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Sinha A, Kar S, Chauhan C, Yadav CP, Kori L. Meta-analysis on Plasmodium falciparum sulfadoxine-pyrimethamine resistance-conferring mutations in India identifies hot spots for genetic surveillance. Int J Antimicrob Agents 2024; 63:107071. [PMID: 38154659 DOI: 10.1016/j.ijantimicag.2023.107071] [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: 07/27/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND India is on track to eliminate malaria by 2030 but emerging resistance to first-line antimalarials is a recognised threat. Two instances of rapid development, spread, and natural selection of drug-resistant mutant parasites in India (chloroquine across the country and artesunate + sulfadoxine-pyrimethamine [AS+SP] in the northeastern states) translated into drug policy changes for Plasmodium falciparum malaria in 2010 and 2013, respectively. Considering these rapid changes in the SP drug resistance-conferring mutation profile of P. falciparum, there is a need to systematically monitor the validated mutations in Pfdhfr and Pfdhps genes across India alongside AS+SP therapeutic efficacy studies. There has been no robust, systematic countrywide surveillance reported for these parameters in India, hence the current study was undertaken. METHODS Studies that reported data on WHO-validated SP resistance markers in P. falciparum across India from 2008 to January 2023 were included. Five major databases, PubMedⓇ, Web of ScienceTM, ScopusⓇ, EmbaseⓇ, and Google Scholar, were exhaustively searched. Individual and pooled prevalence estimates of mutations were obtained through random- and fixed-effect models. Data were depicted using forest plots created with a 95% confidence interval. The study is registered with PROSPERO (CRD42021236012). RESULTS A total of 37 publications, and 533 Pfdhfr and 134 Pfdhps National Centre of Biotechnology Information (NCBI) DNA sequences were included from >4000 samples. The study included information from 80 districts, 21 states and 3 union territories (UTs) from India. The two PfDHFR mutations, C59R (62%) and S108N (74%), were the most prevalent mutations (pooled estimates 61% and 71%, respectively) and appeared to be stabilised/fixed. Although rarest overall, the prevalence of I164L was observed to be as high as 32%. The PfDHFR double mutants were the most prevalent overall (51%; pooled 42%). The prevalence of triple and quadruple mutations was 6% and 5%, respectively, and is an immediate concern for some states. The most prevalent PfDHPS mutation was A437G (39%), followed by K540E (25%) and A581G (12%). There was a low overall prevalence of PfDHFR/PfDHPS quintuple and sextuple mutations but surveillance for these mutations is critical for some areas. CONCLUSION The analyses span the two critical policy changes, highlight the areas of concern, and guide policymakers in strategising and refining the anti-malaria drug policy for malaria elimination. The results of the analyses also highlight the SP-resistance hot spots, critical gaps and challenges, and indicate that focal and local malaria genetic surveillance (including drug-resistance markers) is needed until malaria is successfully eliminated.
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Affiliation(s)
- Abhinav Sinha
- ICMR-National Institute of Malaria Research, New Delhi, India.
| | - Sonalika Kar
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Charu Chauhan
- ICMR-National Institute of Malaria Research, New Delhi, India
| | | | - Lokesh Kori
- ICMR-National Institute of Malaria Research, New Delhi, India
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Naik BR, Tyagi BK, Xue RD. Mosquito-borne diseases in India over the past 50 years and their Global Public Health Implications: A Systematic Review. JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION 2023; 39:258-277. [PMID: 38108431 DOI: 10.2987/23-7131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Mosquito-borne diseases (MBDs) pose a significant public health concern globally, and India, with its unique eco-sociodemographic characteristics, is particularly vulnerable to these diseases. This comprehensive review aims to provide an in-depth overview of MBDs in India, emphasizing their impact and potential implications for global health. The article explores distribution, epidemiology, control or elimination, and economic burden of the prevalent diseases such as malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis, which collectively contribute to millions of cases annually. It sheds light on their profound effects on morbidity, mortality, and socioeconomic burdens and the potential for international transmission through travel and trade. The challenges and perspectives associated with controlling mosquito populations are highlighted, underscoring the importance of effective public health communication for prevention and early detection. The potential for these diseases to spread beyond national borders is recognized, necessitating a holistic approach to address the challenge. A comprehensive literature search was conducted, covering the past five decades (1972-2022), utilizing databases such as Web of Science, PubMed, and Google Scholar, in addition to in-person library consultations. The literature review analyzed 4,082 articles initially identified through various databases. After screening and eligibility assessment, 252 articles were included for analysis. The review focused on malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis. The included studies focused on MBDs occurrence in India, while those conducted outside India, lacking statistical analysis, or published before 1970 were excluded. This review provides valuable insights into the status of MBDs in India and underscores the need for concerted efforts to combat these diseases on both national and global scales through consilience.
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Pundir H, Pant M, Joshi T, Bhat S, Pathak R, Bajpai AB, Chandra S, Tamta S. Identification of essential oil phytocompounds as natural inhibitors of Odorant-binding protein to prevent malaria through in silico approach. J Biomol Struct Dyn 2023; 41:8323-8333. [PMID: 36214706 DOI: 10.1080/07391102.2022.2132419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/28/2022] [Indexed: 10/17/2022]
Abstract
Malaria predominantly affects millions annually in the African and Asian tropical and subtropical countries. With no effective vaccine, malaria prevention is exclusively dependent on preventing human-vector interaction. Anopheles gambiae, the main vector of the malaria parasite Plasmodium falciparum contains Odorant Binding proteins (OBPs) which are considered an attractive drug target for anti-malarial therapy. To identify a potential anti-malarial compound, we performed a structure-based screening of 876 phytocompounds derived from essential oils against the OBP4 by molecular docking. The compounds having better docking scores were assessed for drug-likeness, toxicity, and molecular interaction analysis. As per the results, strong affinities and high stability were demonstrated by two phytocompounds viz. Alpha-cyperone (-8.1 kcal mol-1) and Humulene oxide (-8.1 kcal mol-1) with OBP4. The hydrophobic interactions involve Phe123, Ala106, Thr57, Ala52, Thr69, and Ile64 within the binding cavities, which may block the OBP4 receptor resulting in disorientation. After that, the potential compounds were subjected to molecular dynamics (MD) simulation to evaluate their structural stability and dynamics at the active site of OBP4. The MM-PBSA result revealed that Alpha-cyperone and Humulene oxide had binding free energy of -92.44 kJ mol-1 and -113.25 kJ mol-1, respectively. Simulation outcomes demonstrate that these phytocompounds displayed considerable significant structural and pharmacological properties. The LD50 value of Alpha-cyperone and Humulene oxide also suggested that both are safe and suitable for use in natural repellent development. We suggest that the use of these compounds can minimize the treatment period and the various side effects associated with the currently available anti-malarial drugs.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Hemlata Pundir
- Department of Botany, D.S.B Campus, Kumaun University, Nainital, Uttarakhand, India
| | - Manish Pant
- Department of Post-Harvest Process and Food Engineering, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, Uttarakhand, India
| | - Tanuja Joshi
- Computational Biology & Biotechnology Laboratory, Department of Botany, Soban Singh Jeena University, Almora, Uttarakhand, India
| | - Sunaullah Bhat
- Insect Biosystematics & Insect-Pest Management Laboratory, Department of Zoology, Kumaun University-SSJ Campus, Almora, Uttarakhand, India
| | - Ramanand Pathak
- Department of Botany, M.L.K. College, Balrampur, Uttar Pradesh, India
| | | | - Subhash Chandra
- Computational Biology & Biotechnology Laboratory, Department of Botany, Soban Singh Jeena University, Almora, Uttarakhand, India
| | - Sushma Tamta
- Department of Botany, D.S.B Campus, Kumaun University, Nainital, Uttarakhand, India
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Kale S, Uplekar SM, Bandyopadhyay N, Rao PN, Ali SZ, Sharma S, Tandel N, Patel A, Singh R, Dank A, Ravishankaran S, Lakshmi Priya GS, Asokan A, Eapen A, Singh OP, Carlton JM, Mallick PK. Antimalarial Drug Resistance Profiling of Plasmodium falciparum Infections in India Using Next-Generation Sequencing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.08.23288321. [PMID: 37066213 PMCID: PMC10104178 DOI: 10.1101/2023.04.08.23288321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Tracking the emergence and spread of antimalarial drug resistance has become critical to sustaining progress towards the control and eventual elimination of malaria in South Asia, especially India. Methods An amplicon sequencing protocol was used for high-throughput molecular surveillance of antimalarial drug resistance in a total of 158 isolates at three sites in India: Chennai, Nadiad and Rourkela. Five genes of the Plasmodium falciparum implicated in antimalarial resistance were investigated here; Pfcrt for chloroquine resistance, Pfdhfr for pyrimethamine resistance, Pfdhps for sulfadoxine resistance, Pfk13 for artemisinin resistance and Pfmdr1 for resistance to multiple antimalarials. Results Mutations in the propeller domain of PfK13 were observed in two samples only, however these mutations are not validated for artemisinin resistance. A high proportion of parasites from the P. falciparum dominant site Rourkela showed wild-type Pfcrt and Pfdhfr haplotypes, while mutant Pfcrt and Pfdhfr haplotypes were fixed at the P. vivax dominant sites Chennai and Nadiad. The wild-type PfDHPS haplotype was predominant across all study sites. Finally, we observed the largest proportion of suspected multi-clonal infections at Rourkela, which has the highest transmission of P. falciparum among our study sites. Conclusion This is the first simultaneous high-throughput next generation sequencing of five complete P. falciparum genes from infected patients in India.
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Affiliation(s)
- Sonal Kale
- National Institute of Malaria Research, Indian Council of Medical Research, Sector 8, Dwarka, New Delhi, India
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Disease, NIH, Bethesda, Maryland, USA
| | - Swapna M. Uplekar
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Nabamita Bandyopadhyay
- National Institute of Malaria Research, Indian Council of Medical Research, Sector 8, Dwarka, New Delhi, India
| | - Pavitra N. Rao
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Syed Z. Ali
- National Institute of Malaria Research Field Unit, Sector 1 Health Center, Rourkela, Odisha, India
| | - S.K. Sharma
- National Institute of Malaria Research Field Unit, Sector 1 Health Center, Rourkela, Odisha, India
| | - Nikunj Tandel
- National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Ankita Patel
- National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Ranvir Singh
- National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Aaron Dank
- National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Sangamithra Ravishankaran
- National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - G Sri Lakshmi Priya
- National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Aswin Asokan
- National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Alex Eapen
- National Institute of Malaria Research Field Unit, Indian Council of Medical Research, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Om. P. Singh
- National Institute of Malaria Research, Indian Council of Medical Research, Sector 8, Dwarka, New Delhi, India
| | - Jane M. Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA
| | - Prashant K. Mallick
- National Institute of Malaria Research, Indian Council of Medical Research, Sector 8, Dwarka, New Delhi, India
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Barman L, Sharma A, Kakati S, Sarma DK, Hussain E, Saikia L. Molecular detection of drug-resistant Plasmodium falciparum mutants in Assam. Indian J Med Res 2023; 158:55-65. [PMID: 37602587 PMCID: PMC10550066 DOI: 10.4103/ijmr.ijmr_2976_20] [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: 07/09/2020] [Indexed: 08/22/2023] Open
Abstract
Background & objectives The spread of drug-resistant Plasmodium falciparum (Pf) poses a serious threat to the control and elimination of malaria. The objective of this study was to detect the molecular biomarkers of antimalarial drug resistance in Pf in patients visiting a tertiary care hospital in Assam. Methods Malaria was first detected in fever cases using microscopy and a rapid diagnostic test (RDT), and then confirmed using PCR. Pf chloroquine resistance transporter (Pfcrt), Pf multidrug resistance-1 (Pfmdr-1), and single-nucleotide polymorphisms linked to delayed parasite clearance after treatment with artemisinin MAL 10-688956 and MAL 13-1718319 and Kelch-13 propeller (PfK-13) genes were evaluated by PCR-restriction fragment length polymorphism (RFLP). Results Sixty nine cases of malaria were found among 300 cases of fever. Of these, 54 were positive for Pf, 47 of which were confirmed by PCR. Pfcrt-K76T mutation was seen in 96.6 per cent and Pfmdr1-N86Y mutation in 84.2 per cent of cases. Mutation was not detected in MAL10 and MAL13 genes. Sequence analysis of Kelch-13 gene showed the presence of a novel mutation at amino acid position 675. Statistically, no significant association was found between the molecular biomarkers and demographic profile, clinical presentation and outcome of the cases. Interpretation & conclusions Molecular surveillance is essential to assess the therapeutic efficacy of the drugs against circulating Pf isolates in Assam which are found to be highly resistant to CQ. The role of the new mutation found in the Kelch-13 gene in the development of artemisinin resistance in Assam needs to be thoroughly monitored in future research.
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Affiliation(s)
- Lipika Barman
- Department of Microbiology, Apollo Excelcare Hospital, Guwahati, India
| | - Ajanta Sharma
- Department of Microbiology, Gauhati Medical College, Guwahati, India
| | - Sanjeeb Kakati
- Department of Medicine, Assam Medical College, Dibrugarh, Assam, India
| | - Devojit Kr. Sarma
- Department of Regional Medical Research Centre, Dibrugarh, Assam, India
| | - Ezaz Hussain
- Department of Statistics, Assam Medical College, Dibrugarh, Assam, India
| | - Lahari Saikia
- Department of Microbiology, Gauhati Medical College, Guwahati, India
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Chakrabarti R, Chery-Karschney L, White J, Mascarenhas A, Skillman KM, Kanjee U, Babar PH, Patrapuvich R, Mohapatra PK, Patankar S, Smith JD, Anvikar A, Valecha N, Rahi M, Duraisingh MT, Rathod PK. Diverse Malaria Presentations across National Institutes of Health South Asia International Center for Excellence in Malaria Research Sites in India. Am J Trop Med Hyg 2022; 107:107-117. [PMID: 36228910 PMCID: PMC9662227 DOI: 10.4269/ajtmh.21-1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/14/2022] [Indexed: 11/07/2022] Open
Abstract
The Malaria Evolution in South Asia (MESA) International Center for Excellence in Malaria Research (ICEMR) was established by the US National Institutes of Health (US NIH) as one of 10 malaria research centers in endemic countries. In 10 years of hospital-based and field-based work in India, the MESA-ICEMR has documented the changing epidemiology and transmission of malaria in four different parts of India. Malaria Evolution in South Asia-ICEMR activities, in collaboration with Indian partners, are carried out in the broad thematic areas of malaria case surveillance, vector biology and transmission, antimalarial resistance, pathogenesis, and host response. The program integrates insights from surveillance and field studies with novel basic science studies. This is a two-pronged approach determining the biology behind the disease patterns seen in the field, and generating new relevant biological questions about malaria to be tested in the field. Malaria Evolution in South Asia-ICEMR activities inform local and international stakeholders on the current status of malaria transmission in select parts of South Asia including updates on regional vectors of transmission of local parasites. The community surveys and new laboratory tools help monitor ongoing efforts to control and eliminate malaria in key regions of South Asia including the state of evolving antimalarial resistance in different parts of India, new host biomarkers of recent infection, and molecular markers of pathogenesis from uncomplicated and severe malaria.
