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Looareesuwan P, Krudsood S, Lawpoolsri S, Tangpukdee N, Matsee W, Nguitragool W, Wilairatana P. Gametocyte prevalence and risk factors of P. falciparum malaria patients admitted at the Hospital for Tropical Diseases, Thailand: a 20-year retrospective study. Malar J 2023; 22:321. [PMID: 37872594 PMCID: PMC10591378 DOI: 10.1186/s12936-023-04728-7] [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: 05/10/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The incidence of malaria in Thailand has dramatically declined over the past two decades, and the goal is to eliminate malaria by 2025. Despite significant progress, one of the key challenges to malaria elimination are undetected gametocyte carriers. Human migration adds complexity to the malaria situation, as it not only sustains local transmission but also poses the risk of spreading drug-resistant parasites. Currently, no study has assessed the prevalence of gametocytes across multiple years in Plasmodium falciparum malaria patients in Thailand, and the risk factors for gametocyte carriage have not been fully explored. METHODS Medical records of all P. falciparum malaria patients admitted from January 1, 2001 to December 31, 2020 at the Hospital for Tropical Diseases, Thailand, were retrospectively examined and a total of 1962 records were included for analysis. Both P. falciparum parasites and gametocytes were diagnosed by microscopy. A regression model was used to evaluate predictors of gametocyte carriage. RESULTS The study demonstrated gametocyte prevalence in low malaria transmission areas. Nine risk factors for gametocyte carriage were identified: age between 15 and 24 years [adjusted odds ratio (aOR) = 1.96, 95% confidence interval (CI) 1.18-3.26], Karen ethnicity (aOR = 2.59, 95% CI 1.56-4.29), preadmission duration of fever > 7 days (aOR = 5.40, 95% CI 3.92-7.41), fever on admission (> 37.5 °C) (aOR = 0.61, 95% CI 0.48-0.77), haemoglobin ≤ 8 g/dL (aOR = 3.32, 95% CI 2.06-5.33), asexual parasite density > 5000-25,000/µL (aOR = 0.71, 95% CI 0.52-0.98), asexual parasite density > 25,000-100,000/µL (aOR = 0.74, 95% CI 0.53-1.03), asexual parasite density > 100,000/µL (aOR = 0.51, 95% CI 0.36-0.72), platelet count ≤ 100,000/µL (aOR = 0.65, 95% CI 0.50-0.85, clinical features of severe malaria (aOR = 2.33, 95% CI 1.76-3.10) and dry season (aOR = 1.41, 95% CI 1.10-1.80). An increasing incidence of imported transnational malaria cases was observed over the past two decades. CONCLUSIONS This is the first study to determine the prevalence of gametocytes among patients with symptomatic P. falciparum malaria, identify the risk factors for gametocyte carriage, and potential gametocyte carriers in Thailand. Blocking transmission is one of the key strategies for eliminating malaria in these areas. The results might provide important information for targeting gametocyte carriers and improving the allocation of resources for malaria control in Thailand. This study supports the already nationally recommended use of a single dose of primaquine in symptomatic P. falciparum malaria patients to clear gametocytes.
