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Dembélé P, Cissoko M, Diarra AZ, Doumbia L, Koné A, Magassa MH, Mehadji M, Thera MA, Ranque S. Evaluation of the Performance of Rapid Diagnostic Tests for Malaria Diagnosis and Mapping of Different Plasmodium Species in Mali. Int J Environ Res Public Health 2024; 21:228. [PMID: 38397717 PMCID: PMC10888130 DOI: 10.3390/ijerph21020228] [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] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/09/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The first-line diagnosis of malaria in Mali is based on the use of rapid diagnostic tests (RDT) that detect the Histidin Rich Protein 2 (HRP2) antigen specific to Plasmodium falciparum. Our study, based on a real-time polymerase chain reaction (qPCR) gold standard, aimed to describe the distribution of the Plasmodium species in each administrative region of Mali and to assess the performance of RDTs. METHODS We randomly selected 150 malaria-negative and up to 30 malaria-positive RDTs in 41 sites distributed in 9 regions of Mali. DNA extracted from the RDT nitrocellulose strip was assayed with a pan-Plasmodium qPCR. Positive samples were then analyzed with P. falciparum-, P. malariae-, P. vivax-, or P. ovale-specific qPCRs. RESULTS Of the 1496 RDTs, 258 (18.6%) were positive for Plasmodium spp., of which 96.9% were P. falciparum. The P. vivax prevalence reached 21.1% in the north. RDT displayed acceptable diagnostic indices; the lower CI95% bounds of Youden indices were all ≥0.50, except in the north (Youden index 0.66 (95% CI [0.44-0.82]) and 0.63 (95% CI [0.33-0.83]. CONCLUSIONS Overall, RDT diagnostic indices are adequate for the biological diagnosis of malaria in Mali. We recommend the use of RDTs detecting P. vivax-specific antigens in the north.
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Affiliation(s)
- Pascal Dembélé
- Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France; (P.D.); (A.Z.D.); (L.D.); (M.M.)
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France
- Programme National de Lutte Contre le Paludisme (PNLP), Bamako BP 233, Mali; (M.C.); (M.H.M.)
| | - Mady Cissoko
- Programme National de Lutte Contre le Paludisme (PNLP), Bamako BP 233, Mali; (M.C.); (M.H.M.)
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali;
| | - Adama Zan Diarra
- Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France; (P.D.); (A.Z.D.); (L.D.); (M.M.)
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France
| | - Lassana Doumbia
- Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France; (P.D.); (A.Z.D.); (L.D.); (M.M.)
- Laboratoire de Biologie Moléculaire Appliquée (LBMA), Université des Sciences, des Techniques et des Technologies de Bamako, Badalabougou, Bamako BP 423, Mali;
| | - Aïssata Koné
- Laboratoire de Biologie Moléculaire Appliquée (LBMA), Université des Sciences, des Techniques et des Technologies de Bamako, Badalabougou, Bamako BP 423, Mali;
| | - Mahamadou H. Magassa
- Programme National de Lutte Contre le Paludisme (PNLP), Bamako BP 233, Mali; (M.C.); (M.H.M.)
| | - Maissane Mehadji
- Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France; (P.D.); (A.Z.D.); (L.D.); (M.M.)
- Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France
| | - Mahamadou A. Thera
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali;
| | - Stéphane Ranque
- Institut Hospitalo-Universitaire Méditerranée Infection (IHU), Aix Marseille Université, 13005 Marseille, France; (P.D.); (A.Z.D.); (L.D.); (M.M.)
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Nana RRD, Hawadak J, Foko LPK, Kumar A, Chaudhry S, Arya A, Singh V. Intermittent preventive treatment with Sulfadoxine pyrimethamine for malaria: a global overview and challenges affecting optimal drug uptake in pregnant women. Pathog Glob Health 2023; 117:462-475. [PMID: 36177658 PMCID: PMC10337642 DOI: 10.1080/20477724.2022.2128563] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Malaria in Pregnancy (MiP) leading to morbidity and mortality is a major public health problem that poses significant risk to pregnant women and their fetus. To cope with this alarming situation, administration of Sulfadoxine-pyrimethamine (SP) drugs to pregnant women as an intermittent preventive treatment (IPT) from 16 weeks of gestation is recommended by the World Health Organization (WHO) guidelines. We conducted a comprehensive search of published articles related to MiP in last 10 years with predefined keywords or their synonyms. The mapping of malaria in pregnant women showed a prevalence rate up to 35% in many countries. Although IPTp-SP has been implemented in endemic regions since several years but the IPTp-SP coverage percentage vary from country to country and continue to remain below the target of 80%. Major reasons for low IPTp-SP involve gestational age at first prenatal visit, level of education, place of residence, knowledge of IPTp-SP benefits, and use of antenatal services. Several challenges including the emergence of septuple and octuple SP-resistant parasites is reported from many countries which make the prophylactic use of IPTp-SP currently debatable. This narrative review addresses the barriers for optimal use of IPTp-SP and discusses alternative approaches to increase the use and effectiveness of SP intervention for preventing MiP. The COVID pandemic has drastically affected the public health disrupting the management of diseases worldwide. In view of this, a brief summary of COVID impact on MiP situation is also included.
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Affiliation(s)
- Rodrigue Roman Dongang Nana
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Parasitology laboratory, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Joseph Hawadak
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Loick Pradel Kojom Foko
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Amit Kumar
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Shewta Chaudhry
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Aditi Arya
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Vineeta Singh
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
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Wafula ST, Habermann T, Franke MA, May J, Puradiredja DI, Lorenz E, Brinkel J. What are the pathways between poverty and malaria in sub-Saharan Africa? A systematic review of mediation studies. Infect Dis Poverty 2023; 12:58. [PMID: 37291664 DOI: 10.1186/s40249-023-01110-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/29/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Malaria remains a major burden in sub-Saharan Africa (SSA). While an association between poverty and malaria has been demonstrated, a clearer understanding of explicit mechanisms through which socioeconomic position (SEP) influences malaria risk is needed to guide the design of more comprehensive interventions for malaria risk mitigation. This systematic review provides an overview of the current evidence on the mediators of socioeconomic disparities in malaria in SSA. METHODS We searched PubMed and Web of Science for randomised controlled trials, cohort, case-control and cross-sectional studies published in English between January 1, 2000 to May 31, 2022. Further studies were identified following reviews of reference lists of the studies included. We included studies that either (1) conducted a formal mediation analysis of risk factors on the causal pathway between SEP and malaria infections or (2) adjusted for these potential mediators as confounders on the association between SEP and malaria using standard regression models. At least two independent reviewers appraised the studies, conducted data extraction, and assessed risk of bias. A systematic overview is presented for the included studies. RESULTS We identified 41 articles from 20 countries in SSA for inclusion in the final review. Of these, 30 studies used cross-sectional design, and 26 found socioeconomic inequalities in malaria risk. Three formal mediation analyses showed limited evidence of mediation of food security, housing quality, and previous antimalarial use. Housing, education, insecticide-treated nets, and nutrition were highlighted in the remaining studies as being protective against malaria independent of SEP, suggesting potential for mediation. However, methodological limitations included the use of cross-sectional data, insufficient confounder adjustment, heterogeneity in measuring both SEP and malaria, and generally low or moderate-quality studies. No studies considered exposure mediator interactions or considered identifiability assumptions. CONCLUSIONS Few studies have conducted formal mediation analyses to elucidate pathways between SEP and malaria. Findings indicate that food security and housing could be more feasible (structural) intervention targets. Further research using well-designed longitudinal studies and improved analysis would illuminate the current sparse evidence into the pathways between SEP and malaria and adduce evidence for more potential targets for effective intervention.