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Affiliation(s)
- Rimi Chakrabarti
- Department of Chemistry, University of Washington, Seattle, Washington
- Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa, India
| | | | - John White
- Department of Chemistry, University of Washington, Seattle, Washington
| | - Anjali Mascarenhas
- Department of Chemistry, University of Washington, Seattle, Washington
- Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa, India
| | - Kristen M. Skillman
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Usheer Kanjee
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Prasad H. Babar
- Department of Chemistry, University of Washington, Seattle, Washington
- Department of Medicine, Goa Medical College and Hospital, Bambolim, Goa, India
| | - Rapatbhorn Patrapuvich
- Drug Research Unit for Malaria (DRUM), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Swati Patankar
- Department of Biosciences and Bioengineering, IIT Bombay, Powai, Mumbai, India
| | | | - Anup Anvikar
- National Institute of Biologicals, Noida, UP, India
| | - Neena Valecha
- National Institute of Malaria Research, New Delhi, India
| | - Manju Rahi
- Division of Epidemiology and Communicable Disease, Indian Council of Medical Research, New Delhi, India
| | - Manoj T. Duraisingh
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Rahi M, Sharma A. Malaria control initiatives that have the potential to be gamechangers in India's quest for malaria elimination. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 2:100009. [PMID: 37383297 PMCID: PMC10306036 DOI: 10.1016/j.lansea.2022.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Malaria continues to have devastating effect on people's lives especially in developing countries. India is slated for malaria elimination by 2030. Though India has sustained a decline in malaria burden at the national level the epidemiological picture remains heterogenous. India's road to malaria elimination plan is riddled with many roadblocks. Major challenges include insufficient surveillance, slow and aggregated data reporting especially in exigent situations like cross-border areas and vulnerable high-risk groups. More than half of total malaria cases were due to Plasmodium vivax (P. vivax) in India as reported by national malaria control programme in 2019. This translates into substantial burden of P. vivax malaria in absolute numbers. P. vivax malaria, which is difficult to resolve as compared to other species, poses a threat to India's elimination plans by virtue of its tendency to develop hypnozoites, due to poor compliance to primaquine (PQ), due to host factors like G 6 PD deficiency and other genes that affect PQ metabolism. Also, India's malaria endemic areas largely coincide geographically with tribal regions which are poor in healthcare infrastructure. The tribal population disproportionately bears a huge burden of malaria. They also harbour more G6PD deficient individuals than non-tribal regions. Therefore, in addition to inadequate diagnostic facilities (for both malaria and G6PD testing) these remote rural and tribal communities suffer from lack of timely treatment, incomplete radical treatment due to poor compliance and thus repeated episodes of P. vivax due to relapses and/or reinfections. Another challenge is that the the current diagnostic tools in the national programme in India and other countries are mostly available only via the programme and are able to detect patent infections on the whole. These therefore miss low-density infections which are another major limitation for their use in malaria endemic countries. Drug and insecticide resistance need to be constantly monitored as they have direct impact on the efficacy of the current tools. Need for better vector control products for the diverse entomological requirements is also felt. India is the second most populous country in the world with majority of its population at risk of malaria. Despite many agencies (government and non-government) working in the field of malaria, there needs to be more synergy at the local or central level for malaria control. Here, we have proposed solutions for specific facets of the malaria programme. Surveillance, data visualization and analysis can all be supported through over the counter availability of rapid diagnostics, adoption of molecular tools like PCR (requiring additional infrastructure and expertise), mobile applications for data capture and use of malaria data dashboard. Management could be augmented by inclusion of tafenoquine for treatment of P. vivax malaria with a companion point-of care diagnostic which has been developed to assess G6PD enzyme activity. A switchover to artemether-lumefantrine for the entire country can also be considered. Vector control can be strengthened by commercial availability of insecticidal bednets and exploration of novel vector control tools like ivermectin. Lastly, enhancing synergy amongst various stakeholders would also catalyze the malaria elimination plans. Funding The authors have received no funding for this paper.
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Affiliation(s)
- Manju Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Amit Sharma
- Academy of Scientific and Innovative Research, Ghaziabad, India
- ICMR-National Institute of Malaria Research, New Delhi, India
- Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
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Tilaye T, Tessema B, Alemu K. High asymptomatic malaria among seasonal migrant workers departing to home from malaria endemic areas in northwest Ethiopia. Malar J 2022; 21:184. [PMID: 35690823 PMCID: PMC9188248 DOI: 10.1186/s12936-022-04211-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 06/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background In Ethiopia, thousands of seasonal migrant workers travel from non-malaria or mild malaria transmission areas to malaria-endemic areas for seasonal farm activities. Most of these migrants stay in the farm areas for land preparation, plowing, planting, weeding, and harvesting for a specific period and return to their living areas. However, there is limited evidence of how seasonal migrant workers contribute to the transmission of malaria to new or less malaria transmission areas. Methods A cross-sectional study was conducted at the departure phase of seasonal migrant workers in the Metema district from September 2018 to October 2019. A total of 1208 seasonal migrant workers were interviewed during their departure from farm sites to their homes. The face-to-face interviews were performed using a pretested structured questionnaire. Moreover, blood samples were collected from each study participant for microscopic malaria parasite examination. The data were fitted with the logistic regression model to estimate the predictors of malaria transmission. Results At departure to home, the prevalence of malaria among seasonal migrant workers was 17.5% (15.6–19.45%). Approximately 71.80% (177/212) of the cases were Plasmodium falciparum, and 28.20% (35/212) were Plasmodium vivax. Most seasonal migrant workers 934 (77.4%) were from rural residences and highlanders 660 (55%). Most 661 (55.4%) of the migrants visited two and more farm sites during their stay at development corridors for harvesting activities. Approximately 116 (54.7%) asymptomatic malaria cases returned to the Dembia 46 (21.7%), Chilaga 46 (19.8%) and Metema 28 (13.2%) districts. Conclusion In this study, asymptomatic malaria remains high among seasonal migrant workers departing to home from malaria endemic areas. This may fuel a resurgence of malaria transmission in the high lands and cause challenges to the country's malaria prevention and elimination efforts. Hence, tailored interventions for seasonal migrant workers could be in place to enhance malaria control and elimination in Ethiopia, such as asymptomatic malaria test and treat positive cases at departure and transit, and integration between malaria officers at their origin and departure for further follow-up to decrease any risk of spread at the origin.
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Affiliation(s)
- Tesfaye Tilaye
- Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Belay Tessema
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
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9
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Nirmolia T, Ahmed MA, Sathishkumar V, Sarma NP, Bhattacharyya DR, Mohapatra PK, Bansal D, Bharti PK, Sehgal R, Mahanta J, Sultan AA, Narain K, Patgiri SJ. Genetic diversity of Plasmodium falciparum AMA-1 antigen from the Northeast Indian state of Tripura and comparison with global sequences: implications for vaccine development. Malar J 2022; 21:62. [PMID: 35193607 PMCID: PMC8861999 DOI: 10.1186/s12936-022-04081-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Malaria continues to be a major public health problem in the Northeastern part of India despite the implementation of vector control measures and changes in drug policies. To develop successful vaccines against malaria, it is important to assess the diversity of vaccine candidate antigens in field isolates. This study was done to assess the diversity of Plasmodium falciparum AMA-1 vaccine candidate antigen in a malaria-endemic region of Tripura in Northeast India and compare it with previously reported global isolates with a view to assess the feasibility of developing a universal vaccine based on this antigen. Methods Patients with fever and malaria-like illness were screened for malaria and P. falciparum positive cases were recruited for the current study. The diversity of PfAMA-1 vaccine candidate antigen was evaluated by nested PCR and RFLP. A selected number of samples were sequenced using the Sanger technique. Results Among 56 P. falciparum positive isolates, Pfama-1 was successfully amplified in 75% (n = 42) isolates. Allele frequencies of PfAMA-1 antigen were 16.6% (n = 7) for 3D7 allele and 33.3% (n = 14) in both K1 and HB3 alleles. DNA sequencing revealed 13 haplotypes in the Pfama-1 gene including three unique haplotypes not reported earlier. No unique amino-acid substitutions were found. Global analysis with 2761 sequences revealed 435 haplotypes with a very complex network composition and few clusters. Nucleotide diversity for Tripura (0.02582 ± 0.00160) showed concordance with South-East Asian isolates while recombination parameter (Rm = 8) was lower than previous reports from India. Population genetic structure showed moderate differentiation. Conclusions Besides documenting all previously reported allelic forms of the vaccine candidate PfAMA-1 antigen of P. falciparum, new haplotypes not reported earlier, were found in Tripura. Neutrality tests indicate that the Pfama-1 population in Tripura is under balancing selection. This is consistent with global patterns. However, the high haplotype diversity observed in the global Pfama-1 network analysis indicates that designing a universal vaccine based on this antigen may be difficult. This information adds to the existing database of genetic diversity of field isolates of P. falciparum and may be helpful in the development of more effective vaccines against the parasite. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04081-1.
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Affiliation(s)
- Tulika Nirmolia
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Md Atique Ahmed
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Vinayagam Sathishkumar
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Nilanju P Sarma
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India.,SRL Reference Laboratory, Mumbai, 400060, India
| | - Dibya R Bhattacharyya
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Pradyumna K Mohapatra
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Doha, Qatar.,Ministry of Public Health, Doha, Qatar
| | - Praveen K Bharti
- ICMR - National Institute for Research in Tribal Health, Jabalpur, Madhya Pradesh, 482003, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, 160012, India
| | - Jagadish Mahanta
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Doha, Qatar
| | - Kanwar Narain
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India
| | - Saurav J Patgiri
- ICMR - Regional Medical Research Centre, North East Region, Dibrugarh, Assam, 786001, India.
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10
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Dev V, Manguin S. Defeating malaria in the North-East region: the forerunner for malaria elimination in India. Acta Trop 2021; 222:106040. [PMID: 34252384 DOI: 10.1016/j.actatropica.2021.106040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
India is a malaria endemic country which is targeting malaria elimination by 2027. Transmission intensities are low-to-moderate depending on the region supported by multiple disease vectors. Among these, comparatively North-East India contributes to high proportions of malaria cases annually, the majority of which are due to Plasmodium falciparum (90%). Anopheles minimus and An. baimaii (sibling species in the An. dirus complex) are widely prevalent and incriminated as vectors of malaria. Number of intervention tools were field-evaluated beginning 1988 to date against disease vectors and causative parasites to contain the spread of malaria. These included (i) insecticide-treated netting materials (ITNs) for vector control, (ii) rapid diagnostic tests (RDTs) for in situ diagnosis, and (iii) therapeutic efficacy of artemisinin-based combination therapies (ACTs) for improved drug-policy; all of which were incorporated in healthcare services resulting in substantial disease transmission reduction. Populations of both An. minimus and An. baimaii were observed depleting, instead An. culicifacies s.l. recorded to be fast invading degraded forests and assessed to be resistant to multiple insecticides. Of the two prevalent Plasmodium species, while P. vivax continued to be susceptible to chloroquine therapy, P. falciparum had emerged resistant to most available antimalarial drugs except ACTs over space and time and spreading to peninsular India threatening elimination efforts. Disease transmission trends were observed to be declining for which the state of Assam has made huge strides reporting steady fall in cases each passing year vis-à-vis Meghalaya, Mizoram and Tripura (all sharing international border with Bangladesh), in which malaria transmission remained uninterrupted. Consequently, control of malaria in the North-East region of India is of immediate importance and needs prioritization for intensified disease surveillance and control interventions coupled with improved access to healthcare services mitigating risk of disease outbreaks and spread of drug-resistant malaria helping realize the goal of malaria elimination in the country.
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Affiliation(s)
- Vas Dev
- ICMR, National Institute of Malaria Research, New Delhi, 110 077, India
| | - Sylvie Manguin
- HydroSciences Montpellier (HSM), University Montpellier, CNRS, IRD, 34093 Montpellier, France.
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11
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Sakpal S, Bastikar A, Kothari SL, Bastikar V. In silico analysis of the pyretic effect of drugs on antimalarial receptors. J INDIAN CHEM SOC 2021. [DOI: 10.1016/j.jics.2021.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Onohuean H, Alagbonsi AI, Usman IM, Iceland Kasozi K, Alexiou A, Badr RH, Batiha GES, Ezeonwumelu JOC. Annona muricata Linn and Khaya grandifoliola C.DC. Reduce Oxidative Stress In Vitro and Ameliorate Plasmodium berghei-Induced Parasitemia and Cytokines in BALB/c Mice. J Evid Based Integr Med 2021; 26:2515690X211036669. [PMID: 34350806 PMCID: PMC8358498 DOI: 10.1177/2515690x211036669] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background. Annona muricata and Khaya grandifoliola are ethnomedicinally used for the treatment of malaria and have been experimentally shown to have an anti-plasmodial effect, but the mechanisms involved are not fully understood. This study investigated the effect of the ethanol extracts of their leaves on parasitemia, radical scavenging and cytokines in Plasmodium berghei ANKA-infected BALB/c mice. Methods. BALB/c mice were infected with P. berghei and treated with chloroquine, A. muricata or K. grandifoliola extract for 4 days. The percentage of parasitemia and the level of cytokine expression were determined after treatment. Trace element, phytochemical and nitric oxide (NO) scavenging activity, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging properties assays were done to study the antioxidant effects of AN and KG in vitro. Results. P. berghei consistently increased parasitemia in BALB/c mice. The tested doses (100-, 200-, and 400 mg/kg) of A. muricata and K. grandifoliola attenuated the P. berghei-induced elevation of parasitemia and cytokines (TNF-α, IL-5, and IL-6) in vivo during the experimental period, though not as much as chloroquine. Moreover, both extracts scavenged the DPPH and NO radicals, though A. muricata had more anti-oxidant effect than K. grandifoliola in-vitro. Conclusion. The ethanol extracts of A. muricata and K. grandifoliola reduce parasitemia in P. berghei-treated mice BALB/c by scavenging free radicals and reducing cytokines, though the extracts were not as effective as chloroquine.
