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Suwannin P, Jangpatarapongsa K, Polpanich D, Alhibshi A, Errachid A, Elaissari A. Enhancing leptospirosis control with nanosensing technology: A critical analysis. Comp Immunol Microbiol Infect Dis 2024; 104:102092. [PMID: 37992537 DOI: 10.1016/j.cimid.2023.102092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
Leptospirosis is a serious health problem in tropical areas; thus, animals shed leptospires in the environment. Humans are accidental hosts infected through exposure to contaminating bacteria in the environment. One health strategy can be applied to protect and eliminate leptospirosis because this cooperates and coordinates activities between doctors, veterinarians, and ecologists. However, conventional methods still have limitations. Therefore, the main challenges of leptospirosis control are the high sensing of detection methods to screen and control the pathogens. Interestingly, nano sensing combined with a leptospirosis detection approach can increase the sensitivity and eliminate some limitations. This article reviews nanomaterial development for an advanced leptospirosis detection method, e.g., latex beads-based agglutination test, magnetic nanoparticles enrichment, and gold-nanoparticles-based immunochromatographic assay. Thus, nanomaterials can be functionalized with biomolecules or sensing molecules utilized in various mechanisms such as biosensors. Over the last decade, many biosensors have been developed for Leptospira spp. pathogen and others. The evolution of biosensors for leptospirosis detection was designed for high efficiency and might be an alternative tool. In addition, the high-sensing fabrications are useful for leptospires screening in very low levels, for example, soil or water from the environment.
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Affiliation(s)
- Patcharapan Suwannin
- Center for Research Innovation and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand; Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France
| | - Kulachart Jangpatarapongsa
- Center for Research Innovation and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand
| | - Duangporn Polpanich
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand
| | - Amani Alhibshi
- Department of Neuroscience Research, Institute of Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdelhamid Errachid
- Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France
| | - Abdelhamid Elaissari
- Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France.
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Forero-Peña DA, Carrión-Nessi FS, Lopez-Perez M, Sandoval-de Mora M, Amaya ID, Gamardo ÁF, Chavero M, Figuera L, Marcano MV, Camejo-Ávila NA, Hidalgo M, Arenas CJ, Arévalo-Herrera M, Herrera S. Seroprevalence of viral and bacterial pathogens among malaria patients in an endemic area of southern Venezuela. Infect Dis Poverty 2023; 12:33. [PMID: 37038195 PMCID: PMC10084699 DOI: 10.1186/s40249-023-01089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/27/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Malaria remains a leading public health problem worldwide. Co-infections with other pathogens complicate its diagnosis and may modify the disease's clinical course and management. Similarities in malaria clinical presentation with other infections and overlapping endemicity result in underdiagnosis of co-infections and increased mortality. Thus, the aim of this study was to determine the seroprevalence of viral and bacterial pathogens among diagnosed malaria patients in malaria-endemic areas in Venezuela. METHODS A cross-sectional study was conducted on malaria patients attending three reference medical centres in Ciudad Bolivar, Venezuela. Clinical evaluation and laboratory tests for dengue virus (DENV), chikungunya virus (CHIKV), viral hepatitis [hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV)], and leptospirosis (LEP) were performed by enzyme-linked immunosorbent assays. Previous exposure to these pathogens was defined by the presence of specific immunoglobulin (Ig) G, and co-infection or recent exposure (CoRE) was determined by the presence of specific IgM alone or IgM + IgG. Data analysis considered descriptive statistics. Parameter distribution was statistically evaluated using Kolmogorov-Smirnov test and the necessary comparison tests. Odds ratio (OR) for complications was determined according to CoRE presence with a 95% confidence interval (CI). RESULTS A total of 161 malaria patients were studied, 66% infected with Plasmodium vivax, 27% with P. falciparum, and 7.5% harboured P. vivax/P. falciparum mixed infection. Previous exposure to DENV (60%) and CHIKV (25%) was frequent. CoRE was confirmed in 55 of the 161 malaria patients (34%) and were more frequent in P. falciparum (49%) than in P. vivax (29%) and mixed malaria patients (25%) (OR = 2.43, 95% CI: 1.39-4.25, P = 0.018). The most frequent CoRE was DENV (15%), followed by HAV (12%), HBV (6.2%), CHIKV (5.5%), and LEP (3.7%); HCV CoRE was absent. Complicated malaria was significantly more frequent in patients with CoRE (56%) than those without CoRE (36%; OR = 2.31, 95% CI: 1.18-4.92, P = 0.013). CONCLUSIONS We found high CoRE prevalence in malaria patients as determined by serology in the study region; cases were associated with a worse clinical outcome. Further prospective studies with samples from different infection sites and the use of molecular tools are needed to determine the clinical significance of these findings.