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Affiliation(s)
- Solomon T Wafula
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda.
| | - Theresa Habermann
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Mara Anna Franke
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Charité Global Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lubeck-Riems, Hamburg, Germany
- Department of Tropical Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Dewi Ismajani Puradiredja
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Eva Lorenz
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lubeck-Riems, Hamburg, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Johanna Brinkel
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lubeck-Riems, Hamburg, Germany
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Herman C, Leonard CM, Uhomoibhi P, Maire M, Moss D, Inyang U, Abubakar A, Ogunniyi A, Mba N, Greby SM, Okoye MI, Iriemenam NC, Maikore I, Steinhardt L, Rogier E. Non-falciparum malaria infection and IgG seroprevalence among children under 15 years in Nigeria, 2018. Nat Commun 2023; 14:1360. [PMID: 36914649 PMCID: PMC10011577 DOI: 10.1038/s41467-023-37010-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
Plasmodium falciparum (Pf) is the dominant malaria parasite in Nigeria though P. vivax (Pv), P. ovale (Po), and P. malariae (Pm) are also endemic. Blood samples (n = 31,234) were collected from children aged 0-14 years during a 2018 nationwide HIV survey and assayed for Plasmodium antigenemia, Plasmodium DNA, and IgG against Plasmodium MSP1-19 antigens. Of all children, 6.6% were estimated to have Pm infection and 1.4% Po infection with no Pv infections detected. The highest household wealth quintile was strongly protective against infection with Pm (aOR: 0.11, 95% CI: 0.05-0.22) or Po (aOR= 0.01, 0.00-0.10). Overall Pm seroprevalence was 34.2% (95% CI: 33.3-35.2) with lower estimates for Po (12.1%, 11.6-12.5) and Pv (6.3%, 6.0-6.7). Pm seropositivity was detected throughout the country with several local government areas showing >50% seroprevalence. Serological and DNA indicators show widespread exposure of Nigerian children to Pm with lower rates to Po and Pv.
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Affiliation(s)
- Camelia Herman
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,BeVera Solutions, Atlanta, GA, 30341, USA
| | - Colleen M Leonard
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.,Oak Ridge Institute for Science and Education, US. Department of Energy, Oak Ridge, TN, 37831, USA
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Mark Maire
- U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Delynn Moss
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Uwem Inyang
- U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Abuja, Nigeria
| | - Ado Abubakar
- Institute of Human Virology (IHVN), Abuja, Nigeria
| | | | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Stacie M Greby
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - McPaul I Okoye
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C Iriemenam
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Maikore
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Laura Steinhardt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30029, USA.
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Djigo OKM, Gomez N, Ould Ahmedou Salem MS, Basco L, Ould Mohamed Salem Boukhary A, Briolant S. Performance of a Commercial Multiplex Allele-Specific Polymerase Chain Reaction Kit to Genotype African-Type Glucose-6-Phosphate Dehydrogenase Deficiency. Am J Trop Med Hyg 2023; 108:449-455. [PMID: 36535256 PMCID: PMC9896312 DOI: 10.4269/ajtmh.21-1081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/12/2021] [Accepted: 02/03/2022] [Indexed: 12/23/2022] Open
Abstract
8-Aminoquinoline antimalarial drugs (primaquine, tafenoquine) are required for complete cure of Plasmodium vivax malaria, but they are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. In the absence of spectrophotometry, which is a gold standard for measuring G6PD activity, G6PD genotyping is one of the alternatives to establish a database and distribution map of G6PD enzyme deficiency in Mauritania, which has become a new epicenter of P. vivax malaria in West Africa. The aim of our study was to assess the performance of multiplex allele-specific polymerase chain reaction (PCR) (African-type Diaplex C™ G6PD kit) against PCR-restriction fragment length polymorphism and sequencing. Of 146 mutations associated with G6PD A- genotypes in 177 blood samples from Mauritanian patients, all but two samples were identified correctly using multiplex allele-specific PCR (100% sensitivity and 99% specificity; "almost perfect agreement" between allele-specific PCR and PCR-restriction fragment length polymorphism/sequencing, with a kappa coefficient of 0.977). Despite a suboptimal PCR protocol for dried blood spots and the inability of the commercial assay to predict unequivocally the G6PD enzyme level in heterozygous females, the African-type Diaplex C™ G6PD genotyping kit seemed to be a valuable screening tool for male subjects and for research purposes in resource-limited countries where spectrophotometer and DNA sequencing are not available.
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Affiliation(s)
- Oum Kelthoum Mamadou Djigo
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Nicolas Gomez
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Mohamed Salem Ould Ahmedou Salem
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Leonardo Basco
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Sébastien Briolant
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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Fuehrer HP, Campino S, Sutherland CJ. The primate malaria parasites Plasmodium malariae, Plasmodium brasilianum and Plasmodium ovale spp.: genomic insights into distribution, dispersal and host transitions. Malar J 2022; 21:138. [PMID: 35505317 PMCID: PMC9066925 DOI: 10.1186/s12936-022-04151-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/20/2021] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
During the twentieth century, there was an explosion in understanding of the malaria parasites infecting humans and wild primates. This was built on three main data sources: from detailed descriptive morphology, from observational histories of induced infections in captive primates, syphilis patients, prison inmates and volunteers, and from clinical and epidemiological studies in the field. All three were wholly dependent on parasitological information from blood-film microscopy, and The Primate Malarias” by Coatney and colleagues (1971) provides an overview of this knowledge available at that time. Here, 50 years on, a perspective from the third decade of the twenty-first century is presented on two pairs of primate malaria parasite species. Included is a near-exhaustive summary of the recent and current geographical distribution for each of these four species, and of the underlying molecular and genomic evidence for each. The important role of host transitions in the radiation of Plasmodium spp. is discussed, as are any implications for the desired elimination of all malaria species in human populations. Two important questions are posed, requiring further work on these often ignored taxa. Is Plasmodium brasilianum, circulating among wild simian hosts in the Americas, a distinct species from Plasmodium malariae? Can new insights into the genomic differences between Plasmodium ovale curtisi and Plasmodium ovale wallikeri be linked to any important differences in parasite morphology, cell biology or clinical and epidemiological features?