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Affiliation(s)
- Hope Onohuean
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Biopharmaceutics Unit, Department of Pharmacology and Toxicology, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Abdullateef I Alagbonsi
- Physiology Unit, Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda College of Medicine and Health Sciences, Huye, Republic of Rwanda
| | - Ibe M Usman
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
| | | | - Athanasios Alexiou
- Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia.,AFNP Med Austria, Wien, Austria
| | - Reem H Badr
- Department of Plant Physiology Botany and Microbiology, Faculty of Science, Alex University, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El Beheira, Egypt
| | - Joseph O C Ezeonwumelu
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Clinical Pharmacy and Biopharmacy, School of Pharmacy, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
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13
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Rout UK, Sanket AS, Sisodia BS, Mohapatra PK, Pati S, Kant R, Dwivedi GR. A Comparative Review on Current and Future Drug Targets Against Bacteria & Malaria. Curr Drug Targets 2021; 21:736-775. [PMID: 31995004 DOI: 10.2174/1389450121666200129103618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/13/2019] [Accepted: 12/20/2019] [Indexed: 11/22/2022]
Abstract
Long before the discovery of drugs like 'antibiotic and anti-parasitic drugs', the infectious diseases caused by pathogenic bacteria and parasites remain as one of the major causes of morbidity and mortality in developing and underdeveloped countries. The phenomenon by which the organism exerts resistance against two or more structurally unrelated drugs is called multidrug resistance (MDR) and its emergence has further complicated the treatment scenario of infectious diseases. Resistance towards the available set of treatment options and poor pipeline of novel drug development puts an alarming situation. A universal goal in the post-genomic era is to identify novel targets/drugs for various life-threatening diseases caused by such pathogens. This review is conceptualized in the backdrop of drug resistance in two major pathogens i.e. "Pseudomonas aeruginosa" and "Plasmodium falciparum". In this review, the available targets and key mechanisms of resistance of these pathogens have been discussed in detail. An attempt has also been made to analyze the common drug targets of bacteria and malaria parasite to overcome the current drug resistance scenario. The solution is also hypothesized in terms of a present pipeline of drugs and efforts made by scientific community.
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Affiliation(s)
- Usha K Rout
- Microbiology Department, ICMR-Regional Medical Research Centre, Bhubaneswar-751023, India
| | | | - Brijesh S Sisodia
- Regional Ayurveda Research Institute for Drug Development, Gwalior-474 009, India
| | | | - Sanghamitra Pati
- Microbiology Department, ICMR-Regional Medical Research Centre, Bhubaneswar-751023, India
| | - Rajni Kant
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh- 273013, India
| | - Gaurav R Dwivedi
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh- 273013, India
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14
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Krishna S, Mishra S, Tiwari P, Vishwakarma AK, Khandai S, Shrivastava S, Verma AK, Tiwari S, Barman H, Jhariya S, Tiwari P, Tidgam AS, Varun BM, Singh S, Yerane N, Tembhurne CR, Mandavi PL, Tekam SS, Malik M, Behera KP, Jayswar H, Sonwani K, Diggikar MS, Pradhan MM, Khasotiya SS, Kumar A, Dhingra N, Bustos MDG, Christophel EM, Ringwald P, Kumari R, Shukla MM, Singh N, Das A, Bharti PK. Therapeutic efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in four malaria endemic states of India. Malar J 2021; 20:229. [PMID: 34020652 PMCID: PMC8139028 DOI: 10.1186/s12936-021-03762-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Malaria is a major public health problem in India and accounts for about 88% of malaria burden in South-East Asia. India alone accounted for 2% of total malaria cases globally. Anti-malarial drug resistance is one of the major problems for malaria control and elimination programme. Artemether-lumefantrine (AL) is the first-line treatment of uncomplicated Plasmodium falciparum in north eastern states of India since 2013 after confirming the resistance against sulfadoxine-pyrimethamine. In the present study, therapeutic efficacy of artemether-lumefantrine and k13 polymorphism was assessed in uncomplicated P. falciparum malaria. Methods This study was conducted at four community health centres located in Koraput district of Odisha, Bastar district of Chhattisgarh, Balaghat district of Madhya Pradesh and Gondia district of Maharashtra state. Patients with uncomplicated P. falciparum malaria were administered with fixed dose combination (6 doses) of artemether-lumefantrine for 3days and clinical and parasitological response was recorded up to 28days as per World Health Organization protocol. Nucleotide sequencing of msp1 and msp2 gene was performed to differentiate between recrudescence and reinfection. Amplification and sequencing of k13 propeller gene region covering codon 450680 was also carried out to identify the polymorphism. Results A total 376 malaria patients who fulfilled the enrolment criteria as well as consented for the study were enrolled. Total 356 patients were followed up successfully up to 28days. Overall, the adequate clinical and parasitological response was 98.9% and 99.4% with and without PCR correction respectively. No case of early treatment failure was observed. However, four cases (1.1%) of late parasitological failure were found from the Bastar district of Chhattisgarh. Genotyping of msp1 and msp2 confirmed 2 cases each of recrudescence and reinfection, respectively. Mutation analysis of k13 propeller gene showed one non-synonymous mutation Q613H in one isolate from Bastar. Conclusions The study results showed that artemether-lumefantrine is highly effective in the treatment of uncomplicated P. falciparum malaria among all age groups. No functional mutation in k13 was found in the study area. The data from this study will be helpful in implementation of artemether-lumefantrine in case of treatment failure by artesunate plus sulfadoxine-pyrimethamine.
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Affiliation(s)
- Sri Krishna
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sweta Mishra
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Prakash Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anup K Vishwakarma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sushrikanta Khandai
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Suyesh Shrivastava
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anil K Verma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Shashikant Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Hari Barman
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Surendra Jhariya
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Brij M Varun
- District Malaria Office, Balaghat, Madhya Pradesh, India
| | - Sunil Singh
- Community Health Centre Damoh, Balaghat, Madhya Pradesh, India
| | - Naresh Yerane
- Community Health Centre Darekasa, Gondia, Maharashtra, India
| | | | - Prem L Mandavi
- Community Health Centre, District Bastar, Darbha, Chhattisgarh, India
| | - Shyam S Tekam
- District Malaria Office, District Bastar, Jagdalpur, Chhattisgarh, India
| | - Manas Malik
- Community Health Centre Bandhgram, District Koraput, Dasmantpur, Odisha, India
| | - Kali P Behera
- District Malaria Office, District Koraput, Dasmantpur, Odisha, India
| | - Himanshu Jayswar
- Directorate of Health Services, Satpura Bhawan, Bhopal, Madhya Pradesh, India
| | - Khemraj Sonwani
- Directorate of Health Services, Indravati Bhawan, Raipur, Chhattisgarh, India
| | | | - Madan M Pradhan
- State NVBDCP, Public Health Directorate, Bhubaneswar, Odisha, India
| | - Sher S Khasotiya
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Avdhesh Kumar
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Neeraj Dhingra
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | | | | | - Pascal Ringwald
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Roop Kumari
- World Health Organization, Country Office for India, New Delhi, India
| | - Man M Shukla
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Neeru Singh
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Praveen K Bharti
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India.
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15
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Kumar V, Ray S, Aggarwal S, Biswas D, Jadhav M, Yadav R, Sabnis SV, Banerjee S, Talukdar A, Kochar SK, Shetty S, Sehgal K, Patankar S, Srivastava S. Multiplexed quantitative proteomics provides mechanistic cues for malaria severity and complexity. Commun Biol 2020; 3:683. [PMID: 33204009 PMCID: PMC7672109 DOI: 10.1038/s42003-020-01384-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022] Open
Abstract
Management of severe malaria remains a critical global challenge. In this study, using a multiplexed quantitative proteomics pipeline we systematically investigated the plasma proteome alterations in non-severe and severe malaria patients. We identified a few parasite proteins in severe malaria patients, which could be promising from a diagnostic perspective. Further, from host proteome analysis we observed substantial modulations in many crucial physiological pathways, including lipid metabolism, cytokine signaling, complement, and coagulation cascades in severe malaria. We propose that severe manifestations of malaria are possibly underpinned by modulations of the host physiology and defense machinery, which is evidently reflected in the plasma proteome alterations. Importantly, we identified multiple blood markers that can effectively define different complications of severe falciparum malaria, including cerebral syndromes and severe anemia. The ability of our identified blood markers to distinguish different severe complications of malaria may aid in developing new clinical tests for monitoring malaria severity.
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Affiliation(s)
- Vipin Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sandipan Ray
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Shalini Aggarwal
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Deeptarup Biswas
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Manali Jadhav
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Radha Yadav
- Department of Mathematics, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sanjeev V Sabnis
- Department of Mathematics, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Soumaditya Banerjee
- Medicine Department, Medical College Hospital Kolkata, 88, College Street, Kolkata, 700073, India
| | - Arunansu Talukdar
- Medicine Department, Medical College Hospital Kolkata, 88, College Street, Kolkata, 700073, India
| | - Sanjay K Kochar
- Department of Medicine, Malaria Research Centre, S.P. Medical College, Bikaner, 334003, India
| | - Suvin Shetty
- Dr. L H Hiranandani Hospital, Mumbai, 400076, India
| | | | - Swati Patankar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sanjeeva Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India.
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16
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Rathmes G, Rumisha SF, Lucas TCD, Twohig KA, Python A, Nguyen M, Nandi AK, Keddie SH, Collins EL, Rozier JA, Gibson HS, Chestnutt EG, Battle KE, Humphreys GS, Amratia P, Arambepola R, Bertozzi-Villa A, Hancock P, Millar JJ, Symons TL, Bhatt S, Cameron E, Guerin PJ, Gething PW, Weiss DJ. Global estimation of anti-malarial drug effectiveness for the treatment of uncomplicated Plasmodium falciparum malaria 1991-2019. Malar J 2020; 19:374. [PMID: 33081784 PMCID: PMC7573874 DOI: 10.1186/s12936-020-03446-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/10/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Anti-malarial drugs play a critical role in reducing malaria morbidity and mortality, but their role is mediated by their effectiveness. Effectiveness is defined as the probability that an anti-malarial drug will successfully treat an individual infected with malaria parasites under routine health care delivery system. Anti-malarial drug effectiveness (AmE) is influenced by drug resistance, drug quality, health system quality, and patient adherence to drug use; its influence on malaria burden varies through space and time. METHODS This study uses data from 232 efficacy trials comprised of 86,776 infected individuals to estimate the artemisinin-based and non-artemisinin-based AmE for treating falciparum malaria between 1991 and 2019. Bayesian spatiotemporal models were fitted and used to predict effectiveness at the pixel-level (5 km × 5 km). The median and interquartile ranges (IQR) of AmE are presented for all malaria-endemic countries. RESULTS The global effectiveness of artemisinin-based drugs was 67.4% (IQR: 33.3-75.8), 70.1% (43.6-76.0) and 71.8% (46.9-76.4) for the 1991-2000, 2006-2010, and 2016-2019 periods, respectively. Countries in central Africa, a few in South America, and in the Asian region faced the challenge of lower effectiveness of artemisinin-based anti-malarials. However, improvements were seen after 2016, leaving only a few hotspots in Southeast Asia where resistance to artemisinin and partner drugs is currently problematic and in the central Africa where socio-demographic challenges limit effectiveness. The use of artemisinin-based combination therapy (ACT) with a competent partner drug and having multiple ACT as first-line treatment choice sustained high levels of effectiveness. High levels of access to healthcare, human resource capacity, education, and proximity to cities were associated with increased effectiveness. Effectiveness of non-artemisinin-based drugs was much lower than that of artemisinin-based with no improvement over time: 52.3% (17.9-74.9) for 1991-2000 and 55.5% (27.1-73.4) for 2011-2015. Overall, AmE for artemisinin-based and non-artemisinin-based drugs were, respectively, 29.6 and 36% below clinical efficacy as measured in anti-malarial drug trials. CONCLUSIONS This study provides evidence that health system performance, drug quality and patient adherence influence the effectiveness of anti-malarials used in treating uncomplicated falciparum malaria. These results provide guidance to countries' treatment practises and are critical inputs for malaria prevalence and incidence models used to estimate national level malaria burden.