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Affiliation(s)
- David A. Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Internal Medicine Department, “Ruiz y Páez” University Hospital Complex, Ciudad Bolivar, Venezuela
| | - Fhabián S. Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Mary Lopez-Perez
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Marisol Sandoval-de Mora
- Internal Medicine Department, “Ruiz y Páez” University Hospital Complex, Ciudad Bolivar, Venezuela
| | - Iván D. Amaya
- “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Ángel F. Gamardo
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Melynar Chavero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Luisamy Figuera
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - María V. Marcano
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Natasha A. Camejo-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Mariana Hidalgo
- Immunoparasitology Laboratory, Microbiology and Cell Biology Centre, Venezuelan Institute for Scientific Research, Miranda, Venezuela
| | - Cariagne J. Arenas
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
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Md-Lasim A, Mohd-Taib FS, Abdul-Halim M, Mohd-Ngesom AM, Nathan S, Md-Nor S. Leptospirosis and Coinfection: Should We Be Concerned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179411. [PMID: 34502012 PMCID: PMC8431591 DOI: 10.3390/ijerph18179411] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/05/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
Pathogenic Leptospira is the causative agent of leptospirosis, an emerging zoonotic disease affecting animals and humans worldwide. The risk of host infection following interaction with environmental sources depends on the ability of Leptospira to persist, survive, and infect the new host to continue the transmission chain. Leptospira may coexist with other pathogens, thus providing a suitable condition for the development of other pathogens, resulting in multi-pathogen infection in humans. Therefore, it is important to better understand the dynamics of transmission by these pathogens. We conducted Boolean searches of several databases, including Google Scholar, PubMed, SciELO, and ScienceDirect, to identify relevant published data on Leptospira and coinfection with other pathogenic bacteria. We review the role of the host-microbiota in determining the synanthropic interaction of Leptospira sp. with other bacteria, thus creating a suitable condition for the leptospira to survive and persist successfully. We also discuss the biotic and abiotic factors that amplify the viability of Leptospira in the environment. The coinfection of leptospira with pathogenic bacteria has rarely been reported, potentially contributing to a lack of awareness. Therefore, the occurrence of leptospirosis coinfection may complicate diagnosis, long-lasting examination, and mistreatment that could lead to mortality. Identifying the presence of leptospirosis with other bacteria through metagenomic analysis could reveal possible coinfection. In conclusion, the occurrence of leptospirosis with other diseases should be of concern and may depend on the success of the transmission and severity of individual infections. Medical practitioners may misdiagnose the presence of multiple infections and should be made aware of and receive adequate training on appropriate treatment for leptospirosis patients. Physicians could undertake a more targeted approach for leptospirosis diagnosis by considering other symptoms caused by the coinfected bacteria; thus, more specific treatment could be given.