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Affiliation(s)
- Hans-Peter Fuehrer
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Susana Campino
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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Hawadak J, Dongang Nana RR, Singh V. Epidemiological, Physiological and Diagnostic Comparison of Plasmodium ovale curtisi and Plasmodium ovale wallikeri. Diagnostics (Basel) 2021; 11:1900. [PMID: 34679597 DOI: 10.3390/diagnostics11101900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
Nowadays, Plasmodium ovale is divided into two non-recombinant sympatric species: Plasmodium ovale wallikeri and Plasmodium ovale curtisi. In this mini review, we summarize the available knowledge on the clinical/biological aspects of P. ovale spp. malaria and current techniques for the diagnosis/characterisation of P. ovale curtisi and P. ovale wallikeri. P. ovale wallikeri infections are characterized by a deeper thrombocytopenia and shorter latency compared to P. ovale curtisi infections, indicating that P. ovale wallikeri is more pathogenic than P. ovale curtisi. Rapid diagnosis for effective management is difficult for P. ovale spp., since specific rapid diagnostic tests are not available and microscopic diagnosis, which is recognized as the gold standard, requires expert microscopists to differentiate P. ovale spp. from other Plasmodium species. Neglect in addressing these issues in the prevalence of P. ovale spp. represents the existing gap in the fight against malaria.
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Quaye IK, Aleksenko L, Oeuvray C, Yewhalaw D, Duah N, Gyan B, Haiyambo DH, Dongho GBD, Torgby RA, Amoah L, Hamid MA, Worku S, Bahiti AA, Pasquale HA, Bitshi M, Troare I, Diarra A, Njunju E, Cisse M, Soulama I, Savadogo RJ, Issifou S, Niangaly A, Dembele L, Greco B. The Pan African Vivax and Ovale Network (PAVON): Refocusing on Plasmodium vivax, ovale and asymptomatic malaria in sub-Saharan Africa. Parasitol Int 2021; 84:102415. [PMID: 34216801 DOI: 10.1016/j.parint.2021.102415] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/20/2022]
Abstract
The recent World Malaria report shows that progress in malaria elimination has stalled. Current data acquisition by NMCPs depend on passive case detection and clinical reports focused mainly on Plasmodium falciparum (Pf). In recent times, several countries in sub-Saharan Africa have reported cases of Plasmodium vivax (Pv) with a considerable number being Duffy negative. The burden of Pv and Plasmodium ovale (Po) appear to be more than acknowledged. Similarly, the contribution of asymptomatic malaria in transmission is hardly considered by NMCPs in Africa. Inclusion of these as targets in malaria elimination agenda is necessary to achieve elimination goal, as these harbor hypnozoites. The Pan African Vivax and Ovale Network (PAVON) is a new consortium of African Scientists working in Africa on the transmission profile of Pv and Po. The group collaborates with African NMCPs to train in Plasmodium molecular diagnostics, microscopy, and interpretation of molecular data from active surveys to translate into policy. Details of the mission, rational and modus operandi of the group are outlined.
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Hawadak J, Dongang Nana RR, Singh V. Global trend of Plasmodium malariae and Plasmodium ovale spp. malaria infections in the last two decades (2000-2020): a systematic review and meta-analysis. Parasit Vectors 2021; 14:297. [PMID: 34082791 PMCID: PMC8173816 DOI: 10.1186/s13071-021-04797-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 02/25/2021] [Accepted: 05/20/2021] [Indexed: 11/11/2022] Open
Abstract
Background Recent studies indicate that the prevalence of non-falciparum malaria, including Plasmodium malariae and Plasmodium ovale spp., is increasing, with some complications in infected individuals. The aim of this review is to provide a better understanding of the malaria prevalence and disease burden due to P. malariae and P. ovale spp. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Joanna Briggs Institute prevalence study assessment tool were used to select and evaluate the studies, respectively. Six databases: PubMed, WHOLIS, Wiley Library, ScienceDirect, Web of Science and Google Scholar were used to screen articles published during the period January 2000–December 2020. The pooled prevalence estimates for P. malariae and P. ovale spp. were analysed using a random-effects model and the possible sources of heterogeneity were evaluated through subgroup analysis and meta-regression. Results Out of the 3297 studies screened, only 113 studies were included; among which 51.33% were from the African Region. The P. malariae and P. ovale spp. pooled prevalence were 2.01% (95% CI 1.31–2.85%) and 0.77% (95% CI 0.50–1.10%) respectively, with the highest prevalence in the African Region. P. malariae was equally distributed among adults (2.13%), children (2.90%) and pregnant women (2.77%) (p = 0.862), whereas P. ovale spp. was more prevalent in pregnant women (2.90%) than in children ≤ 15 years (0.97%) and in patients > 15 years old (0.39%) (p = 0.021). In this review, data analysis revealed that P. malariae and P. ovale spp. have decreased in the last 20 years, but not significantly, and these species were more commonly present with other Plasmodium species as co-infections. No difference in prevalence between symptomatic and asymptomatic patients was observed for either P. malariae or P. ovale spp. Conclusion Our analysis suggests that knowledge of the worldwide burden of P. malariae and P. ovale spp. is very important for malaria elimination programmes and a particular focus towards improved tools for monitoring transmission for these non-falciparum species should be stressed upon to deal with increased infections in the future. Graphic Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04797-0.
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Affiliation(s)
- Joseph Hawadak
- ICMR-National Institute of Malaria Research, Dwarka, Sector 8, New-Delhi, 110077, India
| | - Rodrigue Roman Dongang Nana
- ICMR-National Institute of Malaria Research, Dwarka, Sector 8, New-Delhi, 110077, India.,Institute of Medical Research and Medicinal Plants Studies, PO Box 13033, Yaoundé, Cameroon
| | - Vineeta Singh
- ICMR-National Institute of Malaria Research, Dwarka, Sector 8, New-Delhi, 110077, India.