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Affiliation(s)
- Giulia Rathmes
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Susan F Rumisha
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Telethon Kids Institute, Perth, Australia.
| | - Tim C D Lucas
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katherine A Twohig
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Andre Python
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Center for Data Science, Zhejiang University, Hangzhou, 310058, China
| | - Michele Nguyen
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Anita K Nandi
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Suzanne H Keddie
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Emma L Collins
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jennifer A Rozier
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Harry S Gibson
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Elisabeth G Chestnutt
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katherine E Battle
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Georgina S Humphreys
- WorldWide Anti-Malarial Resistance Network (WWARN), Oxford, UK
- Infectious Diseases Data Observatory (IDDO), Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Punam Amratia
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Rohan Arambepola
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Amelia Bertozzi-Villa
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Institute for Disease Modeling, Bellevue, WA, USA
| | - Penelope Hancock
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Justin J Millar
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tasmin L Symons
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Ewan Cameron
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Telethon Kids Institute, Perth, Australia
- Curtin University, Perth, Australia
| | - Philippe J Guerin
- WorldWide Anti-Malarial Resistance Network (WWARN), Oxford, UK
- Infectious Diseases Data Observatory (IDDO), Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Peter W Gething
- Telethon Kids Institute, Perth, Australia
- Curtin University, Perth, Australia
| | - Daniel J Weiss
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Telethon Kids Institute, Perth, Australia
- Curtin University, Perth, Australia
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17
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Pathak A, Mårtensson A, Gawariker S, Sharma A, Diwan V, Purohit M, Ursing J. Stable high frequencies of sulfadoxine-pyrimethamine resistance associated mutations and absence of K13 mutations in Plasmodium falciparum 3 and 4 years after the introduction of artesunate plus sulfadoxine-pyrimethamine in Ujjain, Madhya Pradesh, India. Malar J 2020; 19:290. [PMID: 32795288 PMCID: PMC7427725 DOI: 10.1186/s12936-020-03274-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/29/2020] [Indexed: 11/27/2022] Open
Abstract
Background Artesunate plus sulfadoxine–pyrimethamine (ASP) is first-line treatment for uncomplicated Plasmodium falciparum malaria in most of India, except for six North-eastern provinces where treatment failure rates were high. In Ujjain, central India, the frequency of mutations associated with increased drug tolerance, but not overt resistance to sulfadoxine and pyrimethamine were 9% and > 80%, respectively, in 2009 and 2010, just prior to the introduction of ASP. The frequency of drug resistance associated mutations in Ujjain in 2015–2016 after 3–4 years of ASP use, are reported. Methods Blood samples from patients with P. falciparum mono-infection verified by microscopy were collected on filter-paper at all nine major pathology laboratories in Ujjain city. Codons pfdhfr 16–185, pfdhps 436–632 and K13 407–689 were identified by sequencing. Pfcrt K76T and pfmdr1 N86Y were identified by restriction fragment length polymorphism. Results Sulfadoxine–pyrimethamine resistance-associated pfdhfr 108 N and 59R alleles were found in 100/104 (96%) and 87/91 (96%) samples, respectively. Pfdhps 437G was found in 10/105 (10%) samples. Double mutant pfdhfr 59R + 108 N were found in 75/81 (93%) samples. Triple mutant pfdhfr 59R + 108 N and pfdhps 437G were found in 6/78 (8%) samples. Chloroquine-resistance-associated pfcrt 76T was found in 102/102 (100%). Pfmdr1 N86 and 86Y were identified in 83/115 (72%) and 32/115 (28%) samples, respectively. Conclusion The frequency of P. falciparum with reduced susceptibility to sulfadoxine–pyrimethamine remained high, but did not appear to have increased significantly since the introduction of ASP. No polymorphisms in K13 associated with decreased artemisinin susceptibility were found. ASP probably remained effective, supporting continued ASP use.
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Affiliation(s)
- Ashish Pathak
- Department of Pediatrics, R D Gardi Medical College, Surasa, 456010, Ujjain, India.,Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, 751 85, Uppsala, Sweden.,Global Health-Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Andreas Mårtensson
- Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, 751 85, Uppsala, Sweden
| | - Sudhir Gawariker
- Department of Medicine, R D Gardi Medical College, Surasa, 456010, Ujjain, India
| | - Ashish Sharma
- Department of Medicine, R D Gardi Medical College, Surasa, 456010, Ujjain, India
| | - Vishal Diwan
- Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, 751 85, Uppsala, Sweden.,Public Health & Environment in R D Gardi Medical College, Ujjain, India
| | - Manju Purohit
- Global Health-Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.,Department of Pathology, R D Gardi Medical College, Surasa, 456010, Ujjain, India
| | - Johan Ursing
- Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden. .,Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
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18
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Baghbanzadeh M, Kumar D, Yavasoglu SI, Manning S, Hanafi-Bojd AA, Ghasemzadeh H, Sikder I, Kumar D, Murmu N, Haque U. Malaria epidemics in India: Role of climatic condition and control measures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 712:136368. [PMID: 32050403 DOI: 10.1016/j.scitotenv.2019.136368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 05/28/2023]
Abstract
Malaria is a major public health problem in India, which is the second most populous country in the world. This study aimed to investigate the impact of climatic parameters and malaria control efforts implemented by the Indian national malaria control program on malaria epidemics between January of 2009 and December of 2015. A chi-squared test was used to study the correlation of all implemented control methods with occurrence of epidemics within 30, 45, 60 and 90 days and in the same district, 50, 100 and 200 km distance radiuses. The effect of each control method on probability of epidemics was also measured, and the effects of district population, season, and incidence of malaria parasite types were evaluated using logistic regression models. Fever survey was found to be effective for decreasing the odds of epidemics within 45, 60 and 90 days in 100 km. Anti-larval activity was also effective within 30, 45 and 60 days in 200 km. Winter had negative effects on odds ratio while summer and fall were more likely to trigger epidemics. These results contribute to understanding the role of climate variability and control efforts performed in India.
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Affiliation(s)
- Mahdi Baghbanzadeh
- Department of Business Development, Ofogh Kourosh Chain Stores, Tehran, Iran
| | - Dewesh Kumar
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Sare I Yavasoglu
- Department of Biology, Faculty of Arts & Sciences, Aydin Adnan Menderes University, Aydin, Turkey
| | - Sydney Manning
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran School of Medical Science, Tehran, Iran
| | - Hassan Ghasemzadeh
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, United States
| | - Ifthekar Sikder
- Department of Information System in Cleveland State University, USA
| | - Dilip Kumar
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Nisha Murmu
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA.
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19
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Zomuanpuii R, Hmar CL, Lallawmzuala K, Hlimpuia L, Balabaskaran Nina P, Senthil Kumar N. Epidemiology of malaria and chloroquine resistance in Mizoram, northeastern India, a malaria-endemic region bordering Myanmar. Malar J 2020; 19:95. [PMID: 32103751 PMCID: PMC7045395 DOI: 10.1186/s12936-020-03170-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 02/17/2020] [Indexed: 11/30/2022] Open
Abstract
Background Mizoram, a northeastern state in India, shares international borders with Myanmar and Bangladesh and is considered to be one of the key routes through which drug-resistant parasites of Southeast Asia enter mainland India. Despite its strategic location and importance, malaria epidemiology and molecular status of chloroquine resistance had not been well documented, and since chloroquine (CQ), as the first-line treatment in Plasmodium falciparum infection was discontinued since 2008, it was expected that CQ-sensitive haplotype would be more abundant. Methods Malaria epidemiology data for the period 2010 to 2018 was collected from the office of State Vector Disease Control Programme. Plasmodium falciparum-positive blood samples were collected from government district hospitals, community health centres, primary health centres, sub-centres, and diagnostic centres from six malaria-prone districts. The samples were processed and analysed using genes–P. falciparum chloroquine-resistant transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) via sequencing of PCR amplicon from 2015 to 2017. Results Malaria occurred throughout the year and P. falciparum accounted for > 89% of total malaria cases. During 2010–2018, the highest number of malaria incidence was recorded in Lawngtlai (36% of total malaria cases; average API2010–2018 of 34.8) while Champhai remained consistently low (0.4%; average API2010–2018 of 0.04). Males of ≥ 15 years old contributed maximum (35.7%) among gender and age malarial distribution recorded during 2014–2018. Death due to malaria gradually decreased over the years. A higher abundance of mutated pfcrt (58.5% of the total sample analysed) and a lower prevalence of mutated pfmdr1 (48.7%) were observed. All mutations identified for pfcrt belong to the Southeast Asian CVIET haplotype. Only a single point mutation was observed at 86 (N → Y) position in pfmdr1 (48.7%). The key N86Y mutation in pfmdr1 that had been shown to modulate CQR was found in 67.1% of the samples positive for the CVIET haplotype. Conclusions This is the first report that details malaria epidemiology and also the molecular status of CQ-resistance in P. falciparum population of the region. The efforts of the State Vector Borne Disease Control Programme have proved to be quite effective in controlling the malaria burden in the state. Despite the discontinuation of CQ for a decade, local P. falciparum is observed with decreased CQ-sensitive haplotype. It is believed that the present findings will form a basis for further studies on genetic diversity in P. falciparum, which could confer better understanding of the complexity of the disease in Southeast Asia.
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Affiliation(s)
- Rita Zomuanpuii
- Department of Biotechnology, Mizoram University, Aizawl, Mizoram, India.
| | - Christopher L Hmar
- Department of Orthopaedics, District Hospital, Government of Mizoram, Serchhip, Aizawl, Mizoram, India
| | - Khawlhring Lallawmzuala
- Department of Medicine, District Hospital, Government of Mizoram, Serchhip, Aizawl, Mizoram, India
| | - Lal Hlimpuia
- State Vector Disease Control Programme, Department of Health and Family Welfare, Government of Mizoram, Aizawl, Mizoram, India
| | - Praveen Balabaskaran Nina
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
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20
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Sharma M, Prasher P. An epigrammatic status of the ' azole'-based antimalarial drugs. RSC Med Chem 2020; 11:184-211. [PMID: 33479627 PMCID: PMC7536834 DOI: 10.1039/c9md00479c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/26/2019] [Indexed: 11/21/2022] Open
Abstract
The development of multidrug resistance in the malarial parasite has sabotaged majority of the eradication efforts by restraining the inhibition profile of first line as well as second line antimalarial drugs, thus necessitating the development of novel pharmaceutics constructed on appropriate scaffolds with superior potency against the drug-resistant and drug-susceptible Plasmodium parasite. Over the past decades, the infectious malarial parasite has developed resistance against most of the contemporary therapeutics, thus necessitating the rational development of novel approaches principally focused on MDR malaria. This review presents an epigrammatic collation of the epidemiology and the contemporary antimalarial therapeutics based on the 'azole' motif.
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Affiliation(s)
- Mousmee Sharma
- Department of Chemistry , Uttaranchal University , Dehradun 248007 , India
- UGC Sponsored Centre for Advanced Studies , Department of Chemistry , Guru Nanak Dev University , Amritsar 143005 , India
| | - Parteek Prasher
- Department of Chemistry , University of Petroleum & Energy Studies , Dehradun 248007 , India . ;
- UGC Sponsored Centre for Advanced Studies , Department of Chemistry , Guru Nanak Dev University , Amritsar 143005 , India
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21
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Sarma DK, Mohapatra PK, Bhattacharyya DR, Chellappan S, Karuppusamy B, Barman K, Senthil Kumar N, Dash AP, Prakash A, Balabaskaran Nina P. Malaria in North-East India: Importance and Implications in the Era of Elimination. Microorganisms 2019; 7:microorganisms7120673. [PMID: 31835597 PMCID: PMC6956115 DOI: 10.3390/microorganisms7120673] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/26/2019] [Accepted: 11/29/2019] [Indexed: 12/15/2022] Open
Abstract
Worldwide and in India, malaria elimination efforts are being ramped up to eradicate the disease by 2030. Malaria elimination efforts in North-East (NE) India will have a great bearing on the overall efforts to eradicate malaria in the rest of India. The first cases of chloroquine and sulfadoxine-pyrimethamine resistance were reported in NE India, and the source of these drug resistant parasites are most likely from South East Asia (SEA). NE India is the only land route through which the parasites from SEA can enter the Indian mainland. India’s malaria drug policy had to be constantly updated due to the emergence of drug resistant parasites in NE India. Malaria is highly endemic in many parts of NE India, and Plasmodium falciparum is responsible for the majority of the cases. Highly efficient primary vectors and emerging secondary vectors complicate malaria elimination efforts in NE India. Many of the high transmission zones in NE India are tribal belts, and are difficult to access. The review details the malaria epidemiology in seven NE Indian states from 2008 to 2018. In addition, the origin and evolution of resistance to major anti-malarials are discussed. Furthermore, the bionomics of primary vectors and emergence of secondary malaria vectors, and possible strategies to prevent and control malaria in NE are outlined.
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Affiliation(s)
- Devojit Kumar Sarma
- ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh 462030, India;
| | | | | | | | | | - Keshab Barman
- State NVBDCP Unit, Directorate of Health Services, Govt. of Assam, Guwahati 781005, Assam, India;
| | | | | | - Anil Prakash
- ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh 462030, India;
- Correspondence: (A.P.); (P.B.N.)
| | - Praveen Balabaskaran Nina
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur 610005, India
- Correspondence: (A.P.); (P.B.N.)
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22
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van Eijk AM, Sutton PL, Ramanathapuram L, Sullivan SA, Kanagaraj D, Priya GSL, Ravishankaran S, Asokan A, Sangeetha V, Rao PN, Wassmer SC, Tandel N, Patel A, Desai N, Choubey S, Ali SZ, Barla P, Oraon RR, Mohanty S, Mishra S, Kale S, Bandyopadhyay N, Mallick PK, Huck J, Valecha N, Singh OP, Pradhan K, Singh R, Sharma SK, Srivastava HC, Carlton JM, Eapen A. The burden of submicroscopic and asymptomatic malaria in India revealed from epidemiology studies at three varied transmission sites in India. Sci Rep 2019; 9:17095. [PMID: 31745160 PMCID: PMC6863831 DOI: 10.1038/s41598-019-53386-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/31/2019] [Indexed: 01/14/2023] Open
Abstract
Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012-2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive clinical questionnaire completed. Malaria prevalence ranged from 3-8% by PCR in community surveys (24 infections in Chennai, 56 in Nadiad, 101 in Rourkela), with Plasmodium vivax dominating in Chennai (70.8%) and Nadiad (67.9%), and Plasmodium falciparum in Rourkela (77.3%). A proportional high burden of asymptomatic and submicroscopic infections was detected in community surveys in Chennai (71% and 71%, respectively, 17 infections for both) and Rourkela (64% and 31%, 65 and 31 infections, respectively). In clinic studies, a proportional high burden of infections was identified as submicroscopic in Rourkela (45%, 42 infections) and Chennai (19%, 42 infections). In the community surveys, anemia and fever were significantly more common among microscopic than submicroscopic infections. Exploratory spatial analysis identified a number of potential malaria hotspots at all three sites. There is a considerable burden of submicroscopic and asymptomatic malaria in malarious regions in India, which may act as a reservoir with implications for malaria elimination strategies.
