide polymorphism was present at codon 976. The proportions of single and double mutant types were 48.0% and 52.0%, respectively. A K10 “AAG” insertion in the Pvcrt-o gene was not detected. Mutations in Pvdhfr at codons 57, 58, 61, 99 and 117 were detected in 29.9%, 54.3%, 27.6%, 44.9% and 55.1% of the samples, respectively. Wild type was predominant (46.3%), followed by quadruple and double mutant haplotypes. Of three types of tandem repeat variations of Pvdhfr, Type B, with three copies of GGDN repeats, was the most common. Pvdhps mutations were only detected at codons 383 and 553 and the wild type Pvdhps was dominant (78.0%). Eleven haplotypes were identified when combining the mutations of Pvdhfr and Pvdhps, among which the predominant one was the wild type (33.9%), followed by double mutant alleles S58R/S117N /WT (24.6%). Conclusions This study demonstrated resistant P. vivax phenotypes exists in northeastern Myanmar. Continued surveillance of drug resistance markers is needed to update treatment guidelines in this region. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04084-y.
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Affiliation(s)
- Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China. .,Chinese Center for Tropical Diseases Research, Shanghai, China. .,NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China. .,WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China.
| | - Shigang Li
- Yingjiang County Center for Disease Control and Prevention, Yingjiang, Yunnan, China
| | - Peng Tian
- Yunnan Institute of Parasitic Diseases, Pu'er, Yunnan, China
| | | | - Yanwen Cui
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.,Chinese Center for Tropical Diseases Research, Shanghai, China.,NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China.,WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Hui Liu
- Yunnan Institute of Parasitic Diseases, Pu'er, Yunnan, China
| | - Lianzhi Yang
- Nabang Township Hospital, Yingjiang, Yunnan, China
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Feng X, Zhang L, Tu H, Xia Z. Malaria Elimination in China and Sustainability Concerns in the Post-elimination Stage. China CDC Wkly 2022; 4:990-994. [DOI: 10.46234/ccdcw2022.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
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