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10
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Bredu D, Donu D, Amoah LE. Dynamics of the Composition of Plasmodium Species Contained within Asymptomatic Malaria Infections in the Central Region of Ghana. J Trop Med 2021; 2021:7419548. [PMID: 33727937 DOI: 10.1155/2021/7419548] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/25/2020] [Accepted: 02/12/2021] [Indexed: 12/02/2022] Open
Abstract
Background Monitoring changes in the composition of the Plasmodium species circulating within the population over a period can inform appropriate treatment recommendations. This study monitored variations in the prevalence of four common human Plasmodium species carried by children with asymptomatic malaria infections over a two-year period. Methods Two cross-sectional studies were conducted in November 2017 and December 2019. A total of 210 children aged between 4 and 13 years were recruited in 2017, and 164 similarly aged children were recruited in 2019. Approximately 150 μl of finger-pricked blood was used to prepare thick and thin blood smears as well as spot Whatman® #3 filter paper. Genomic DNA was extracted from the dried blood spots and used in PCR to amplify the 18S rRNA gene from four different human Plasmodium parasites. Results Parasite prevalence by microscopy and the prevalence of P. falciparum detected by PCR was relatively similar at the two time points (Pearson chi-square = 0.405, p=0.525, and Pearson chi-square = 0.452, p=0.501, respectively). However, the prevalence of PCR detectable P. malariae increased by 8.5-fold, whilst P. ovale increased from 0 to 9% in the children sampled in 2019 relative to the children sampled in 2017. The only parasite species identified by microscopy in this study was P. falciparum, and no P. vivax was identified by either microscopy or PCR in the study population during the study period. Conclusion There is the need to implement molecular diagnostic tools for malaria parasite surveillance in Ghana. This will enable the identification and treatment of all circulating malaria parasites including P. malariae and P. ovale, whose population is expanding in parts of Ghana including Simiw.
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Oriero EC, Amenga-Etego L, Ishengoma DS, Amambua-Ngwa A. Plasmodium malariae, current knowledge and future research opportunities on a neglected malaria parasite species. Crit Rev Microbiol 2021; 47:44-56. [PMID: 33507842 DOI: 10.1080/1040841x.2020.1838440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Plasmodium malariae is often reported as a benign malaria parasite. There are limited data on its biology and disease burden in sub-Saharan Africa (sSA) possibly due to the unavailability of specific and affordable tools for routine diagnosis and large epidemiology studies. In addition, P. malariae occurs at low parasite densities and in co-infections with other species, predominately P. falciparum. The paucity of data on P. malariae infections limits the capacity to accurately determine its contribution to malaria and the effect of control interventions against P. falciparum on its prevalence. Here, we summarise the current knowledge on P. malariae epidemiology in sSA - overall prevalence ranging from 0-32%, as detected by different diagnostic methods; seroprevalence ranging from 0-56% in three countries (Mozambique, Benin and Zimbabwe), and explore the future application of next-generation sequencing technologies as a tool for enriching P. malariae genomic epidemiology. This will provide insights into important adaptive mechanisms of this neglected non-falciparum species, including antimalarial drug resistance, local and regional parasite transmission patterns and genomic signatures of selection. Improved diagnosis and genomic surveillance of non-falciparum malaria parasites in Africa would be helpful in evaluating progress towards elimination of all human Plasmodium species.
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Affiliation(s)
- Eniyou C Oriero
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Lucas Amenga-Etego
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Deus S Ishengoma
- Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania
| | - Alfred Amambua-Ngwa
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
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12
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Dosoo DK, Chandramohan D, Atibilla D, Oppong FB, Ankrah L, Kayan K, Agyemang V, Adu-Gyasi D, Twumasi M, Amenga-Etego S, Bruce J, Asante KP, Greenwood B, Owusu-Agyei S. Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study. Malar J 2020; 19:381. [PMID: 33097044 PMCID: PMC7585211 DOI: 10.1186/s12936-020-03457-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 06/22/2020] [Accepted: 10/19/2020] [Indexed: 01/15/2023] Open
Abstract
Background Malaria during pregnancy may result in unfavourable outcomes in both mothers and their foetuses. This study sought to document the current burden and factors associated with malaria and anaemia among pregnant women attending their first antenatal clinic visit in an area of Ghana with perennial malaria transmission. Methods A total of 1655 pregnant women aged 18 years and above with a gestational age of 13–22 weeks, who attended an antenatal care (ANC) clinic for the first time, were consented and enrolled into the study. A structured questionnaire was used to collect socio-demographic and obstetric data and information on use of malaria preventive measures. Venous blood (2 mL) was collected before sulfadoxine-pyrimethamine administration. Malaria parasitaemia and haemoglobin concentration were determined using microscopy and an automated haematology analyser, respectively. Data analysis was carried out using Stata 14. Results Mean age (SD) and gestational age (SD) of women at enrolment were 27.4 (6.2) years and 16.7 (4.3) weeks, respectively. Overall malaria parasite prevalence was 20.4% (95% CI 18.5–22.4%). Geometric mean parasite density was 442 parasites/µL (95% CI 380–515). Among women with parasitaemia, the proportion of very low (1–199 parasites/µL), low (200–999 parasites/µL), medium (1000–9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite density were 31.1, 47.0, 18.9, and 3.0%, respectively. Age ≥ 25 years (OR 0.57, 95% CI 0.41–0.79), multigravid (OR 0.50, 95% CI 0.33–0.74), educated to high school level or above (OR 0.53, 95% CI 0.33–0.83) and in household with higher socio-economic status (OR 0.34, 95% CI 0.21–0.54) were associated with a lower risk of malaria parasitaemia. The prevalence of anaemia (< 11.0 g/dL) was 56.0%, and the mean haemoglobin concentration in women with or without parasitaemia was 9.9 g/dL or 10.9 g/dL, respectively. Conclusion One out of five pregnant women attending their first ANC clinic visit in an area of perennial malaria transmission in the middle belt of Ghana had Plasmodium falciparum infection. Majority of the infections were below 1000 parasites/µL and with associated anaemia. There is a need to strengthen existing malaria prevention strategies to prevent unfavourable maternal and fetal birth outcomes in this population.