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Affiliation(s)
- Panita Looareesuwan
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Srivicha Krudsood
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
- Clinical Malaria Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Noppadon Tangpukdee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Wasin Matsee
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Wang Nguitragool
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
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Biabi MFAB, Fogang B, Essangui E, Maloba F, Donkeu C, Keumoe R, Cheteug G, Magoudjou N, Slam C, Kemleu S, Efange N, Perraut R, Nsango SE, Eboumbou Moukoko CE, Assam JPA, Etoa FX, Lamb T, Ayong L. High Prevalence of Polyclonal Plasmodium falciparum Infections and Association with Poor IgG Antibody Responses in a Hyper-Endemic Area in Cameroon. Trop Med Infect Dis 2023; 8:390. [PMID: 37624328 PMCID: PMC10459087 DOI: 10.3390/tropicalmed8080390] [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: 05/23/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/26/2023] Open
Abstract
Malaria remains a major public health problem worldwide, with eradication efforts thwarted by drug and insecticide resistance and the lack of a broadly effective malaria vaccine. In continuously exposed communities, polyclonal infections are thought to reduce the risk of severe disease and promote the establishment of asymptomatic infections. We sought to investigate the relationship between the complexity of P. falciparum infection and underlying host adaptive immune responses in an area with a high prevalence of asymptomatic parasitaemia in Cameroon. A cross-sectional study of 353 individuals aged 2 to 86 years (median age = 16 years) was conducted in five villages in the Centre Region of Cameroon. Plasmodium falciparum infection was detected by multiplex nested PCR in 316 samples, of which 278 were successfully genotyped. Of these, 60.1% (167/278) were polyclonal infections, the majority (80.2%) of which were from asymptomatic carriers. Host-parasite factors associated with polyclonal infection in the study population included peripheral blood parasite density, participant age and village of residence. The number of parasite clones per infected sample increased significantly with parasite density (r = 0.3912, p < 0.0001) but decreased with participant age (r = -0.4860, p < 0.0001). Parasitaemia and the number of clones per sample correlated negatively with total plasma levels of IgG antibodies to three highly reactive P. falciparum antigens (MSP-1p19, MSP-3 and EBA175) and two soluble antigen extracts (merozoite and mixed stage antigens). Surprisingly, we observed no association between the frequency of polyclonal infection and susceptibility to clinical disease as assessed by the recent occurrence of malarial symptoms or duration since the previous fever episode. Overall, the data indicate that in areas with the high perennial transmission of P. falciparum, parasite polyclonality is dependent on underlying host antibody responses, with the majority of polyclonal infections occurring in persons with low levels of protective anti-plasmodial antibodies.
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Affiliation(s)
- Marie Florence A Bite Biabi
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biochemistry, Faculty of Science, University of Douala, Douala BP 2701, Cameroon
| | - Balotin Fogang
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon
| | - Estelle Essangui
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala BP 2701, Cameroon
| | - Franklin Maloba
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
| | - Christiane Donkeu
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon
| | - Rodrigue Keumoe
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon
| | - Glwadys Cheteug
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Medical Laboratory Sciences, Faculty of Science, University of Buea, Buea BP 63, Cameroon
| | - Nina Magoudjou
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon
| | - Celine Slam
- Department of Pathology, School of Medicine, University of Utah, 15 N Medical Drive, Salt Lake City, UT 84112, USA;
| | - Sylvie Kemleu
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
| | - Noella Efange
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biochemistry, Faculty of Science, University of Buea, Buea BP 63, Cameroon
| | - Ronald Perraut
- Centre Pasteur du Cameroun Annex, Garoua BP 921, Cameroon;
| | - Sandrine Eveline Nsango
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala BP 2701, Cameroon
| | - Carole Else Eboumbou Moukoko
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala BP 2701, Cameroon
| | - Jean Paul Assam Assam
- Department of Microbiology, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon; (J.P.A.A.); (F.-X.E.)
| | - François-Xavier Etoa
- Department of Microbiology, Faculty of Science, University of Yaounde I, Yaounde BP 812, Cameroon; (J.P.A.A.); (F.-X.E.)
| | - Tracey Lamb
- Department of Pathology, School of Medicine, University of Utah, 15 N Medical Drive, Salt Lake City, UT 84112, USA;
| | - Lawrence Ayong
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaounde BP 1274, Cameroon; (M.F.A.B.B.); (B.F.); (E.E.); (F.M.); (C.D.); (R.K.); (G.C.); (N.M.); (S.K.); (N.E.); (S.E.N.); (C.E.E.M.)