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Affiliation(s)
- Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Patrick L Sutton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,GlaxoSmithKline, 5 Moore Drive, PO Box 13398, RTP, Raleigh, NC, 27709-3398, United States
| | - Lalitha Ramanathapuram
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Deena Kanagaraj
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - G Sri Lakshmi Priya
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.,Department of Zoology, Madras Christian College, University of Madras, Tambaram, Chennai, 600 059, India
| | - Sangamithra Ravishankaran
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Aswin Asokan
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - V Sangeetha
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Pavitra N Rao
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Samuel C Wassmer
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Nikunj Tandel
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.,Institute of Science, Nirma University, Gujarat, 382481, India
| | - Ankita Patel
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Nisha Desai
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Sandhya Choubey
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Syed Zeeshan Ali
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Punam Barla
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Rajashri Rani Oraon
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Stuti Mohanty
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Shobhna Mishra
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Sonal Kale
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Nabamita Bandyopadhyay
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Prashant K Mallick
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Jonathan Huck
- Department of Geography Arthur Lewis Building, The University of Manchester, Manchester, England
| | - Neena Valecha
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Om P Singh
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - K Pradhan
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Ranvir Singh
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - S K Sharma
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Harish C Srivastava
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
| | - Alex Eapen
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
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23
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Marshall JM, Raban RR, Kandul NP, Edula JR, León TM, Akbari OS. Winning the Tug-of-War Between Effector Gene Design and Pathogen Evolution in Vector Population Replacement Strategies. Front Genet 2019; 10:1072. [PMID: 31737050 PMCID: PMC6831721 DOI: 10.3389/fgene.2019.01072] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
While efforts to control malaria with available tools have stagnated, and arbovirus outbreaks persist around the globe, the advent of clustered regularly interspaced short palindromic repeat (CRISPR)-based gene editing has provided exciting new opportunities for genetics-based strategies to control these diseases. In one such strategy, called "population replacement", mosquitoes, and other disease vectors are engineered with effector genes that render them unable to transmit pathogens. These effector genes can be linked to "gene drive" systems that can bias inheritance in their favor, providing novel opportunities to replace disease-susceptible vector populations with disease-refractory ones over the course of several generations. While promising for the control of vector-borne diseases on a wide scale, this sets up an evolutionary tug-of-war between the introduced effector genes and the pathogen. Here, we review the disease-refractory genes designed to date to target Plasmodium falciparum malaria transmitted by Anopheles gambiae, and arboviruses transmitted by Aedes aegypti, including dengue serotypes 2 and 3, chikungunya, and Zika viruses. We discuss resistance concerns for these effector genes, and genetic approaches to prevent parasite and viral escape variants. One general approach is to increase the evolutionary hurdle required for the pathogen to evolve resistance by attacking it at multiple sites in its genome and/or multiple stages of development. Another is to reduce the size of the pathogen population by other means, such as with vector control and antimalarial drugs. We discuss lessons learned from the evolution of resistance to antimalarial and antiviral drugs and implications for the management of resistance after its emergence. Finally, we discuss the target product profile for population replacement strategies for vector-borne disease control. This differs between early phase field trials and wide-scale disease control. In the latter case, the demands on effector gene efficacy are great; however, with new possibilities ushered in by CRISPR-based gene editing, and when combined with surveillance, monitoring, and rapid management of pathogen resistance, the odds are increasingly favoring effector genes in the upcoming evolutionary tug-of-war.
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Affiliation(s)
- John M. Marshall
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, United States
- Innovative Genomics Institute, Berkeley, CA, United States
| | - Robyn R. Raban
- Section of Cell and Developmental Biology, University of California, San Diego, CA, United States
| | - Nikolay P. Kandul
- Section of Cell and Developmental Biology, University of California, San Diego, CA, United States
| | - Jyotheeswara R. Edula
- Section of Cell and Developmental Biology, University of California, San Diego, CA, United States
| | - Tomás M. León
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, United States
| | - Omar S. Akbari
- Section of Cell and Developmental Biology, University of California, San Diego, CA, United States
- Tata Institute for Genetics and Society, University of California, San Diego, CA, United States
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24
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Transcriptional Modulation of the Host Immunity Mediated by Cytokines and Transcriptional Factors in Plasmodium falciparum-Infected Patients of North-East India. Biomolecules 2019; 9:biom9100600. [PMID: 31614626 PMCID: PMC6843480 DOI: 10.3390/biom9100600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022] Open
Abstract
Complications due to malaria are caused mostly by host immunological responses. Plasmodium falciparum subverts host immunity by various strategies, including modulation in the host immune responses by regulating cytokines. The transcriptional alterations of major cytokines and immunoregulators were analyzed in this study through gene expression profiling in clinically defined subgroups of P. falciparum patients. Malaria patients were included from Dhalai district hospital of Tripura with uncomplicated malaria (UC) and severe malaria (SM) and healthy controls from endemic and non-endemic areas of India. qPCR gene expression analysis was performed for all factors and they were grouped into three clusters based on their altered expressions. The first cluster was downregulated with an increased parasitic burden which included T-BET, GATA3, EOMES, TGF-β, STAT4, STAT6 and cytokines IFN-γ, IL-12, IL-4, IL-5, and IL-13. RANTES, IL-8, CCR8, and CXCR3 were decreased in the SM group. The second cluster was upregulated with severity and included TNF-α, IL-10, IL-1β and IL-7. PD-1 and BCL6 were increased in the SM group. The third cluster comprised of NF-κB and was not altered. The level of perforin was suppressed while GrB expression was elevated in SM. P. falciparum malaria burden is characterized by the modulation of host immunity via compromization of T cell-mediated responses and suppression of innate immune-regulators.
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25
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Wedam J, Tacoli C, Gai PP, Siegert K, Kulkarni SS, Rasalkar R, Boloor A, Jain A, Mahabala C, Baliga S, Shenoy D, Devi R, Gai P, Mockenhaupt FP. Molecular Evidence for Plasmodium falciparum Resistance to Sulfadoxine-Pyrimethamine but Absence of K13 Mutations in Mangaluru, Southwestern India. Am J Trop Med Hyg 2019; 99:1508-1510. [PMID: 30398146 DOI: 10.4269/ajtmh.18-0549] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In most of India, sulfadoxine-pyrimethamine (SP) plus artesunate serves as first-line treatment for uncomplicated falciparum malaria. In 112 clinical Plasmodium falciparum isolates from Mangaluru, southwestern India, we sequenced molecular markers associated with resistance to SP, lumefantrine, and artemisinin (pfdhfr, pfdhps, pfmdr1, and K13). The pfdhfr double mutation 59R-108N combined with the dhps 437G mutation occurred in 39.3% and the pfdhfr double mutation plus the pfdhps double mutation 437G-540E in additional 24.1%. As for pfmdr1, the allele combination N86-184F-D1246 dominated (98.2%). K13 variants were absent. No evidence for artemisinin resistance was seen. However, the antifolate resistance alleles compromise the current first-line antimalarial sulfadoxine-pyrimethamine plus artesunate, which may facilitate the emergence of artemisinin resistance. Artemether-lumefantrine, introduced in northeastern parts of the country, in the study area faces the predominant pfmdr1 NFD genotype, known to impair lumefantrine efficacy. Further monitoring of resistance alleles and treatment trials on alternative artemisinin-based combination therapies are required.
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Affiliation(s)
- Jakob Wedam
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Costanza Tacoli
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Prabhanjan P Gai
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Konrad Siegert
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | | | | | - Archith Boloor
- Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India
| | - Animesh Jain
- Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India
| | - Chakrapani Mahabala
- Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India
| | - Shantaram Baliga
- Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India
| | - Damodara Shenoy
- Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, India
| | | | - Pramod Gai
- Karnataka Institute for DNA Research, Dharwad-Hubli, India
| | - Frank P Mockenhaupt
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
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26
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Bansal D, Bharti PK, Acharya A, Abdelraheem MH, Patel P, Elmalik A, Abosalah S, Khan FY, ElKhalifa M, Kaur H, Farag E, Sarmah NP, Mohapatra PK, Sehgal R, Mahanta J, Sultan AA. Molecular surveillance of putative drug resistance markers of antifolate and artemisinin among imported Plasmodium falciparum in Qatar. Pathog Glob Health 2019; 113:158-166. [PMID: 31296112 PMCID: PMC6758627 DOI: 10.1080/20477724.2019.1639018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Malaria remains a significant public health challenge and is of global importance. Imported malaria is a growing problem in non-endemic areas throughout the world and also in Qatar due to a massive influx of migrants from endemic countries. Antimalarial drug resistance is an important deterrent in our fight against malaria today. Molecular markers mirror intrinsic antimalarial drug resistance and their changes precede clinical resistance. Thus, in the present study, molecular markers of sulphadoxine-pyrimethamine (Pfdhfr and Pfdhps) and artemisinin (PfATPase6 and Pfk13) were sequenced to determine the drug resistance genotypes among 118 imported P. falciparum isolates in Qatar, between 2013 and 2016. All the isolates had mutant Pfdhfr alleles, with either double mutant (51I/108N) (59.3%) or triple mutant (51I, 59R and 108N) (30.6%) genotypes. I164L substitution was not found in this study. In case of Pfdhps, majority of the samples were carriers of either single (S436A/ A437G/ K540E) mutant (47.2%) or double (S436A/K540E, A437G/K540E, K540E/A581G) mutant (39.8%). A single novel point mutation (431V) was observed in the samples originated from Nigeria and Ghana. Polymorphisms in PfATPase6 were absent and only one non-synonymous mutation in Pfk13 was found at codon G453A from a sample of Kenyan origin. High levels of sulphadoxine-pyrimethamine resistance in the present study provide potential information about the spread of antimalarial drug resistance and will be beneficial for the treatment of imported malaria cases in Qatar.
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Affiliation(s)
- Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City , Doha , Qatar
| | - Praveen K Bharti
- National Institute for Research in Tribal Health, Indian Council of Medical Research , Jabalpur , India
| | - Anushree Acharya
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City , Doha , Qatar
| | - Mohamed H Abdelraheem
- Department of Microbiology & Immunology, Faculty of Medicine and Health Sciences, Sultan Qaboos University , Muscat , Oman
| | - Priyanka Patel
- National Institute for Research in Tribal Health, Indian Council of Medical Research , Jabalpur , India
| | - Ashraf Elmalik
- Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Salem Abosalah
- Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Fahmi Y Khan
- Department of Medicine, Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Mohamed ElKhalifa
- Department of Laboratory Medicine and Pathology, Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Hargobinder Kaur
- Department of Parasitology, Postgraduate Institute of Medical Education and Research , Chandigarh , India
| | | | - Nilanju P Sarmah
- Regional Medical Research Centre, NE, Indian Council of Medical Research , Dibrugarh , India
| | - Pradyumna K Mohapatra
- Regional Medical Research Centre, NE, Indian Council of Medical Research , Dibrugarh , India
| | - Rakesh Sehgal
- Department of Parasitology, Postgraduate Institute of Medical Education and Research , Chandigarh , India
| | - Jagadish Mahanta
- Regional Medical Research Centre, NE, Indian Council of Medical Research , Dibrugarh , India
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City , Doha , Qatar
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Chahar M, Anvikar A, Valecha N. Development and Evaluation of a Novel HNB Based Isothermal Amplification Assay for Fast Detection of Pyrimethamine Resistance (S108N) in Plasmodium falciparum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091635. [PMID: 31083343 PMCID: PMC6539687 DOI: 10.3390/ijerph16091635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/08/2019] [Accepted: 02/11/2019] [Indexed: 11/16/2022]
Abstract
Sulphadoxine and pyrimethamine (SP) have been used as long-acting partner antimalarial drugs in artemisinin combination therapy (ACT) for falciparum malaria. The emergence and increasing spread of SP resistance in malaria-endemic areas have become a challenge for the control of malaria. Therefore, regular monitoring of the mutation status of partner drugs is important for the better management of drug policy. There are limitations with traditional molecular methods and there is an urgent need for an easy method for diagnosis of drug resistance. In this study we have introduced and developed a novel single nucleotide polymorphism loop-mediated isothermal amplification (SNP-LAMP) approach based on a hydroxynaphthol blue (HNB) indicator for the easier and quicker detection of pyrimethamine resistance in Plasmodium falciparum malaria. To implement this novel approach, many sets of LAMP primers were designed and tested. Finally, one set of forward inner primer M1 (FIPM1) of LAMP primer was selected that specifically distinguishes pyrimethamine-resistant P. falciparum malaria. The LAMP reactions were optimized at 60-66 °C for 45 min. High sensitivity (7 parasites/µL) was observed with 10-4 fold dilutions (<2 ng DNA) of genomic DNA. Moreover, this approach has the potential to be applied even in laboratories unfamiliar with PCR or other molecular methods, and in future, this can be helpful for the better management of anti-malarial policy.
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Affiliation(s)
- Madhvi Chahar
- Division of Epidemiology and Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi 110077, India.
| | - Anup Anvikar
- Division of Epidemiology and Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi 110077, India.
| | - Neena Valecha
- Division of Epidemiology and Clinical Research, National Institute of Malaria Research, Sector-8 Dwarka, New Delhi 110077, India.
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Thakur S, Dharavath R. Artificial neural network based prediction of malaria abundances using big data: A knowledge capturing approach. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.03.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Mohapatra PK, Pachuau E, Kumar C, Borkakoty B, Zomawia E, Singh A, Walia K, Arora R, Mahanta J, Subbarao SK. HIV-malaria interactions in North-East India: A prospective cohort study. Indian J Med Res 2018; 145:387-394. [PMID: 28749403 PMCID: PMC5555069 DOI: 10.4103/ijmr.ijmr_1427_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background & objectives: The interactions between HIV and malaria co-infection have been shown to influence each other in their clinical outcomes in Sub-Saharan Africa. This study was carried out in the two States of north east India endemic for both HIV and malaria infections, to study the interactions between the two diseases in the HIV-infected population. Methods: In this prospective study, a total of 333 HIV-infected individuals were followed up for a period of 6-18 months in Mizoram and Manipur during 2010-2011. The study assessed the changes in viral load and also the therapeutic efficacy of artesunate plus sulphadoxine-pyrimethamine (AS+SP) combination therapy in HIV-infected and HIV-uninfected individuals with Plasmodium falciparum malaria. Results: Viral load in HIV-infected malaria patients on day zero (D0) ranged from 1110 to 147,000 copies/ml. The log transformation of the geometric means of HIV viral loads revealed no significant difference on different days of follow up. There was 100 per cent adequate clinical and parasitological response (ACPR) after treating with artemisinin based combination therapy (ACT) both in HIV-infected and HIV-uninfected P. falciparum-positive individuals. Similarly, chloroquine showed 100 per cent ACPR in P. vivax HIV-infected individuals. Interpretation & conclusion: The study showed no significant increase in HIV viral load in malaria cases. All HIV-infected and HIV-uninfected P. falciparum malaria-positive cases responded to the treatment with 100 per cent ACPR.