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Affiliation(s)
- David Kwame Dosoo
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana. .,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Daniel Chandramohan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Dorcas Atibilla
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Felix Boakye Oppong
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Love Ankrah
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Kingsley Kayan
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Veronica Agyemang
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Dennis Adu-Gyasi
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Mieks Twumasi
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Seeba Amenga-Etego
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Jane Bruce
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana
| | - Brian Greenwood
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana.,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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13
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Mwesigwa J, Achan J, Affara M, Wathuo M, Worwui A, Mohammed NI, Kanuteh F, Prom A, Dierickx S, di Tanna GL, Nwakanma D, Bousema T, Drakeley C, Van Geertruyden JP, D'Alessandro U. Mass Drug Administration With Dihydroartemisinin-piperaquine and Malaria Transmission Dynamics in The Gambia: A Prospective Cohort Study. Clin Infect Dis 2020; 69:278-286. [PMID: 30304511 PMCID: PMC6603267 DOI: 10.1093/cid/ciy870] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 05/07/2018] [Accepted: 10/05/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mass drug administration (MDA) may further reduce malaria transmission in low-transmission areas. The impact of MDA on the dynamics of malaria transmission was determined in a prospective cohort study. METHODS Annual rounds of MDA with dihydroartemisinin-piperaquine (DP) were implemented were implemented in 2014 and 2015 in six village pairs before the malaria transmission season. Blood samples were collected from residents between July and December for microscopy and nested PCR. Incidence and prevalence of infection, clinical disease, and risk of malaria reinfection post-MDA were determined. RESULTS Coverage of three DP doses was 68.2% (2014) and 65.6% (2015), compliance was greater than 80%. Incidence of infection was significantly lower in 2014 (incidence rate [IR] = 0.2 per person year [PPY]) than in 2013 (IR = 1.1 PPY; P < .01); monthly infection prevalence declined in the first three months post-MDA. Clinical malaria incidence was lower in 2014 (IR = 0.1 PPY) and 2015 (IR = 0.2 PPY) than in 2013 (IR = 0.4 PPY; P < .01), but remained higher in eastern Gambia. Individuals infected before MDA had a 2-fold higher odds of reinfection post-MDA (adjusted odds ratio = 2.5, 95% confidence interval 1.5-4.3; P < .01). CONCLUSIONS MDA reduced malaria infection and clinical disease during the first months. The reduction was maintained in low-transmission areas, but not in eastern Gambia. Annual MDA could be followed by focal MDA targeting individuals infected during the dry season. Repeated MDA rounds, some during the dry season over larger geographical areas, may result in a more marked and sustained decrease of malaria transmission.
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Affiliation(s)
- Julia Mwesigwa
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul.,Department of Global Health, Faculty of Medicine and Health Sciences, University of Antwerp
| | - Jane Achan
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Muna Affara
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Miriam Wathuo
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Archibald Worwui
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Nuredin Ibrahim Mohammed
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Fatoumatta Kanuteh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Aurelia Prom
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Susan Dierickx
- Centre of Expertise on Gender, Diversity and Intersectionality, Brussels University, Belgium
| | - Gian Luca di Tanna
- Risk Centre, Institut de Recerca en Economia Aplicada, Department of Econometrics, Statistics and Applied Economics, Universitat de Barcelona, Spain
| | - Davis Nwakanma
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
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14
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Leski TA, Taitt CR, Swaray AG, Bangura U, Reynolds ND, Holtz A, Yasuda C, Lahai J, Lamin JM, Baio V, Jacobsen KH, Ansumana R, Stenger DA. Use of real-time multiplex PCR, malaria rapid diagnostic test and microscopy to investigate the prevalence of Plasmodium species among febrile hospital patients in Sierra Leone. Malar J 2020; 19:84. [PMID: 32085711 DOI: 10.1186/s12936-020-03163-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background Malaria continues to affect over 200 million individuals every year, especially children in Africa. Rapid and sensitive detection and identification of Plasmodium parasites is crucial for treating patients and monitoring of control efforts. Compared to traditional diagnostic methods such as microscopy and rapid diagnostic tests (RDTs), DNA based methods, such as polymerase chain reaction (PCR) offer significantly higher sensitivity, definitive discrimination of Plasmodium species, and detection of mixed infections. While PCR is not currently optimized for routine diagnostics, its role in epidemiological studies is increasing as the world moves closer toward regional and eventually global malaria elimination. This study demonstrates the field use of a novel, ambient temperature-stabilized, multiplexed PCR assay in a small hospital setting in Sierra Leone. Methods Blood samples from 534 febrile individuals reporting to a hospital in Bo, Sierra Leone, were tested using three methods: a commercial RDT, microscopy, and a Multiplex Malaria Sample Ready (MMSR) PCR designed to detect a universal malaria marker and species-specific markers for Plasmodium falciparum and Plasmodium vivax. A separate PCR assay was used to identify species of Plasmodium in samples in which MMSR detected malaria, but was unable to identify the species. Results MMSR detected the presence of any malaria marker in 50.2% of all tested samples with P. falciparum identified in 48.7% of the samples. Plasmodium vivax was not detected. Testing of MMSR P. falciparum-negative/universal malaria-positive specimens with a panel of species-specific PCRs revealed the presence of Plasmodium malariae (n = 2) and Plasmodium ovale (n = 2). The commercial RDT detected P. falciparum in 24.6% of all samples while microscopy was able to detect malaria in 12.8% of tested specimens. Conclusions Wider application of PCR for detection of malaria parasites may help to fill gaps existing as a result of use of microscopy and RDTs. Due to its high sensitivity and specificity, species coverage, room temperature stability and relative low complexity, the MMSR assay may be useful for detection of malaria and epidemiological studies especially in low-resource settings.
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15
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Amoah LE, Donu D, Abuaku B, Ahorlu C, Arhinful D, Afari E, Malm K, Koram KA. Probing the composition of Plasmodium species contained in malaria infections in the Eastern region of Ghana. BMC Public Health 2019; 19:1617. [PMID: 31791319 PMCID: PMC6889690 DOI: 10.1186/s12889-019-7989-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 07/11/2019] [Accepted: 11/21/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Asymptomatic falciparum and non-falciparum malaria infections are major challenges to malaria control interventions, as they remain a source of continual infection in the community. This becomes even more important as the debate moves towards elimination and eradication. This study sought to quantify the burden of Plasmodium malaria infection in seven communities in the Eastern Region of Ghana. METHODS The cross-sectional study recruited 729 participants aged 85 years old and below from 7 closely linked communities. Finger pricked blood was used to prepare thick and thin blood smears as well as spot filter paper and an histidine rich protein 2 (HRP2) rapid diagnostic test kit (RDT). Genomic DNA was extracted from the filter paper dry blood spot (DBS) and used in PCR to amplify the Plasmodium 18S rRNA gene using species specific PCR. RESULTS 96.6% of the participants were identified as afebrile, with axillary temperatures below 37.5 °C. PCR identified 66% of the participants to harbor malaria parasites, with 9 P. malariae and 7 P. ovale mono-infections accounting for 2.2% and P. falciparum combined with either 36 P. malariae or 25 P. ovale infections, accounting for 13.3%. Parasite prevalence by microscopy (32%) was similar to the RDT positivity rate (33%). False positive RDT results ranged from 64.6% in children aged between 5 and 9 years to 10% in adults aged 20 years and above. No significant differences were observed in falciparum and non-falciparum parasite carriage at the community level, however young adults aged between 15 and 19 years had the highest prevalence (34.8% (16/46)) of P. falciparum and P. malariae parasite carriage whilst children aged between 5 and 9 years had the highest level (11.4% (14/123)) of P. ovale carriage. CONCLUSION The high rate of misidentification of non-falciparum parasites and the total absence of detection of P. ovale by microscopy suggests that more sensitive malaria diagnostic tools including molecular assays are required to accurately determine the prevalence of carriers of non-falciparum parasites and low density P. falciparum infections, especially during national surveillance exercises. Additionally, malaria control interventions targeting the non-falciparum species P. malariae and P. ovale parasites are needed.