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3
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Alemayehu A. Biology and epidemiology of Plasmodium falciparum and Plasmodium vivax gametocyte carriage: Implication for malaria control and elimination. Parasite Epidemiol Control 2023; 21:e00295. [PMID: 36950502 PMCID: PMC10025134 DOI: 10.1016/j.parepi.2023.e00295] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 09/15/2022] [Revised: 01/01/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Malaria is among the leading public health problems worldwide. Female anopheles mosquito orchestrates the transmission of malaria by taking gametocytes and introducing sporozoite while taking blood meals. Interrupting transmission is the major strategy for malaria elimination. The gametocyte stage is essential for the onward transmission of malaria. Thus, understanding its basic biology and epidemiology is key to malaria control and elimination. Therefore, the current review focuses on revealing the biology, prevalence, and determinants of gametocyte carriage as well as its implication on mitigation of malaria. It also illustrates the role of asymptomatic and sub-microscopic Plasmodium infections and G-6-PD deficiency in gametocyte carriage and hence malaria transmission. Gametocytogenesis is initiated at committed merozoites and gives rise to the development of gametocytes. The trigger for gametocytogenesis depends on the host, parasite, and intervention factors. Gametocytes pass through five developmental stages identifiable by molecular markers. A considerable number of malaria patients carry gametocytes at a sub-microscopic level, thereby serving as a potential infectious reservoir of transmission. Factors involving the human host, Plasmodium parasite, and intervention parameters play a critical role in gametocyte biology and prevalence. The contribution of asymptomatic and sub-microscopic infections to malaria transmission is unknown. The clear impact of G-6-PD deficiency on malaria control and elimination remains unclear. Lack of clarity on such issues might impede the success of interventions. Basic science and epidemiological studies should continue to overcome the challenges and cope with the ever-evolving parasite and guide interventions.
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Affiliation(s)
- Aklilu Alemayehu
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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4
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Tebeje SK, Chali W, Hailemeskel E, Ramjith J, Gashaw A, Ashine T, Nebret D, Esayas E, Emiru T, Tsegaye T, Teelen K, Lanke K, Takashima E, Tsuboi T, Salinas ND, Tolia NH, Narum D, Drakeley C, Witkowski B, Vantaux A, Jore MM, Stone WJR, Hansen IS, Tadesse FG, Bousema T. Naturally acquired antibodies to gametocyte antigens are associated with reduced transmission of Plasmodium vivax gametocytes to Anopheles arabiensis mosquitoes. Front Cell Infect Microbiol 2023; 12:1106369. [PMID: 36726645 PMCID: PMC9885094 DOI: 10.3389/fcimb.2022.1106369] [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: 11/23/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Naturally acquired antibodies may reduce the transmission of Plasmodium gametocytes to mosquitoes. Here, we investigated associations between antibody prevalence and P. vivax infectivity to mosquitoes. A total of 368 microscopy confirmed P. vivax symptomatic patients were passively recruited from health centers in Ethiopia and supplemented with 56 observations from asymptomatic P. vivax parasite carriers. Direct membrane feeding assays (DMFA) were performed to assess mosquito infectivity; for selected feeds these experiments were also performed after replacing autologous plasma with malaria naïve control serum (n=61). The prevalence of antibodies against 6 sexual stage antigens (Pvs47, Pvs48/45, Pvs230, PvsHAP2, Pvs25 and PvCelTOS) and an array of asexual antigens was determined by ELISA and multiplexed bead-based assays. Gametocyte (ρ< 0.42; p = 0.0001) and parasite (ρ = 0.21; p = 0.0001) densities were positively associated with mosquito infection rates. Antibodies against Pvs47, Pvs230 and Pvs25 were associated with 23 and 34% reductions in mosquito infection rates (p<0.0001), respectively. Individuals who showed evidence of transmission blockade in serum-replacement DMFAs (n=8) were significantly more likely to have PvsHAP2 or Pvs47 antibodies. Further studies may demonstrate causality for the observed associations, improve our understanding of the natural transmission of P. vivax and support vaccine development.