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Affiliation(s)
| | - Elsa Pachuau
- Department of Pathology, Civil Hospital, Aizawl, India
| | - Chandra Kumar
- Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, India
| | | | - Eric Zomawia
- Department of Pathology, Civil Hospital, Aizawl, India
| | - Achouba Singh
- Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, India
| | - Kamini Walia
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Rashmi Arora
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Sarala K Subbarao
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Abstract
A marked decrease in malaria-related deaths worldwide has been attributed to the administration of effective antimalarials against Plasmodium falciparum, in particular, artemisinin-based combination therapies (ACTs). Increasingly, ACTs are also used to treat Plasmodium vivax, the second major human malaria parasite. However, resistance to frontline artemisinins and partner drugs is now causing the failure of P. falciparum ACTs in southeast Asia. In this Review, we discuss our current knowledge of markers and mechanisms of resistance to artemisinins and ACTs. In particular, we describe the identification of mutations in the propeller domains of Kelch 13 as the primary marker for artemisinin resistance in P. falciparum and explore two major mechanisms of resistance that have been independently proposed: the activation of the unfolded protein response and proteostatic dysregulation of parasite phosphatidylinositol 3- kinase. We emphasize the continuing challenges and the imminent need to understand mechanisms of resistance to improve parasite detection strategies, develop new combinations to eliminate resistant parasites and prevent their global spread.
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Acharya A, Bansal D, Bharti PK, Khan FY, Abusalah S, Elmalik A, ElKhalifa M, Mohapatra PK, Mahanta J, Sehgal R, Singh N, Sultan AA. Molecular surveillance of chloroquine drug resistance markers (Pfcrt and Pfmdr1) among imported Plasmodium falciparum malaria in Qatar. Pathog Glob Health 2017; 112:57-62. [PMID: 29125042 DOI: 10.1080/20477724.2017.1399234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Imported malaria has been a great challenge for public health in Qatar due to influx of large number of migrant workers. Antimalarial drug resistance has emerged as one of the greatest challenges facing malaria control today. Monitoring parasite haplotypes that predict susceptibility to major antimalarial can guide treatment policies. This study aimed to determine molecular drug resistance pattern in imported malaria cases in Qatar. Blood samples from the uncomplicated P. falciparum malaria patients were collected at Hamad General Hospital, HMC, Doha, Qatar. The samples were further confirmed by nested-polymerase chain reaction (PCR) for P. falciparum. Molecular markers of chloroquine (Pfcrt and Pfmdr1) were analyzed by using nested PCR- RFLP method to determine the key point mutations associated with chloroquine (CQ) drug resistance. A total 118 blood samples were positive for P. falciparum. Overall, by RFLP, 72% harboured wild type allele (N86) of Pfmdr1 gene. The prevalence of Pfcrt mutant (T76), WT (K76) and mixed alleles (K76T) was 63.6% (n = 75), 22.9% (n = 27) and 13.5% (n = 16), respectively. Mean parasitaemia level was higher among the wild type alleles of Pfcrt gene as compared to the mixed/mutant alleles whereas mixed alleles of Pfmdr1 gene having high parasitaemia. Molecular surveillance strategy based on imported malaria cases can be used to detect and track CQ drug-resistant malaria. The data presented here might be helpful for enrichment of molecular surveillance of antimalarial resistance and will be useful for developing and updating antimalarial guidance for non-immune imported cases in Qatar.
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Affiliation(s)
- Anushree Acharya
- a Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University , Qatar Foundation - Education City , Doha , Qatar
| | - Devendra Bansal
- a Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University , Qatar Foundation - Education City , Doha , Qatar
| | - Praveen K Bharti
- b National Institute for Research in Tribal Health, Indian Council of Medical Research , Jabalpur , India
| | - Fahmi Y Khan
- c Department of Medicine , Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Salem Abusalah
- d Department of Emergency Medicine , Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Ashraf Elmalik
- d Department of Emergency Medicine , Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Mohammed ElKhalifa
- e Department of Laboratory Medicine and Pathology , Hamad General Hospital, Hamad Medical Corporation , Doha , Qatar
| | - Pradyumna K Mohapatra
- f Regional Medical Research Centre, NE , Indian Council of Medical Research , Dibrugarh , India
| | - Jagadish Mahanta
- f Regional Medical Research Centre, NE , Indian Council of Medical Research , Dibrugarh , India
| | - Rakesh Sehgal
- g Department of Parasitology , Postgraduate Institute of Medical Education and Research , Chandigarh , India
| | - Neeru Singh
- b National Institute for Research in Tribal Health, Indian Council of Medical Research , Jabalpur , India
| | - Ali A Sultan
- a Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University , Qatar Foundation - Education City , Doha , Qatar
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Singh US, Siwal N, Pande V, Das A. Can Mixed Parasite Infections Thwart Targeted Malaria Elimination Program in India? BIOMED RESEARCH INTERNATIONAL 2017; 2017:2847548. [PMID: 28900620 PMCID: PMC5576395 DOI: 10.1155/2017/2847548] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/09/2017] [Accepted: 07/13/2017] [Indexed: 12/31/2022]
Abstract
India is highly endemic to malaria with prevalence of all five species of human malaria parasites of Plasmodium genus. India is set for malaria elimination by 2030. Since cases of mixed Plasmodium species infections remain usually undetected but cause huge disease burden, in order to understand the distributional prevalence of both monospecies infections and mixed species infections in India, we collated published data on the differential infection incidences of the five different malaria parasites based on PCR diagnostic assay. About 11% of total cases were due to mixed species infection. Among several interesting observations on both single and mixed parasitic infections, incidences of Plasmodium falciparum monoinfection were found to be significantly higher than P. vivax monoinfection. Also, P. malariae seems to be emerging as a potential malaria threat in India. Putting all the facts together, it appears that the dream of achieving malaria elimination in India will not be completely successful without dealing with mixed species infection.
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Affiliation(s)
- Upasana Shyamsunder Singh
- Division of Genomic Epidemiology, ICMR-Centre for Research in Medical Entomology, No. 4, Sarojini Street, Chinna Chokkikulam, Madurai 625002, India
| | - Nisha Siwal
- Division of Genomic Epidemiology, ICMR-Centre for Research in Medical Entomology, No. 4, Sarojini Street, Chinna Chokkikulam, Madurai 625002, India
| | - Veena Pande
- Department of Biotechnology, Kumaun University, Nainital 263001, India
| | - Aparup Das
- Division of Genomic Epidemiology, ICMR-Centre for Research in Medical Entomology, No. 4, Sarojini Street, Chinna Chokkikulam, Madurai 625002, India
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Wickremasinghe AR, Wickremasinghe R, Herath HDB, Fernando SD. Should chemoprophylaxis be a main strategy for preventing re-introduction of malaria in highly receptive areas? Sri Lanka a case in point. Malar J 2017; 16:102. [PMID: 28259152 PMCID: PMC5336652 DOI: 10.1186/s12936-017-1763-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 02/28/2017] [Indexed: 12/22/2022] Open
Abstract
Background Imported malaria cases continue to be reported in Sri Lanka, which was declared ‘malaria-free’ by the World Health Organization in September 2016. Chemoprophylaxis, a recommended strategy for malaria prevention for visitors travelling to malaria-endemic countries from Sri Lanka is available free of charge. The strategy of providing chemoprophylaxis to visitors to a neighbouring malaria-endemic country within the perspective of a country that has successfully eliminated malaria but is highly receptive was assessed, taking Sri Lanka as a case in point. Methods The risk of a Sri Lankan national acquiring malaria during a visit to India, a malaria-endemic country, was calculated for the period 2008–2013. The cost of providing prophylaxis for Sri Lankan nationals travelling to India for 1, 2 and 4 weeks was estimated for that same period. Results The risk of a Sri Lankan traveller to India acquiring malaria ranged from 5.25 per 100,000 travellers in 2012 to 13.45 per 100,000 travellers in 2010. If 50% of cases were missed by the Sri Lankan healthcare system, then the risk of acquiring malaria in India among returning Sri Lankans would double. The 95% confidence intervals for both risks are small. As chloroquine is the chemoprophylactic drug recommended for travellers to India by the Anti Malaria Campaign of Sri Lanka, the costs of chemoprophylaxis for travellers for a 1-, 2- and 4-weeks stay in India on average are US$ 41,604, 48,538 and 62,407, respectively. If all Sri Lankan travellers to India are provided with chemoprophylaxis for four weeks, it will comprise 0.65% of the national malaria control programme budget. Conclusions Based on the low risk of acquiring malaria among Sri Lankan travellers returning from India and the high receptivity in previously malarious areas of the country, chemoprophylaxis should not be considered a major strategy in the prevention of re-introduction. In areas with high receptivity, universal access to quality-assured diagnosis and treatment cannot be compromised at whatever cost.
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Affiliation(s)
- A Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, 11010, Sri Lanka.
| | - Renu Wickremasinghe
- Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Hemantha D B Herath
- Anti Malaria Campaign, 555/5 Elvitigala Mawatha, Public Health Complex, Narahenpita, Colombo, 00500, Sri Lanka
| | - S Deepika Fernando
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Structure based virtual screening identifies Pranlukast as a potential inhibitor against Plasmodium falciparum Adenosine Deaminase enzyme. GENE REPORTS 2017. [DOI: 10.1016/j.genrep.2016.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Dev V, Adak T, Singh OP, Nanda N, Baidya BK. Malaria transmission in Tripura: Disease distribution & determinants. Indian J Med Res 2016; 142 Suppl:S12-22. [PMID: 26905237 PMCID: PMC4795342 DOI: 10.4103/0971-5916.176597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Malaria is a major public health problem in Tripura and focal disease outbreaks are of frequent occurrence. The state is co-endemic for both Plasmodium falciparum and P. vivax and transmission is perennial and persistent. The present study was aimed to review data on disease distribution to prioritize high-risk districts, and to study seasonal prevalence of disease vectors and their bionomical characteristics to help formulate vector species-specific interventions for malaria control. METHODS Data on malaria morbidity in the State were reviewed retrospectively (2008-2012) for understanding disease distribution and transmission dynamics. Cross-sectional mass blood surveys were conducted in malaria endemic villages of South Tripura district to ascertain the prevalence of malaria and proportions of parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT. RESULTS The study showed that malaria was widely prevalent and P. falciparum was the predominant infection (>90%), the remaining were P. vivax cases. The disease distribution, however, was uneven with large concentration of cases in districts of South Tripura and Dhalai coinciding with vast forest cover and tribal populations. Both Anopheles minimus s.s. and An. baimaii were recorded to be prevalent and observed to be highly anthropophagic and susceptible to DDT. Of these, An. minimus was incriminated (sporozoite infection rate 4.92%), and its bionomical characteristics revealed this species to be largely indoor resting and endophagic. INTERPRETATION & CONCLUSIONS For effective control of malaria in the state, it is recommended that diseases surveillance should be robust, and vector control interventions including DDT spray coverage, mass distribution of insecticide-treated nets/ long-lasting insecticidal nets should be intensified prioritizing population groups most at risk to avert impending disease outbreaks and spread of drug-resistant malaria.
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Affiliation(s)
- Vas Dev
- National Institute of Malaria Research (Field Station) (ICMR), Guwahati, India
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Therapeutic efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria from three highly malarious states in India. Malar J 2016; 15:498. [PMID: 27737665 PMCID: PMC5064902 DOI: 10.1186/s12936-016-1555-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022] Open
Abstract
Background Anti-malarial drug resistance continues to be a leading threat to malaria control efforts and calls for continued monitoring of waning efficacy of artemisinin-based combination therapy (ACT). Artesunate + sulfadoxine/pyrimethamine (AS + SP) is used for the treatment of uncomplicated Plasmodium falciparum malaria in India. However, resistance against AS + SP is emerged in northeastern states. Therefore, artemether–lumefantrine (AL) is the recommended first line treatment for falciparum malaria in north eastern states. This study investigates the therapeutic efficacy and safety of AL for the treatment of uncomplicated falciparum malaria in three malaria-endemic states in India. The data generated through this study will benefit the immediate implementation of second-line ACT as and when required. Methods This was a one-arm prospective evaluation of clinical and parasitological responses for uncomplicated falciparum malaria using WHO protocol. Patients diagnosed with uncomplicated mono P. falciparum infection were administered six-dose regimen of AL over 3 days and subsequent follow-up was carried out up to 28 days. Molecular markers msp-1 and msp-2 were used to differentiate recrudescence and re-infection and K13 propeller gene was amplified and sequenced covering the codon 450–680. Results A total of 402 eligible patients were enrolled in the study from all four sites. Overall, adequate clinical and parasitological response (ACPR) was 98 % without PCR correction and 99 % with PCR correction. At three study sites, ACPR rates were 100 %, while at Bastar, cure rate was 92.5 % on day 28. No early treatment failure was found. The PCR-corrected endpoint finding confirmed that one late clinical failure (LCF) and two late parasitological failures (LPF) were recrudescences. The PCR corrected cure rate was 96.5 %. The mean fever clearance time was 27.2 h ± 8.2 (24–48 h) and the mean parasite clearance time was 30.1 h ± 11.0 (24–72 h). Additionally, no adverse event was recorded. Analysis of total 186 samples revealed a mutation in the k13 gene along with non-synonymous mutation at codon M579T in three (1.6 %) samples. Conclusion AL is an efficacious drug for the treatment of uncomplicated falciparum malaria. However, regular monitoring of AL is required in view of malaria elimination initiatives, which will be largely dependent on therapeutic interventions, regular surveillance and targeted vector control. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1555-4) contains supplementary material, which is available to authorized users.