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Affiliation(s)
- Linda Eva Amoah
- Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana. .,West Africa Center for Cell biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.
| | - Dickson Donu
- Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Benjamin Abuaku
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Colins Ahorlu
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Daniel Arhinful
- Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edwin Afari
- School of Public Health, University of Ghana, Accra, Ghana
| | - Keziah Malm
- National Malaria Control Program, Accra, Ghana
| | - Kwadwo Ansah Koram
- West Africa Center for Cell biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.,Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Kavunga-Membo H, Ilombe G, Masumu J, Matangila J, Imponge J, Manzambi E, Wastenga F, Ngoyi DM, Van Geetruyden JP, Muyembe JJ. Molecular identification of Plasmodium species in symptomatic children of Democratic Republic of Congo. Malar J 2018; 17:334. [PMID: 30236117 PMCID: PMC6149035 DOI: 10.1186/s12936-018-2480-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 02/21/2018] [Accepted: 09/10/2018] [Indexed: 11/20/2022] Open
Abstract
Background Worldwide, the highest malaria mortality is due to Plasmodium falciparum infection. However, other species of Plasmodium (Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi) can also cause malaria. Therefore, accurate identification of malaria species is crucial for patient management and epidemiological surveillance. This study aimed to determine the different Plasmodium species causing malaria in children under 5 years old in two provinces (Kinshasa and North Kivu) of the Democratic Republic of Congo (DRC). Methods From October to December 2015, a health-facility based cross-sectional study was conducted in General Reference Hospitals in Kinshasa and North Kivu. Four hundred and seven blood samples were collected from febrile children aged ≤ 5 years. Nested polymerase chain reaction assays were performed for Plasmodium species identification. Results Out of 407 children, 142 (34.9%) were infected with Plasmodium spp. and P. falciparum was the most prevalent species (99.2%). Among those infected children, 124 had a mono infection with P. falciparum and one with P. malariae. Mixed infections with P. falciparum/P. malariae and P. falciparum/P. vivax were observed in 6 (1.5%) and 8 (2.0%) children, respectively. The prevalence of infection was higher in females (64.8%) than in males (35.2%), p < 0.001. The age-specific distribution of infection showed that children of less than 2 years old were less infected (18.4%) compared to those aged above 2 years (81.6%), p < 0.001. Conclusion Although this study showed clearly that the most prevalent species identified was P. falciparum, the findings demonstrate the existence of non-falciparum malaria, especially P. malariae and P. vivax among children aged ≤ 5 years living both Kinshasa and North Kivu Provinces in DRC.
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Affiliation(s)
- Hugo Kavunga-Membo
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.
| | - Gillon Ilombe
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Justin Masumu
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Université Pédagogique National (UPN), Kinshasa, Democratic Republic of the Congo.,Laboratoire Vétérinaire de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Matangila
- Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | - Joël Imponge
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Emile Manzambi
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Francis Wastenga
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | - Dieudonné Mumba Ngoyi
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | | | - Jean Jacques Muyembe
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
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17
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Lopez-Perez M, Larsen MD, Bayarri-Olmos R, Ampomah P, Stevenson L, Arévalo-Herrera M, Herrera S, Hviid L. IgG Responses to the Plasmodium falciparum Antigen VAR2CSA in Colombia Are Restricted to Pregnancy and Are Not Induced by Exposure to Plasmodium vivax. Infect Immun 2018; 86:e00136-18. [PMID: 29784859 DOI: 10.1128/IAI.00136-18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/11/2018] [Indexed: 12/20/2022] Open
Abstract
Clinical immunity to malaria is associated with the acquisition of IgG specific for members of the Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) family of clonally variant antigens on the surface of infected erythrocytes (IEs). The VAR2CSA subtype of PfEMP1 mediates IE binding in the placenta. Clinical immunity to malaria is associated with the acquisition of IgG specific for members of the Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) family of clonally variant antigens on the surface of infected erythrocytes (IEs). The VAR2CSA subtype of PfEMP1 mediates IE binding in the placenta. VAR2CSA-specific IgG is normally acquired only after exposure to placental parasites. However, it was recently reported that men and children from Colombia often have high levels of functional VAR2CSA-specific IgG. This potentially undermines the current understanding of malaria immunity in pregnant women, and we thus conducted a study to assess further the levels of VAR2CSA-specific IgG in pregnant and nonpregnant Colombians. Plasma IgG against two full-length recombinant PfEMP1 proteins (one of the VAR2CSA type and one not) produced in baculovirus-transfected insect cells was detected frequently among Colombian men, children, and pregnant women with acute or previous malaria exposure. In contrast, IgG reactivity to a homologous full-length VAR2CSA-type protein expressed in Chinese hamster ovary (CHO) cells was low and infrequent among the Colombian plasma samples, as was reactivity to both corresponding native PfEMP1 proteins. Moreover, human and rabbit antibodies specific for Plasmodium vivax Duffy-binding protein (PvDBP), a protein with some homology to PfEMP1, did not react with VAR2CSA-type recombinant or native proteins, although the mouse monoclonal and PvDBP-specific antibody 3D10 was weakly reactive with recombinant proteins expressed in baculovirus-transfected insect cells. Our data indicate that the previously reported Colombian IgG reactivity to recombinant VAR2CSA is not malaria specific and that the acquisition of VAR2CSA-specific IgG is restricted to pregnancy, in Colombia and elsewhere.