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Affiliation(s)
- Asmalia Md-Lasim
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
- Herbal Medicine Research Centre (HMRC), Institute for Medical Research (IMR), National Institue of Health (NIH), Ministry of Health, Shah Alam 40170, Selangor, Malaysia
| | - Farah Shafawati Mohd-Taib
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
- Correspondence: ; Tel.: +60-12-3807701
| | - Mardani Abdul-Halim
- Biotechnology Research Institute, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Ahmad Mohiddin Mohd-Ngesom
- Center for Toxicology and Health Risk, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Federal Territory of Kuala Lumpur, Malaysia;
| | - Sheila Nathan
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
| | - Shukor Md-Nor
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
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Balasundaram PK, Kanakamma LG, Jayageetha K, Selvarajan B. Epidemiological, clinical and laboratory features of leptospirosis compared to other acute febrile illnesses. J R Coll Physicians Edinb 2020; 50:118-123. [PMID: 32568280 DOI: 10.4997/jrcpe.2020.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Background Leptospirosis is a common zoonotic disease. Many waterborne diseases and mosquito-borne diseases are common causes of acute febrile illnesses in the southern Indian state of Kerala posing diagnostic challenges. The objective of this study was to describe the epidemiological, clinical and laboratory features of leptospirosis diagnosed using the modified Faine's criteria (with amendment) compared to other common acute febrile illnesses. METHODS In this prospective study, all consecutive patients with acute febrile illness, headache and myalgia presenting to our tertiary care hospital's single unit from March 2013 to February 2015 were subjected to detailed history taking and thorough clinical examination. Leptospiral immunoglobulin M (IgM) serology was confirmed by RecombiLISA ELISA and modified Faine's criteria were used for diagnosis of leptospirosis. Other diagnoses for acute febrile illnesses were assigned based on clinical and laboratory investigations. Bivariate and regression analysis was carried out to analyse epidemiological, clinical and laboratory parameters of both groups. RESULTS A total of 389 patients were enrolled, out of which 110 patients had the presumptive diagnosis of leptospirosis. Among the 279 with non-leptospirosis acute febrile illness, dengue (39%) and other viral febrile illnesses (25%) were the most common diagnoses. Regression analysis identified several epidemiological (contact with contaminated animals or water and drinking unboiled water), clinical (conjunctival congestion and muscle tenderness) and laboratory investigations (leucocytosis, neutrophilia, elevated erythrocyte sedimentation rate [ESR] and aspartate aminotransferase) which were helpful in distinguishing leptospirosis from other acute febrile illnesses. CONCLUSION Our study suggests that certain epidemiological, clinical and laboratory features in patients with leptospirosis may allow an early diagnosis. Our study also underscores the usefulness of confirming the leptospiral serology by enzyme-linked immunosorbent assay (ELISA) in combination with relevant epidemiological and clinical features in diagnosing leptospirosis using the modified Faine's criteria.
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Affiliation(s)
| | | | - Kumari Jayageetha
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
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Priya SP, Sakinah S, Sharmilah K, Hamat RA, Sekawi Z, Higuchi A, Ling MP, Nordin SA, Benelli G, Kumar SS. Leptospirosis: Molecular trial path and immunopathogenesis correlated with dengue, malaria and mimetic hemorrhagic infections. Acta Trop 2017; 176:206-223. [PMID: 28823908 DOI: 10.1016/j.actatropica.2017.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 12/12/2022]
Abstract
Immuno-pathogenesis of leptospirosis can be recounted well by following its trail path from entry to exit, while inducing disastrous damages in various tissues of the host. Dysregulated, inappropriate and excessive immune responses are unanimously blamed in fatal leptospirosis. The inherent abilities of the pathogen and inabilities of the host were debated targeting the severity of the disease. Hemorrhagic manifestation through various mechanisms leading to a fatal end is observed when this disease is unattended. The similar vascular destructions and hemorrhage manifestations are noted in infections with different microbes in endemic areas. The simultaneous infection in a host with more than one pathogen or parasite is referred as the coinfection. Notably, common endemic infections such as leptospirosis, dengue, chikungunya, and malaria, harbor favorable environments to flourish in similar climates, which is aggregated with stagnated water and aggravated with the poor personal and environmental hygiene of the inhabitants. These factors aid the spread of pathogens and parasites to humans and potential vectors, eventually leading to outbreaks of public health relevance. Malaria, dengue and chikungunya need mosquitoes as vectors, in contrast with leptospirosis, which directly invades human, although the environmental bacterial load is maintained through other mammals, such as rodents. The more complicating issue is that infections by different pathogens exhibiting similar symptoms but require different treatment management. The current review explores different pathogens expressing specific surface proteins and their ability to bind with array of host proteins with or without immune response to enter into the host tissues and their ability to evade the host immune responses to invade and their affinity to certain tissues leading to the common squeal of hemorrhage. Furthermore, at the host level, the increased susceptibility and inability of the host to arrest the pathogens' and parasites' spread in different tissues, various cytokines accumulated to eradicate the microorganisms and their cellular interactions, the antibody dependent defense and the susceptibility of individual organs bringing the manifestation of the diseases were explored. Lastly, we provided a discussion on the immune trail path of pathogenesis from entry to exit to narrate the similarities and dissimilarities among various hemorrhagic fevers mentioned above, in order to outline future possibilities of prevention, diagnosis, and treatment of coinfections, with special reference to endemic areas.