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Wangdi K, Gatton ML, Kelly GC, Banwell C, Dev V, Clements ACA. Malaria elimination in India and regional implications. THE LANCET. INFECTIOUS DISEASES 2016; 16:e214-e224. [PMID: 27527748 DOI: 10.1016/s1473-3099(16)30123-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/30/2016] [Accepted: 05/05/2016] [Indexed: 12/16/2022]
Abstract
The malaria situation in India is complex as a result of diverse socio-environmental conditions. India contributes a substantial burden of malaria outside sub-Saharan Africa, with the third highest Plasmodium vivax prevalence in the world. Successful malaria control in India is likely to enhance malaria elimination efforts in the region. Despite modest gains, there are many challenges for malaria elimination in India, including: varied patterns of malaria transmission in different parts of the country demanding area-specific control measures; intense malaria transmission fuelled by favourable climatic and environment factors; varying degrees of insecticide resistance of vectors; antimalarial drug resistance; a weak surveillance system; and poor national coordination of state programmes. Prevention and protection against malaria are low as a result of a weak health-care system, as well as financial and socioeconomic constraints. Additionally, the open borders of India provide a potential route of entry for artesunate-resistant parasites from southeast Asia. This situation calls for urgent dialogue around tackling malaria across borders-between India's states and neighbouring countries-through sharing of information and coordinated control and preventive measures, if we are to achieve the aim of malaria elimination in the region.
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Affiliation(s)
- Kinley Wangdi
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia; Phuentsholing General Hospital, Phuentsholing, Bhutan.
| | - Michelle L Gatton
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Gerard C Kelly
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
| | - Cathy Banwell
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
| | - Vas Dev
- National Institute of Malaria Research (ICMR), Guwahati, Assam, India
| | - Archie C A Clements
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
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Haanshuus CG, Chandy S, Manoharan A, Vivek R, Mathai D, Xena D, Singh A, Langeland N, Blomberg B, Vasanthan G, Sitaram U, Appasamy J, Nesaraj J, Henry A, Patil S, Alvarez-Uria G, Armstrong L, Mørch K. A High Malaria Prevalence Identified by PCR among Patients with Acute Undifferentiated Fever in India. PLoS One 2016; 11:e0158816. [PMID: 27389396 PMCID: PMC4936667 DOI: 10.1371/journal.pone.0158816] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022] Open
Abstract
Background Approximately one million malaria cases were reported in India in 2015, based on microscopy. This study aims to assess the malaria prevalence among hospitalised fever patients in India identified by PCR, and to evaluate the performance of routine diagnostic methods. Methods During June 2011-December 2012, patients admitted with acute undifferentiated fever to seven secondary level community hospitals in Assam (Tezpur), Bihar (Raxaul), Chhattisgarh (Mungeli), Maharashtra (Ratnagiri), Andhra Pradesh (Anantapur) and Tamil Nadu (Oddanchatram and Ambur) were included. The malaria prevalence was assessed by polymerase chain reaction (PCR), routine microscopy, and a rapid diagnostic test (RDT) with PCR as a reference method. Results The malaria prevalence by PCR was 19% (268/1412) ranging from 6% (Oddanchatram, South India) to 35% (Ratnagiri, West India). Among malaria positive patients P. falciparum single infection was detected in 46%, while 38% had P. vivax, 11% mixed infections with P. falciparum and P. vivax, and 5% P. malariae. Compared to PCR, microscopy had sensitivity of 29% and specificity of 98%, while the RDT had sensitivity of 24% and specificity of 99%. Conclusions High malaria prevalence was identified by PCR in this cohort. Routine diagnostic methods had low sensitivity compared to PCR. The results suggest that malaria is underdiagnosed in rural India. However, low parasitaemia controlled by immunity may constitute a proportion of PCR positive cases, which calls for awareness of the fact that other pathogens could be responsible for the febrile disease in submicroscopic malaria.
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Affiliation(s)
- Christel Gill Haanshuus
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Sara Chandy
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Anand Manoharan
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
- * E-mail:
| | - Rosario Vivek
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Dilip Mathai
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Deepika Xena
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Ashita Singh
- Baptist Christian Hospital, Tezpur, Assam, India
| | - Nina Langeland
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - George Vasanthan
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Usha Sitaram
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | | | | | - Anil Henry
- Christian Hospital, Mungeli, Chhattisgarh, India
| | - Suvarna Patil
- B.K.L. Walawalkar Hospital, Ratnagiri, Maharashtra, India
| | | | | | - Kristine Mørch
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Clinicopathological Analysis and Multipronged Quantitative Proteomics Reveal Oxidative Stress and Cytoskeletal Proteins as Possible Markers for Severe Vivax Malaria. Sci Rep 2016; 6:24557. [PMID: 27090372 PMCID: PMC4835765 DOI: 10.1038/srep24557] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 03/30/2016] [Indexed: 02/04/2023] Open
Abstract
In Plasmodium vivax malaria, mechanisms that trigger transition from uncomplicated to fatal severe infections are obscure. In this multi-disciplinary study we have performed a comprehensive analysis of clinicopathological parameters and serum proteome profiles of vivax malaria patients with different severity levels of infection to investigate pathogenesis of severe malaria and identify surrogate markers of severity. Clinicopathological analysis and proteomics profiling has provided evidences for the modulation of diverse physiological pathways including oxidative stress, cytoskeletal regulation, lipid metabolism and complement cascades in severe malaria. Strikingly, unlike severe falciparum malaria the blood coagulation cascade was not found to be affected adversely in acute P. vivax infection. To the best of our knowledge, this is the first comprehensive proteomics study, which identified some possible cues for severe P. vivax infection. Our results suggest that Superoxide dismutase, Vitronectin, Titin, Apolipoprotein E, Serum amyloid A, and Haptoglobin are potential predictive markers for malaria severity.
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Sharma VP, Dev V, Phookan S. Neglected Plasmodium vivax malaria in northeastern States of India. Indian J Med Res 2016; 141:546-55. [PMID: 26139771 PMCID: PMC4510752 DOI: 10.4103/0971-5916.159511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND & OBJECTIVES The northeastern States of India are co-endemic for Plasmodium falciparum and P. vivax malaria. The transmission intensity is low-to-moderate resulting in intermediate to stable malaria. Malaria control prioritized P. falciparum being the predominant and life threatening infection (>70%). P. vivax malaria remained somewhat neglected. The present study provides a status report of P. vivax malaria in the northeastern States of India. METHODS Data on spatial distribution of P. vivax from seven northeastern States (Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland and Tripura) were analysed retrospectively from 2008-2013. In addition, cross-sectional malarial surveys were conducted during 1991-2012 in malaria endemic pockets across the States of Assam, Meghalaya, Mizoram and Tripura to ascertain the prevalence of P. vivax in different age groups. RESULTS Vivax malaria was encountered in all northeastern States but there existed a clear division of two malaria ecotypes supporting ≤30 and >30 per cent of total malaria cases. High proportions of P. vivax cases (60-80%) were seen in Arunachal Pradesh and Nagaland in the north with alpine environment, 42-67 per cent in Manipur, whereas in Assam it varied from 23-31 per cent with subtropical and tropical climate. Meghalaya, Tripura and Mizoram had the lowest proportion of P. vivax cases. Malaria cases were recorded in all age groups but a higher proportion of P. vivax consistently occurred among <5 yr age group compared to P. falciparum (P<0.05). P. vivax cases were recorded throughout the year with peak coinciding with rainy season although transmission intensity and duration varied. INTERPRETATION & CONCLUSIONS In northeast India, P. vivax is a neglected infection. Estimating the relapsing pattern and transmission dynamics of P. vivax in various ecological settings is an important pre-requisite for planning malaria elimination in the northeastern States.
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Affiliation(s)
| | - Vas Dev
- National Institute of Malaria Research (Field Station) (ICMR), Guwahati, Assam, India
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White J, Mascarenhas A, Pereira L, Dash R, Walke JT, Gawas P, Sharma A, Manoharan SK, Guler JL, Maki JN, Kumar A, Mahanta J, Valecha N, Dubhashi N, Vaz M, Gomes E, Chery L, Rathod PK. In vitro adaptation of Plasmodium falciparum reveal variations in cultivability. Malar J 2016; 15:33. [PMID: 26794408 PMCID: PMC4722725 DOI: 10.1186/s12936-015-1053-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 12/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Culture-adapted Plasmodium falciparum parasites can offer deeper understanding of geographic variations in drug resistance, pathogenesis and immune evasion. To help ground population-based calculations and inferences from culture-adapted parasites, the complete range of parasites from a study area must be well represented in any collection. To this end, standardized adaptation methods and determinants of successful in vitro adaption were sought. METHODS Venous blood was collected from 33 P. falciparum-infected individuals at Goa Medical College and Hospital (Bambolim, Goa, India). Culture variables such as whole blood versus washed blood, heat-inactivated plasma versus Albumax, and different starting haematocrit levels were tested on fresh blood samples from patients. In vitro adaptation was considered successful when two four-fold or greater increases in parasitaemia were observed within, at most, 33 days of attempted culture. Subsequently, parasites from the same patients, which were originally cryopreserved following blood draw, were retested for adaptability for 45 days using identical host red blood cells (RBCs) and culture media. RESULTS At a new endemic area research site, ~65% of tested patient samples, with varied patient history and clinical presentation, were successfully culture-adapted immediately after blood collection. Cultures set up at 1% haematocrit and 0.5% Albumax adapted most rapidly, but no single test condition was uniformly fatal to culture adaptation. Success was not limited by low patient parasitaemia nor by patient age. Some parasites emerged even after significant delays in sample processing and even after initiation of treatment with anti-malarials. When 'day 0' cryopreserved samples were retested in parallel many months later using identical host RBCs and media, speed to adaptation appeared to be an intrinsic property of the parasites collected from individual patients. CONCLUSIONS Culture adaptation of P. falciparum in a field setting is formally shown to be robust. Parasites were found to have intrinsic variations in adaptability to culture conditions, with some lines requiring longer attempt periods for successful adaptation. Quantitative approaches described here can help describe phenotypic diversity of field parasite collections with precision. This is expected to improve population-based extrapolations of findings from field-derived fresh culture-adapted parasites to broader questions of public health importance.
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Affiliation(s)
- John White
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA.
| | - Anjali Mascarenhas
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Ligia Pereira
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Rashmi Dash
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Jayashri T Walke
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Pooja Gawas
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Ambika Sharma
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Suresh Kumar Manoharan
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Jennifer L Guler
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Biology, University of Virginia, Charlottesville, VA, 22904, USA.
| | - Jennifer N Maki
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA.
| | - Ashwani Kumar
- National Institute of Malaria Research (ICMR), Panaji, 403001, Goa, India.
| | - Jagadish Mahanta
- Regional Medical Research Centre (NE), Dibrugarh, 786001, Assam, India.
| | - Neena Valecha
- National Institute of Malaria Research (ICMR), New Delhi, 110077, India.
| | - Nagesh Dubhashi
- Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Marina Vaz
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA. .,Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Edwin Gomes
- Department of Medicine, Goa Medical College and Hospital, Bambolim, 403202, Goa, India.
| | - Laura Chery
- Department of Chemistry, University of Washington, Seattle, WA, 98195, USA.
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Swain SS, Sahu MC, Padhy RN. In silico attempt for adduct agent(s) against malaria: Combination of chloroquine with alkaloids of Adhatoda vasica. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 122:16-25. [PMID: 26142781 DOI: 10.1016/j.cmpb.2015.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/11/2015] [Accepted: 06/15/2015] [Indexed: 06/04/2023]
Abstract
With the aim of controlling drug resistant Plasmodium falciparum, a computational attempt of designing novel adduct antimalarial drugs through the molecular docking method of combining chloroquine with five alkaloids, individually is presented. These alkaloids were obtained from the medicinal plant, Adhatoda vasica. From the obtained individual docking values of important derivatives of quinine and chloroquine, as well as, individual alkaloids and adduct agents of chloroquine with Adhatoda alkaloids as ligands, it was discernible that the 'adduct agent-1 with chloroquine and adhatodine' combination had the minimum energy of interaction, as the docking score value of -11.144 kcal/mol against the target protein, triosephosphate isomerase (TIM), the key enzyme of glycolytic pathway. Drug resistance of P. falciparum is due to a mutation in the polypeptide of TIM. Moratorium of mutant TIM would disrupt the metabolism during the control of the drug resistant P. falciparum. This in silico work helped to locate the 'adduct agent-1 with chloroquine and adhatodine', which could be taken up by pharmacology for further development of this compound as a new drug against drug resistant Plasmodium.
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Affiliation(s)
- Shasank S Swain
- Central Research Laboratory, IMS and Sum Hospital, Siksha 'O' Anusandhan University, K-8 Kalinga Nagar, Bhubaneswar 751003, Odisha, India
| | - Mahesh C Sahu
- Central Research Laboratory, IMS and Sum Hospital, Siksha 'O' Anusandhan University, K-8 Kalinga Nagar, Bhubaneswar 751003, Odisha, India
| | - Rabindra N Padhy
- Central Research Laboratory, IMS and Sum Hospital, Siksha 'O' Anusandhan University, K-8 Kalinga Nagar, Bhubaneswar 751003, Odisha, India.