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Affiliation(s)
- Surafel K. Tebeje
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wakweya Chali
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Elifaged Hailemeskel
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands,Department of Biology, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia
| | - Jordache Ramjith
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Abrham Gashaw
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Temesgen Ashine
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Desalegn Nebret
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Endashaw Esayas
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Tadele Emiru
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Tizita Tsegaye
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia
| | - Karina Teelen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kjerstin Lanke
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eizo Takashima
- Division of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan
| | - Takafumi Tsuboi
- Division of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan
| | - Nichole D. Salinas
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - Niraj H. Tolia
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - David Narum
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - Chris Drakeley
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Amelie Vantaux
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Matthijs M. Jore
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Ivo S. Hansen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Fitsum G. Tadesse
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Disease Directorate, Addis Ababa, Ethiopia,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands,London School of Hygiene & Tropical Medicine, London, United Kingdom,*Correspondence: Teun Bousema,
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Zou Y, Julie N, Guo S, Tang Y, Zhang H, Xu Z, Wu W, Yuan Y, Wu Z, Guo W, Li C, Huang X, Xu Q, Deng C, Song J, Wang Q. The Effect of Artemisinin-Based Drugs vs Non-artemisinin-based Drugs on Gametophyte Carrying in the Body After the Treatment of Uncomplicated Falciparum Malaria: A Systematic Review and Meta-analysis. Front Pharmacol 2022; 12:707498. [PMID: 35069184 PMCID: PMC8770988 DOI: 10.3389/fphar.2021.707498] [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: 07/29/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
The WHO recommends Artemisinin-based combination therapy (ACTs) as the first-line treatment for malaria. This meta-analysis aims to analyze the effects of artemisinin and its derivatives as well as non-artemisinin drugs on the gametophytes in the host during the treatment of falciparum malaria. Fourteen studies were included in this analysis, and the artemisinin combination drugs involved were: artemether-lumefantrine (AL), artemisinin (AST), artemether-benflumetol (AB), dihydroartemisinin-piperaquine + trimethoprim + primaquine (CV8), amodiaquine + sulfadoxine-pyrimethamine (ASP), pyronaridine-phosphate + dihydroartemisinin (PP-DHA), dihydroartemisinin (DHA), and mefloquine + artesunate (MA), with 1702 patients. The control intervention measures involved the following: sulfadoxine-pyrimethamine (SP), mefloquine (MQ), atovaquone-proguanil (AT-PG), chloroquine + sulfadoxine-pyrimethamine (C-SP), quinine (Q), pyronaridine-phosphate (PP), pyronaridine (PN), and mefloquine + primaquine (MP), with 833 patients. The effect of ACTs was more obvious (OR = 0.37, 95%CI: 0.22–0.62, p < 0.05). In the control group of second malaria attacks, the difference between the two groups was not statistically significant (RD = 1.16, 95%CI: 0.81–1.66, p < 0.05); there was no significant difference in treatment failure during follow-up (RD = -0.01, 95%CI: 0.04–0.03, p < 0.05). There were also very few serious adverse events in both groups. ACTs showed good therapeutic effects in preventing gametocythemia but did not control the recrudescence rate and overall cure, which indicated the effectiveness of the combination of antimalarial drugs. Further research is required to explore which compatibility method is most conducive to the development of clinical malaria control.