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Doungchawee G, Sutdan D, Niwatayakul K, Inwisai T, Sitthipunya A, Boonsathorn N, Sakulterdkiat T, Sirawaraporn W, Thongboonkerd V. Development and evaluation of an immunochromatographic assay to detect serum anti-leptospiral lipopolysaccharide IgM in acute leptospirosis. Sci Rep 2017; 7:2309. [PMID: 28536483 PMCID: PMC5442160 DOI: 10.1038/s41598-017-02654-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/12/2017] [Indexed: 01/22/2023] Open
Abstract
Leptospirosis is a common life-threatening disease worldwide. However, its diagnosis is frequently ineffective because the gold standard bacterial culture and microscopic agglutination test (MAT) are usually positive 1-2 weeks after the disease onset. We thus developed an immunochromatographic assay (LEPkit) to detect serum anti-leptospiral lipopolysaccharide (LPS) IgM for rapid diagnosis of acute leptospirosis. Using referenced sera of 77 leptospirosis and 91 non-leptospirosis cases, LEPkit yielded 97.4% sensitivity, 94.5% specificity, 93.8 positive predictive value (PPV), 97.7% negative predictive value (NPV), and 95.8% accuracy. The stability of this kit stored for up to 18 months and its reproducibility were confirmed. Testing in 74 new cases using samples at admission-phase and subsequent paired samples (total n = 135), overall sensitivity was 98.5%, whereas that of culture and single MAT (≥1:400) was 15.6% and 35.6%, respectively. When only the samples at admission-phase were used (n = 74), the sensitivity remained at 98.7%, whereas that of culture and single MAT (≥1:400) was 28.4% and 13.5%, respectively. In summary, our LEPkit was far more effective than any conventional methods for the diagnosis of acute leptospirosis, especially within the first few days after the disease onset. The ease of use, stability and reproducibility further enhance its feasibility for clinical use on-site.
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Affiliation(s)
- Galayanee Doungchawee
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
| | | | | | - Tasanee Inwisai
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Athisri Sitthipunya
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | | | - Worachart Sirawaraporn
- Center of Excellence for Vectors and Vector-Borne Diseases, Faculty of Science, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - Visith Thongboonkerd
- Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. .,Center for Research in Complex Systems Science, Mahidol University, Bangkok, Thailand.
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Chaudhry R, Saigal K, Bahadur T, Kant K, Chourasia B, Gupta N. Varied presentations of leptospirosis: experience from a tertiary care hospital in north India. Trop Doct 2017; 47:128-132. [PMID: 28092222 DOI: 10.1177/0049475516687431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leptospirosis has been recognised as an emerging global public health problem. The aim of our study was to explore the epidemiological and clinical pattern of disease occurrence in suspected cases and to search for any existing co-infections. Ours was a retrospective study in patients with acute febrile illness in north India over a period of three years (April 2011 to June 2014). Serological diagnosis of leptospirosis was made using the PanBio IgM ELISA kit. Using modified Faine's criteria, presumptive and possible diagnosis was made in 57% and 34% cases, respectively. Most of the affected population was resident in north and central India. Nineteen patients showed co-infection with other common pathogens prevailing locally. There is a need to increase awareness and understand the local sero-epidemiological pattern of leptospirosis so that timely preventive and curative action may be taken by healthcare authorities.