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18
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Doritchamou JYA, Akuffo RA, Moussiliou A, Luty AJF, Massougbodji A, Deloron P, Tuikue Ndam NG. Submicroscopic placental infection by non-falciparum Plasmodium spp. PLoS Negl Trop Dis 2018; 12:e0006279. [PMID: 29432484 PMCID: PMC5825172 DOI: 10.1371/journal.pntd.0006279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/23/2018] [Accepted: 01/29/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Among the Plasmodium species that infect humans, adverse effects of P. falciparum and P. vivax have been extensively studied and reported with respect to poor outcomes particularly in first time mothers and in pregnant women living in areas with unstable malaria transmission. Although, other non-falciparum malaria infections during pregnancy have sometimes been reported, little is known about the dynamics of these infections during pregnancy. METHODS AND FINDINGS Using a quantitative PCR approach, blood samples collected from Beninese pregnant women during the first antenatal visit (ANV) and at delivery including placental blood were screened for Plasmodium spp. Risk factors associated with Plasmodium spp. infection during pregnancy were assessed as well as the relationships with pregnancy outcomes. P. falciparum was the most prevalent Plasmodium species detected during pregnancy, irrespective either of parity, of age or of season during which the infection occurred. Although no P. vivax infections were detected in this cohort, P. malariae (9.2%) and P. ovale (5.8%) infections were observed in samples collected during the first ANV. These non-falciparum infections were also detected in maternal peripheral blood (1.3% for P. malariae and 1.2% for P. ovale) at delivery. Importantly, higher prevalence of P. malariae (5.5%) was observed in placental than peripheral blood while that of P. ovale was similar (1.8% in placental blood). Among the non-falciparum infected pregnant women with paired peripheral and placental samples, P. malariae infections in the placental blood was significantly higher than in the peripheral blood, suggesting a possible affinity of P. malariae for the placenta. However, no assoctiation of non-falciparum infections and the pregnancy outcomes was observed. CONCLUSIONS Overall this study provided insights into the molecular epidemiology of Plasmodium spp. infection during pregnancy, indicating placental infection by non-falciparum Plasmodium and the lack of association of these infections with adverse pregnancy outcomes.
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Affiliation(s)
- Justin Y. A. Doritchamou
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
| | - Richard A. Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Azizath Moussiliou
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
| | - Adrian J. F. Luty
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
| | - Achille Massougbodji
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
| | - Philippe Deloron
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Nicaise G. Tuikue Ndam
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail:
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19
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Katrak S, Murphy M, Nayebare P, Rek J, Smith M, Arinaitwe E, Nankabirwa JI, Kamya M, Dorsey G, Rosenthal PJ, Greenhouse B. Performance of Loop-Mediated Isothermal Amplification for the Identification of Submicroscopic Plasmodium falciparum Infection in Uganda. Am J Trop Med Hyg 2017; 97:1777-1781. [PMID: 29016335 PMCID: PMC5805042 DOI: 10.4269/ajtmh.17-0225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Accurately identifying and targeting the human reservoir of malaria parasitemia is critical for malaria control, and requires a reliable and sensitive diagnostic method. Loop-mediated isothermal amplification (LAMP) is increasingly used to diagnose submicroscopic parasitemia. Although most published studies report the sensitivity of LAMP compared with nested polymerase chain reaction (PCR) as ≥ 80%, they have failed to use a consistent, sensitive diagnostic as a comparator. We used cross-sectional samples from children and adults in Tororo, Uganda, a region with high but declining transmission due to indoor residual spraying, to characterize the sensitivity and specificity of pan-Plasmodium LAMP for detecting submicroscopic infections. We compared LAMP results targeting a mitochondrial DNA sequence conserved in all Plasmodium species, performed on DNA extracted from dried blood spots, to those of a gold standard quantitative PCR assay targeting the var gene acidic terminal sequence of Plasmodium falciparum (varATS qPCR), performed on DNA extracted from 200 µL of whole blood. Using LAMP and varATS qPCR increased the detection of parasitemia 2- to 5-fold, compared with microscopy. Among microscopy-negative samples, the sensitivity of LAMP was 81.5% for detecting infection ≥ 1 parasites/µL. However, low density infections were common, and LAMP failed to identify more than half of all infections diagnosed by varATS qPCR, performing with an overall sensitivity of 44.7% for detecting submicroscopic infections ≥ 0.01 parasites/µL. Thus, although the LAMP assay is more sensitive than microscopy, it missed a significant portion of the submicroscopic reservoir. These findings have important implications for malaria control, particularly in settings where low-density infections predominate.
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Affiliation(s)
- Shereen Katrak
- Department of Medicine, University of California San Francisco, San Francisco, California;,Address correspondence to Shereen Katrak, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S380, Box 0654, San Francisco, CA 94143. E-mail:
| | - Maxwell Murphy
- Department of Medicine, University of California San Francisco, San Francisco, California
| | | | - John Rek
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Mary Smith
- Chicago Medical School, Rosalind Franklin University, North Chicago, Illinois
| | - Emmanuel Arinaitwe
- Infectious Diseases Research Collaboration, Kampala, Uganda;,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joaniter I. Nankabirwa
- Infectious Diseases Research Collaboration, Kampala, Uganda;,School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Moses Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda;,School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grant Dorsey
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Philip J. Rosenthal
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Bryan Greenhouse
- Department of Medicine, University of California San Francisco, San Francisco, California
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20
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Berry I, Walker P, Tagbor H, Bojang K, Coulibaly SO, Kayentao K, Williams J, Oduro A, Milligan P, Chandramohan D, Greenwood B, Cairns M. Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care. Am J Trop Med Hyg 2017; 98:534-542. [PMID: 29210351 PMCID: PMC5929207 DOI: 10.4269/ajtmh.17-0620] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In malaria-endemic areas, Plasmodium falciparum prevalence is often high in young women because of 1) low use of insecticide-treated nets before their first pregnancy and 2) acquired immunity, meaning infections are asymptomatic and thus untreated. Consequently, a common source of malaria in pregnancy (MiP) may be infected women becoming pregnant, rather than pregnant women becoming infected. In this study, prevalence of infection was determined by microscopy at first antenatal care (ANC) visit in primigravidae and secundigravidae in Ghana, Burkina Faso, Mali, and The Gambia, four countries with strong seasonal variations in transmission. Duration of pregnancy spent in the rainy season and other risk factors for infection were evaluated using multivariable Poisson regression. We found that the overall prevalence of malaria at first ANC was generally high and increased with time spent pregnant during the rainy season: prevalence among those with the longest exposure was 59.7% in Ghana, 56.7% in Burkina Faso, 42.2% in Mali, and 16.8% in Gambia. However, the prevalence was substantial even among women whose entire pregnancy before first ANC had occurred in the dry season: 41.3%, 34.4%, 11.5%, and 7.8%, respectively, in the four countries. In multivariable analysis, risk of infection was also higher among primigravidae, younger women, and those of lower socioeconomic status, independent of seasonality. High prevalence among women without exposure to high transmission during their pregnancy suggests that part of the MiP burden results from long-duration infections, including those acquired preconception. Prevention of malaria before pregnancy is needed to reduce the MiP burden.