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Affiliation(s)
- Yuanyuan Zou
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nadia Julie
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiyuan Guo
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yexiao Tang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongying Zhang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhiyong Xu
- Institute of Science and Technology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanting Wu
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yueming Yuan
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhibin Wu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenfeng Guo
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Changqing Li
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinan Huang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qin Xu
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Changsheng Deng
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianping Song
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Wang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Lung Diseases, Guangzhou Chest Hospital, Guangzhou, China
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6
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Fogang B, Biabi MF, Megnekou R, Maloba FM, Essangui E, Donkeu C, Cheteug G, Kapen M, Keumoe R, Kemleu S, Nsango S, Eboumbou C, Lamb TJ, Ayong L. High Prevalence of Asymptomatic Malarial Anemia and Association with Early Conversion from Asymptomatic to Symptomatic Infection in a Plasmodium falciparum Hyperendemic Setting in Cameroon. Am J Trop Med Hyg 2022; 106:293-302. [PMID: 34724628 PMCID: PMC8733519 DOI: 10.4269/ajtmh.21-0316] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/30/2021] [Indexed: 01/03/2023] Open
Abstract
Asymptomatic malarial parasitemia is highly prevalent in Plasmodium falciparum endemic areas and often associated with increased prevalence of mild to moderate anemia. The aim of this study was to assess the prevalence of anemia during asymptomatic malaria parasitemia and its interplay with persistent infection in highly exposed individuals. A household-based longitudinal survey was undertaken in a malaria hyperendemic area in Cameroon using multiplex nested polymerase chain reaction to detect plasmodial infections. Residents with P. falciparum asymptomatic parasitemia were monitored over a 3-week period with the aid of structured questionnaires and weekly measurements of axillary temperatures. Of the 353 individuals included (median age: 26 years, range 2-86 years, male/female sex ratio 0.9), 328 (92.9%) were positive for malaria parasitemia of whom 266 (81.1%) were asymptomatic carriers. The prevalence of anemia in the study population was 38.6%, of which 69.2% were asymptomatic. Multivariate analyses identified high parasitemia (> 327 parasites/µL) and female gender as associated risk factors of asymptomatic malarial anemia in the population. Furthermore, risk analyses revealed female gender and anemia at the time of enrolment as key predictors of early development of febrile illness (< 3 weeks post enrolment) among the asymptomatic individuals. Together, the data reveal an extremely high prevalence of asymptomatic malaria parasitemia and anemia in the study area, unveiling for the first time the association of asymptomatic malarial anemia with early clinical conversion from asymptomatic to symptomatic infection. Furthermore, these findings underscore the negative impact of asymptomatic malaria parasitemia on individual health, necessitating the development of appropriate control and preventive measures.
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Affiliation(s)
- Balotin Fogang
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Animal Biology and Physiology of the University of Yaoundé I, Yaounde, Cameroon
| | - Marie Florence Biabi
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Biochemistry, University of Douala, Douala, Cameroon
| | - Rosette Megnekou
- Department of Animal Biology and Physiology of the University of Yaoundé I, Yaounde, Cameroon
| | - Franklin M. Maloba
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Estelle Essangui
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Christiane Donkeu
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Animal Biology and Physiology of the University of Yaoundé I, Yaounde, Cameroon
| | - Glwadys Cheteug
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Medical Laboratory Sciences, University of Buea, Buea, Cameroon
| | - Marie Kapen
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Rodrigue Keumoe
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Sylvie Kemleu
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Department of Medical Laboratory Sciences, University of Buea, Buea, Cameroon
| | - Sandrine Nsango
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Carole Eboumbou
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Tracey J. Lamb
- Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Lawrence Ayong
- Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, Yaounde, Cameroon;,Address correspondence to Lawrence Ayong, Molecular Parasitology Laboratory, Centre Pasteur du Cameroun, BP 1274 Yaounde, Cameroon. E-mail:
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Assefa DG, Yismaw G, Makonnen E. Comparative effect of dihydroartemisinin-piperaquine and artemether-lumefantrine on gametocyte clearance and haemoglobin recovery in children with uncomplicated Plasmodium falciparum malaria in Africa: a systematic review and meta-analysis of randomized control trials. Int J Infect Dis 2021; 113:136-47. [PMID: 34653658 DOI: 10.1016/j.ijid.2021.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/04/2021] [Accepted: 10/06/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Plasmodium falciparum gametocytaemia has been associated with anaemia. The aim of this review was to synthesize available evidence on the comparative effect of dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) on gametocyte clearance and haemoglobin recovery in children with uncomplicated P. falciparum malaria in Africa. METHODS A systematic literature search was undertaken to identify relevant articles from online databases. The search was performed from August 2020 to 30 April 2021. Extracted data from eligible studies were pooled as risk ratios with 95% confidence intervals (CI). RESULTS Gametocyte carriage was reduced in both treatment groups, with no significant difference found between the groups. However, on days 28 and 42, a significant increase in serum haemoglobin level from baseline was observed in the DHA-PQ group (standardized mean difference 0.15, 95% CI 0.05-0.26; participants=2715; studies=4; I2=32%, high quality of evidence) compared with the AL group (mean difference 0.35, 95% CI 0.12-0.59; participants=1434; studies=3; I2=35%, high quality of evidence). CONCLUSION DHA-PQ had a greater impact on haemoglobin recovery than AL on days 28 and 42; this difference was significant.