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Affiliation(s)
- Rama Chaudhry
- 1 Professor, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Karnika Saigal
- 2 Ex Senior Resident, Department of Microbiology All India Institute of Medical Sciences, New Delhi, India
| | - Tej Bahadur
- 3 PhD Scholar, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kamla Kant
- 4 Senior Resident, Department of Microbiology All India Institute of Medical Sciences, New Delhi, India
| | - Bishwanath Chourasia
- 3 PhD Scholar, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nitin Gupta
- 5 Senior Resident, Infectious Disease Division, Department of Medicine and Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Narayanasamy K, Chery L, Basu A, Duraisingh MT, Escalante A, Fowble J, Guler JL, Herricks T, Kumar A, Majumder P, Maki J, Mascarenhas A, Rodrigues J, Roy B, Sen S, Shastri J, Smith J, Valecha N, White J, Rathod PK. Malaria evolution in South Asia: knowledge for control and elimination. Acta Trop 2012; 121:256-66. [PMID: 22266213 PMCID: PMC3894252 DOI: 10.1016/j.actatropica.2012.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/04/2012] [Accepted: 01/05/2012] [Indexed: 11/16/2022]
Abstract
The study of malaria parasites on the Indian subcontinent should help us understand unexpected disease outbreaks and unpredictable disease presentations from Plasmodium falciparum and Plasmodium vivax infections. The Malaria Evolution in South Asia (MESA) research program is one of ten International Centers of Excellence for Malaria Research (ICEMR) sponsored by the US National Institutes of Health. In this second of two reviews, we describe why population structures of Plasmodia in India will be characterized and how we will determine their consequences on disease presentation, outcome and patterns. Specific projects will determine if genetic diversity, possibly driven by parasites with higher genetic plasticity, plays a role in changing epidemiology, pathogenesis, vector competence of parasite populations and whether innate human genetic traits protect Indians from malaria today. Deep local clinical knowledge of malaria in India will be supplemented by basic scientists who bring new research tools. Such tools will include whole genome sequencing and analysis methods; in vitro assays to measure genome plasticity, RBC cytoadhesion, invasion, and deformability; mosquito infectivity assays to evaluate changing parasite-vector compatibilities; and host genetics to understand protective traits in Indian populations. The MESA-ICEMR study sites span diagonally across India and include a mixture of very urban and rural hospitals, each with very different disease patterns and patient populations. Research partnerships include government-associated research institutes, private medical schools, city and state government hospitals, and hospitals with industry ties. Between 2012 and 2017, in addition to developing clinical research and basic science infrastructure at new clinical sites, our training workshops will engage new scientists and clinicians throughout South Asia in the malaria research field.
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Affiliation(s)
| | - Laura Chery
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | - Analabha Basu
- National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | | | | | - Joseph Fowble
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | | | | | - Ashwani Kumar
- National Institute of Malaria Research (ICMR), Panaji, Goa, India
| | - Partha Majumder
- National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | - Jennifer Maki
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | | | | | - Bikram Roy
- National Institute of Biomedical Genomics, Kalyani, West Bengal, India
| | - Somdutta Sen
- SphaeraPharma Research and Development, Manesar, Haryana, India
| | - Jayanthi Shastri
- Kasturba Hospital for Infectious Diseases, Mumbai, Maharashtra, India
- Topiwala Medical College & BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Joseph Smith
- Seattle Biomedical Research Institute, Seattle, WA, USA
| | - Neena Valecha
- National Institute of Malaria Research (ICMR), New Delhi, India
| | - John White
- Department of Chemistry, University of Washington, Seattle, WA, USA
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Gurjar M, Saigal S, Baronia AK, Azim A, Poddar B, Singh RK. Clinical manifestations of co-infection with malaria and leptospirosis. Trop Doct 2011; 41:175-8. [PMID: 21724689 DOI: 10.1258/td.2011.110082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Though both malaria and leptospirosis are frequent in the tropics, co-infections are under-recognized due to overlapping of clinical features. Here, we reviewed clinical manifestations of published co-infection along with our three cases. Out of a total of 18 patients, nine patients (50%) required ICU admission. Almost all patients had prodromal symptoms in the form of fever, headache and myalgia. Seven patients (37%) had altered sensorium, three patients (17%) had hypotension at admission, and 11 patients (61%) had acute kidney injury (AKI). Pulmonary manifestations in the form of pulmonary bleeding were present in four cases (22%). Three (17%) patients had acute lung injury/ acute respiratory distress syndrome. Almost 55% patients had DIC in the form of altered prothrombin time, activated partial thromboplastin time and low fibrinogen level. Four patients (22%) had subconjuctival suffusion, two of them had haematuria, while one presented with nasal bleeding. All patients had altered liver function tests. Of all the 18 patients, 17 (94%) survived, while one died.
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Affiliation(s)
- Mohan Gurjar
- Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) - Critical Care Medicine, SGPGIMS, Rae Bareli Road, Lucknow, UP 226014, India.
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