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Affiliation(s)
- Isha Berry
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Harry Tagbor
- University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Kassoum Kayentao
- Malaria Research and Training Center, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies, Bamako, Mali
| | | | | | - Paul Milligan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Brian Greenwood
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthew Cairns
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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21
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Abstract
One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med7: e1000221 [2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drug-resistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason. No other drugs have yet been shown to be safe, tolerable, and effective as prevention for pregnant women, although monthly dihydroartemisinin-piperaquine has shown promise for reducing poor pregnancy outcomes. Insecticide-treated nets provide some benefits, such as reducing placental malaria and low birth weight. However, this leaves a heavy burden of maternal, fetal, and infant morbidity and mortality that could be avoided. Women naturally acquire resistance to Plasmodium falciparum over successive pregnancies as they acquire antibodies against parasitized red cells that bind chondroitin sulfate A in the placenta, suggesting that a vaccine is feasible. Pregnant women are an important reservoir of parasites in the community, and women of reproductive age must be included in any elimination effort, but several features of malaria during pregnancy will require special consideration during the implementation of elimination programs.
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Affiliation(s)
- Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, NIAID, NIH, Bethesda, MD 20892
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, NIAID, NIH, Bethesda, MD 20892
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22
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Abstract
INTRODUCTION Malaria during pregnancy is a massive health problem in endemic areas. Placental malaria infections caused by Plasmodium falciparum are responsible for up to one million babies being born with a low birth weight every year. Significant efforts have been invested into preventing the condition. Areas covered: Pub Med was searched using the broad terms 'malaria parasite placenta' to identify studies of interactions between parasite and host, 'prevention of placental malaria' to identify current strategies to prevent placental malaria, and 'placental malaria vaccine' to identify pre-clinical vaccine development. However, all papers from these searches were not systematically included. Expert commentary: The first phase I clinical trials of vaccines are well underway. Trials testing efficacy are more complicated to carry out as only women that are exposed to parasites during pregnancy will contribute to endpoint measurements, further it may require extensive follow-up to establish protection. Future second generation vaccines may overcome the inherent challenges in making an effective placental malaria vaccine.
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Affiliation(s)
- Caroline Pehrson
- a Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science , University of Copenhagen , Copenhagen , Denmark.,b Department of Infectious Diseases , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | - Ali Salanti
- a Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science , University of Copenhagen , Copenhagen , Denmark.,b Department of Infectious Diseases , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | - Thor G Theander
- a Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science , University of Copenhagen , Copenhagen , Denmark.,b Department of Infectious Diseases , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | - Morten A Nielsen
- a Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science , University of Copenhagen , Copenhagen , Denmark.,b Department of Infectious Diseases , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
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23
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Rogier E, Moss DM, Chard AN, Trinies V, Doumbia S, Freeman MC, Lammie PJ. Evaluation of Immunoglobulin G Responses to Plasmodium falciparum and Plasmodium vivax in Malian School Children Using Multiplex Bead Assay. Am J Trop Med Hyg 2016; 96:312-318. [PMID: 27895279 DOI: 10.4269/ajtmh.16-0476] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/21/2016] [Indexed: 12/23/2022] Open
Abstract
Malaria serology through assaying for IgG against Plasmodium spp. antigens provides evidence into the infection history for an individual. The multiplex bead assay (MBA) allows for detection of IgG against multiple Plasmodium spp., and can be especially useful in many regions where Plasmodium falciparum is of primary clinical focus, but other species are co-endemic. Dried blood spots were collected from 805 Malian children attending 42 elementary schools in the regions of Mopti, Sikasso, Koulikoro, and Bamako capital district, and IgG assayed by MBA. As southern Mali is known to be holoendemic for P. falciparum, merozoite surface protein 1 19-kDa subunit (MSP-142) and apical membrane antigen 1 (AMA-1) antigens were included for serology against this parasite. Responses to these antigens both provided high estimates for lifetime exposure, with 730 (90%) children with IgG antibodies for MSP-142, 737 (91%) for AMA-1, and 773 (96%) positive for either or both. Also included was the antigen Plasmodium vivax MSP-119, against which 140 (17.4%) children were found to have antibodies. Increases in antibody titers with older age were clearly seen with the P. falciparum antigens, but not with the P. vivax antigen, likely indicating more of a sporadic, rather than sustained transmission for this species. The MBA provides effective opportunities to evaluate malaria transmission through serological analysis for multiple Plasmodium species.
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Affiliation(s)
- Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Delynn M Moss
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna N Chard
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Victoria Trinies
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Patrick J Lammie
- Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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24
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Doctor SM, Liu Y, Anderson OG, Whitesell AN, Mwandagalirwa MK, Muwonga J, Keeler C, Emch M, Likwela JL, Tshefu A, Meshnick SR. Low prevalence of Plasmodium malariae and Plasmodium ovale mono-infections among children in the Democratic Republic of the Congo: a population-based, cross-sectional study. Malar J 2016; 15:350. [PMID: 27392905 PMCID: PMC4938993 DOI: 10.1186/s12936-016-1409-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 04/06/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background In an effort to improve surveillance for epidemiological and clinical outcomes, rapid diagnostic tests (RDTs) have become increasingly widespread as cost-effective and field-ready methods of malaria diagnosis. However, there are concerns that using RDTs specific to Plasmodium falciparum may lead to missed detection of other malaria species such as Plasmodium malariae and Plasmodium ovale. Methods Four hundred and sixty six samples were selected from children under 5 years old in the Democratic Republic of the Congo (DRC) who took part in a Demographic and Health Survey (DHS) in 2013–14. These samples were first tested for all Plasmodium species using an 18S ribosomal RNA-targeted real-time PCR; malaria-positive samples were then tested for P. falciparum, P. malariae and P.ovale using a highly sensitive nested PCR. Results The prevalence of P. falciparum, P. malariae and P. ovale were 46.6, 12.9 and 8.3 %, respectively. Most P. malariae and P. ovale infections were co-infected with P. falciparum—the prevalence of mono-infections of these species were only 1.0 and 0.6 %, respectively. Six out of these eight mono-infections were negative by RDT. The prevalence of P. falciparum by the more sensitive nested PCR was higher than that found previously by real-time PCR. Conclusions Plasmodium malariae and P. ovale remain endemic at a low rate in the DRC, but the risk of missing malarial infections of these species due to falciparum-specific RDT use is low. The observed prevalence of P. falciparum is higher with a more sensitive PCR method. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1409-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephanie M Doctor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA
| | - Yunhao Liu
- Department of Statistics and Operations Research, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Olivia G Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA
| | - Amy N Whitesell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA
| | - Melchior Kashamuka Mwandagalirwa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA.,Ecole de Santé Publique, Faculté de Medecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jérémie Muwonga
- Programme National de Lutte contre le SIDA et les IST, Kinshasa, Democratic Republic of the Congo
| | - Corinna Keeler
- Department of Geography, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA.,Department of Geography, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Joris L Likwela
- Programme National de Lutte contre le Paludisme, Kinshasa, Democratic Republic of the Congo
| | - Antoinette Tshefu
- Ecole de Santé Publique, Faculté de Medecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599-7435, USA.
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