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Nyasa RB, Fotabe EL, Ndip RN. Trends in malaria prevalence and risk factors associated with the disease in Nkongho-mbeng; a typical rural setting in the equatorial rainforest of the South West Region of Cameroon. PLoS One 2021; 16:e0251380. [PMID: 34003847 PMCID: PMC8130964 DOI: 10.1371/journal.pone.0251380] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
Globally, malaria in recent years has witnessed a decline in the number of cases and death, though the most recent world malaria report shows a slight decrease in the number of cases in 2018 compared to 2017 and, increase in 2017 compared to 2016. Africa remains the region with the greatest burden of the disease. Cameroon is among the countries with a very high burden of malaria, with the coastal and forest regions carrying the highest burden of the disease. Nkongho-mbeng is a typical rural setting in the equatorial rain forest region of Cameroon, with no existing knowledge of the epidemiology of malaria in this locality. This study aimed at determining the current status of malaria epidemiology in Nkongho-mbeng. A cross-sectional survey was conducted, during which blood samples were collected from 500 participants and examined by microscopy. Risk factors such as, age, sex, duration of stay in the locality, housing type, environmental sanitation and intervention strategies including use of, LLINs and drugs were investigated. Trends in malaria morbidity were also determined. Of the 500 samples studied, 60 were positive, giving an overall prevalence of 12.0% with the prevalence of asymptomatic infection (10.8%), more than quadruple the prevalence of symptomatic infections (1.2%) and, fever burden not due to malaria was 1.4%. The GMPD was 6,869.17 parasites/μL of blood (95% C.I: 4,977.26/μL– 9,480.19/μL). A LLINs coverage of 84.4% and 77.88% usage was observed. Unexpectedly, the prevalence of malaria was higher among those sleeping under LLINs (12.56%) than those not sleeping under LLINs (8.97%), though the difference was not significant (p = 0.371). Being a male (p = 0.044), being unemployed (p = 0.025) and, living in Mbetta (p = 0.013) or Lekwe (p = 0.022) and the presence bushes around homes (p = 0.002) were significant risk factors associated with malaria infection. Trends in proportion demonstrated that, the prevalence of malaria amongst patients receiving treatment in the health center from 2015 to 2019 decreased significantly (p < 0.001) and linearly from 9.74% to 3.08% respectively. Data generated from this study can be exploited for development of a more effective control measures to curb the spread of malaria within Nkongho-mbeng.
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Affiliation(s)
- Raymond Babila Nyasa
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Faculty of Science, Biotechnology Unit, University of Buea, Buea, South West Region, Cameroon
| | | | - Roland N. Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
- * E-mail: ,
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Rodriguez AM, Hambly MG, Jandu S, Simão-Gurge R, Lowder C, Lewis EE, Riffell JA, Luckhart S. Histamine Ingestion by Anopheles stephensi Alters Important Vector Transmission Behaviors and Infection Success with Diverse Plasmodium Species. Biomolecules 2021; 11:719. [PMID: 34064869 PMCID: PMC8151525 DOI: 10.3390/biom11050719] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
An estimated 229 million people worldwide were impacted by malaria in 2019. The vectors of malaria parasites (Plasmodium spp.) are Anopheles mosquitoes, making their behavior, infection success, and ultimately transmission of great importance. Individuals with severe malaria can exhibit significantly increased blood concentrations of histamine, an allergic mediator in humans and an important insect neuromodulator, potentially delivered to mosquitoes during blood-feeding. To determine whether ingested histamine could alter Anopheles stephensi biology, we provisioned histamine at normal blood levels and at levels consistent with severe malaria and monitored blood-feeding behavior, flight activity, antennal and retinal responses to host stimuli and lifespan of adult female Anopheles stephensi. To determine the effects of ingested histamine on parasite infection success, we quantified midgut oocysts and salivary gland sporozoites in mosquitoes infected with Plasmodium yoelii and Plasmodium falciparum. Our data show that provisioning An. stephensi with histamine at levels consistent with severe malaria can enhance mosquito behaviors and parasite infection success in a manner that would be expected to amplify parasite transmission to and from human hosts. Such knowledge could be used to connect clinical interventions by reducing elevated histamine to mitigate human disease pathology with the delivery of novel lures for improved malaria control.
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Affiliation(s)
- Anna M. Rodriguez
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
| | - Malayna G. Hambly
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
| | - Sandeep Jandu
- Department of Biology, University of Washington, Seattle, WA 98195-1800, USA; (S.J.); (J.A.R.)
| | - Raquel Simão-Gurge
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
| | - Casey Lowder
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
| | - Edwin E. Lewis
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
| | - Jeffrey A. Riffell
- Department of Biology, University of Washington, Seattle, WA 98195-1800, USA; (S.J.); (J.A.R.)
| | - Shirley Luckhart
- Department of Entomology, Plant Pathology and Nematology, University of Idaho, Moscow, ID 83843-3051, USA; (A.M.R.); (M.G.H.); (R.S.-G.); (C.L.); (E.E.L.)
- Department of Biological Sciences, University of Idaho, Moscow, ID 83843-3051, USA
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10
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Stiffler DM, Oyieko J, Kifude CM, Rockabrand DM, Luckhart S, Stewart VA. HIV-1 Infection Is Associated With Increased Prevalence and Abundance of Plasmodium falciparum Gametocyte-Specific Transcripts in Asymptomatic Adults in Western Kenya. Front Cell Infect Microbiol 2021; 10:600106. [PMID: 33614525 PMCID: PMC7892447 DOI: 10.3389/fcimb.2020.600106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/28/2020] [Accepted: 12/16/2020] [Indexed: 01/05/2023] Open
Abstract
As morbidity and mortality due to malaria continue to decline, the identification of individuals with a high likelihood of transmitting malaria is needed to further reduce the prevalence of malaria. In areas of holoendemic malaria transmission, asymptomatically infected adults may be infected with transmissible gametocytes. The impact of HIV-1 on gametocyte carriage is unknown, but co-infection may lead to an increase in gametocytemia. In this study, a panel of qPCR assays was used to quantify gametocyte stage-specific transcripts present in dried blood spots obtained from asymptomatic adults seeking voluntary HIV testing in Kombewa, Kenya. A total of 1,116 Plasmodium-specific 18S-positive samples were tested and 20.5% of these individuals had detectable gametocyte-specific transcripts. Individuals also infected with HIV-1 were 1.82 times more likely to be gametocyte positive (P<0.0001) and had significantly higher gametocyte copy numbers when compared to HIV-negative individuals. Additionally, HIV-1 positivity was associated with higher gametocyte prevalence in men and increased gametocyte carriage with age. Overall, these data suggest that HIV-positive individuals may have an increased risk of transmitting malaria parasites in regions with endemic malaria transmission and therefore should be at a higher priority for treatment with gametocidal antimalarial drugs.
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Affiliation(s)
- Deborah M Stiffler
- Department of Preventive Medicine and Biostatistics, Division of Tropical Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Janet Oyieko
- Basic Science Laboratory, US Army Medical Research Directorate-Africa/Kenya Medical Research Institute, Kisumu, Kenya
| | - Carolyne M Kifude
- Basic Science Laboratory, US Army Medical Research Directorate-Africa/Kenya Medical Research Institute, Kisumu, Kenya
| | - David M Rockabrand
- Department of Preventive Medicine and Biostatistics, Division of Tropical Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Shirley Luckhart
- Department of Entomology, Plant Pathology and Nematology and Department of Biological Sciences, University of Idaho, Moscow, ID, United States
| | - V Ann Stewart
- Department of Preventive Medicine and Biostatistics, Division of Tropical Public Health, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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