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Sharma D, Lather M, Dykes CL, Dang AS, Adak T, Singh OP. Disagreement in genotyping results of drug resistance alleles of the Plasmodium falciparum dihydrofolate reductase (Pfdhfr) gene by allele-specific PCR (ASPCR) assays and Sanger sequencing. Parasitol Res 2015; 115:323-8. [PMID: 26407876 DOI: 10.1007/s00436-015-4750-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/17/2015] [Indexed: 11/26/2022]
Abstract
The rapid spread of antimalarial drug resistance in Plasmodium falciparum over the past few decades has necessitated intensive monitoring of such resistance for an effective malaria control strategy. P. falciparum dihydropteroate synthase (Pfdhps) and P. falciparum dihydrofolate reductase (Pfdhfr) genes act as molecular markers for resistance against the antimalarial drugs sulphadoxine and pyrimethamine, respectively. Resistance to pyrimethamine which is used as a partner drug in artemisinin combination therapy (ACT) is associated with several mutations in the Pfdhfr gene, namely A16V, N51I, C59R, S108N/T and I164L. Therefore, routine monitoring of Pfdhfr-drug-resistant alleles in a population may help in effective drug resistance management. Allele-specific PCR (ASPCR) is one of the commonly used methods for molecular genotyping of these alleles. In this study, we genotyped 55 samples of P. falciparum for allele discrimination at four codons of Pfdhfr (N51, C59, S108 and I164) by ASPCR using published methods and by Sanger's DNA sequencing method. We found that the ASPCR identified a significantly higher number of mutant alleles as compared to the DNA sequencing method. Such discrepancies arise due to the non-specificity of some of the allele-specific primer sets and due to the lack of sensitivity of Sanger's DNA sequencing method to detect minor alleles present in multiple clone infections. This study reveals the need of a highly specific and sensitive method for genotyping and detecting minor drug-resistant alleles present in multiple clonal infections.
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Affiliation(s)
- Divya Sharma
- National Institute of Malaria Research (NIMR), Sector-8, Dwarka, New Delhi, India.
| | - Manila Lather
- National Institute of Malaria Research (NIMR), Sector-8, Dwarka, New Delhi, India.
| | - Cherry L Dykes
- National Institute of Malaria Research (NIMR), Sector-8, Dwarka, New Delhi, India.
| | - Amita S Dang
- Maharshi Dayanand University (MDU), Rohtak, 124001, Haryana, India.
| | - Tridibes Adak
- National Institute of Malaria Research (NIMR), Sector-8, Dwarka, New Delhi, India.
| | - Om P Singh
- National Institute of Malaria Research (NIMR), Sector-8, Dwarka, New Delhi, India.
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Sharma D, Lather M, Mallick PK, Adak T, Dang AS, Valecha N, Singh OP. Polymorphism in drug resistance genes dihydrofolate reductase and dihydropteroate synthase in Plasmodium falciparum in some states of India. Parasit Vectors 2015; 8:471. [PMID: 26381498 PMCID: PMC4574150 DOI: 10.1186/s13071-015-1080-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sulfadoxine-pyrimethamine (SP) combination drug is currently being used in India for the treatment of Plasmodium falciparum as partner drug in artemisinin-based combination therapy (ACT). Resistance to sulfadoxine and pyrimethamine in P. falciparum is linked with mutations in dihydropteroate synthase (pfdhps) and dihydrofolate reductase (pfdhfr) genes respectively. This study was undertaken to estimate the prevalence of such mutations in pfdhfr and pfdhps genes in four states of India. METHODS Plasmodium falciparum isolates were collected from two states of India with high malaria incidence i.e., Jharkhand and Odisha and two states with low malaria incidence i.e., Andhra Pradesh and Uttar Pradesh between years 2006 to 2012. Part of sulfadoxine-pyrimethamine (SP) drug resistance genes, pfdhfr and pfdhps were PCR-amplified, sequenced and analyzed. RESULTS A total of 217 confirmed P. falciparum isolates were sequenced for both Pfdhfr and pfdhps gene. Two pfdhfr mutations 59R and 108N were most common mutations prevalent in all localities in 77 % of isolates. Additionally, I164L was found in Odisha and Jharkhand only (4/70 and 8/84, respectively). Another mutation 51I was found in Odisha only (3/70). The pfdhps mutations 436A, 437G, 540E and 581G were found in Jharkhand and Odisha only in 13, 26, 14 and 13 % isolates respectively, and was absent in Uttar Pradesh and Andhra Pradesh. Combined together for pfdhps and pfdhfr locus, triple, quadruple, quintuple and sextuple mutations were present in Jharkhand and Odisha while absent in Uttar Pradesh and Andhra Pradesh. CONCLUSION While only double mutants of pfdhfr was present in low transmission area (Uttar Pradesh and Andhra Pradesh) with total absence of pfdhps mutants, up to sextuple mutations were present in high transmission areas (Odisha and Jharkhand) for both the genes combined. Presence of multiple mutations in pfdhfr and pfdhps genes linked to SP resistance in high transmission area may lead to fixation of multiple mutations in presence of high drug pressure and high recombination rate.
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Affiliation(s)
- Divya Sharma
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
| | - Manila Lather
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
| | - Prashant K Mallick
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
| | - Tridibes Adak
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
| | - Amita S Dang
- Centre for Medical Biotechnology, Maharshi Dayanand University, Rohtak, 124001, India.
| | - Neena Valecha
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
| | - Om P Singh
- National Institute of Malaria Research, Sector 8, Dwarka, Delhi-110077, India.
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Wilson ML, Krogstad DJ, Arinaitwe E, Arevalo-Herrera M, Chery L, Ferreira MU, Ndiaye D, Mathanga DP, Eapen A. Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission Across Seven Diverse ICEMR Network Sites. Am J Trop Med Hyg 2015; 93:110-123. [PMID: 26259941 PMCID: PMC4574269 DOI: 10.4269/ajtmh.14-0834] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 06/19/2015] [Indexed: 11/30/2022] Open
Abstract
A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission.
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Affiliation(s)
- Mark L. Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Infectious Diseases Research Collaboration, Mulago Hospital Campus, Kampala, Uganda; Caucaseo Research Center/School of Health, Universidad del Valle, Cali, Colombia; Department of Chemistry, University of Washington, Seattle, Washington; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; University Cheikh Anta Diop, Dakar, Senegal; College of Medicine, University of Malawi, Blantyre, Malawi; National Institute of Malaria Research (Indian Council of Medical Research), National Institute of Epidemiology Campus, Tamil Nadu, India
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Emergence of sulfadoxine-pyrimethamine resistance in Indian isolates of Plasmodium falciparum in the last two decades. INFECTION GENETICS AND EVOLUTION 2015; 36:190-198. [PMID: 26319997 DOI: 10.1016/j.meegid.2015.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/21/2015] [Accepted: 08/22/2015] [Indexed: 01/15/2023]
Abstract
Genotyping the sulfadoxine-pyrimethamine (SP) genes will help in identifying the genes under drug selection and the emergence of resistance in dhfr and dhps genes. India is an important hotspot for studying malaria due to the immense climatic diversity prevalent in the country. The central and eastern parts of the country are most vulnerable sites where malaria cases are reported throughout the year. From different regions of the country 173 field isolates were genotyped at various loci in dhfr and dhps genes collected between 1994 and 2013. This encompasses the period before antimalarial resistance emerged and the period after the use of combination therapy was made mandatory in the country. We observed the rise of resistant SP alleles from very low frequencies (in the year 1994) to steadily rising (in the year 2000) and maintaining this increasing trend subsequently (in the year 2013) as shown by the sequence analysis of dhfr and dhps genes. This study assessed the prevalence of mutations in dhfr and dhps genes associated with SP resistance in samples indicative of increase in resistance levels of Plasmodium falciparum to SP even after the change in malaria treatment policy in the country.
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Ray S, Kumar V, Bhave A, Singh V, Gogtay NJ, Thatte UM, Talukdar A, Kochar SK, Patankar S, Srivastava S. Proteomic analysis of Plasmodium falciparum induced alterations in humans from different endemic regions of India to decipher malaria pathogenesis and identify surrogate markers of severity. J Proteomics 2015; 127:103-13. [PMID: 25982387 DOI: 10.1016/j.jprot.2015.04.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/21/2015] [Accepted: 04/29/2015] [Indexed: 11/17/2022]
Abstract
India significantly contributes to the global malaria burden and has the largest population in the world at risk of malaria. This study aims to analyze alterations in the human serum proteome as a consequence of non-severe and severe infections by the malaria parasite Plasmodium falciparum to identify markers related to disease severity and to obtain mechanistic insights about disease pathogenesis and host immune responses. In discovery phase of the study, a comprehensive quantitative proteomic analysis was performed using gel-based (2D-DIGE) and gel-free (iTRAQ) techniques on two independent mass spectrometry platforms (ESI-Q-TOF and Q-Exactive mass spectrometry), and selected targets were validated by ELISA. Proteins showing altered serum abundance in falciparum malaria patients revealed the modulation of different physiological pathways including chemokine and cytokine signaling, IL-12 signaling and production in macrophages, complement cascades, blood coagulation, and protein ubiquitination pathways. Some muscle related and cytoskeletal proteins such as titin and galectin-3-binding protein were found to be up-regulated in severe malaria patients. Hemoglobin levels and platelet counts were also found to be drastically lower in severe malaria patients. Identified proteins including serum amyloid A, C-reactive protein, apolipoprotein E and haptoglobin, which exhibited sequential alterations in their serum abundance in different severity levels of malaria, could serve as potential predictive markers for disease severity. To the best of our information, we report here the first comprehensive analysis describing the serum proteomic alterations observed in severe P. falciparum infected patients from different malaria endemic regions of India. This article is part of a Special Issue entitled: Proteomics in India.
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Affiliation(s)
- Sandipan Ray
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Vipin Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Amruta Bhave
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Vaidhvi Singh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Nithya J Gogtay
- Department of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai 400012, India
| | - Urmila M Thatte
- Department of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai 400012, India
| | - Arunansu Talukdar
- Department of Medicine, Medical College and Hospital Kolkata, 88, College Street, Kolkata 700073, India
| | - Sanjay K Kochar
- Department of Medicine, Malaria Research Center, S.P. Medical College, Bikaner 334003, India
| | - Swati Patankar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Sanjeeva Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India.
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Singh N, Kaushik NK, Mohanakrishnan D, Tiwari SK, Sahal D. Antiplasmodial activity of medicinal plants from Chhotanagpur plateau, Jharkhand, India. JOURNAL OF ETHNOPHARMACOLOGY 2015; 165:152-162. [PMID: 25721804 DOI: 10.1016/j.jep.2015.02.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/13/2015] [Accepted: 02/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The alarmingly increasing problem of drug resistance in treatment of malaria has led to an urgent need for identifying new anti-malarial drugs for both prophylaxis and chemotherapy. AIM OF THE STUDY The present study presents a systematic exploration of the ex vivo blood stage antiplasmodial potential of medicinal plants to corroborate their traditional usage against malaria in Jharkhand, India. METHODS An ethnobotanical survey in and around Ranchi was done to grasp the traditional knowledge of medicinal plants used by local healers for malaria, other fevers and for other medicinal purposes like, antiamoebic, antihelmenthic, antidote to poisons, etc. Following the survey, the selected 22 plant samples were extracted in ethanol for studying ex vivo SYBR Green I fluorescence assay based anti-plasmodial activity against both chloroquine-sensitive Pf3D7 and chloroquine resistant PfINDO strains of Plasmodium falciparum grown in human red blood cell cultures. Cytotoxicity was determined against HeLa and L929 cells using MTT assay. Further the most potent extract was chromatographed on reverse phase HPLC towards antiplasmodial activity guided purification of metabolites. RESULTS Of the 22 plant species assayed, the highest antiplasmodial activity (Pf3D7IC50 ≤ 5 µg/ml) was seen in leaf ethanol extracts of Corymbia citriodora (Hook.) K.D.Hill & L.A.S.Johnson, Calotropis procera (Aiton) Dryand. and Annona squamosa L. and bark ethanol extract of Holarrhena pubescens Wall. ex G.Don. Leaf ethanol extract of H. pubescens, bark ethanol extract of Pongamia pinnata (L.) Pierre and whole plant ethanol extract of Partheniumhysterophorus L. showed promising activity (IC50 6-10 µg/ml). Good antiplasmodial activity (IC50: 11-20 µg/ml) was observed in leaf ethanol extract of Bryophyllum pinnatum (Lam.) Oken and whole plant ethanol extract of Catharanthus roseus (L.) G.Don. The extracts of plants showing highest to good antiplasmodial activity exhibited HeLa/Pf3D7 selectivity indices of the order of 20-45. Bioassay guided fractionation of P. hysterophorus led to fivefold enrichment of antiplasmodial activities (IC50 ~450 ng/ml) in some fractions. CONCLUSION These results provide confirmation to the traditional usage of some medicinal plants against malaria in areas around Ranchi, Jharkhand.
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Affiliation(s)
- Niharika Singh
- Malaria Research Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi 110067, India
| | - Naveen Kumar Kaushik
- Malaria Research Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi 110067, India
| | - Dinesh Mohanakrishnan
- Malaria Research Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi 110067, India
| | - Santosh Kumar Tiwari
- Department of Genetics, Mahrishi Dayanand University, Rohtak, Haryana 124001, India
| | - Dinkar Sahal
- Malaria Research Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi 110067, India.
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Dev V, Sharma VP, Barman K. Mosquito-borne diseases in Assam, north-east India: current status and key challenges. WHO South East Asia J Public Health 2015; 4:20-29. [PMID: 28607271 DOI: 10.4103/2224-3151.206616] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Mosquito-borne diseases, including malaria, Japanese encephalitis (JE), lymphatic filariasis and dengue, are major public health concerns in the north-eastern state of Assam, deterring equitable socioeconomic and industrial development. Among these, malaria and JE are the predominant infections and are spread across the state. The incidence of malaria is, however, gradually receding, with a consistent decline in cases over the past few years, although entry and spread of artemisinin-resistant Plasmodium falciparum remains a real threat in the country. JE, formerly endemic in upper Assam, is currently spreading fast across the state, with confirmed cases and a high case-fatality rate affecting all ages. Lymphatic filariasisis is prevalent but its distribution is confined to a few districts and disease transmission is steadily declining. Dengue has recently invaded the state, with a large concentration of cases in Guwahati city that are spreading to suburban areas. Control of these diseases requires robust disease surveillance and integrated vector management on a sustained basis, ensuring universal coverage of evidence-based key interventions based on sound epidemiological data. This paper aims to present a comprehensive review of the status of vector-borne diseases in Assam and to address the key challenges.
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Affiliation(s)
- V Dev
- National Institute of Malaria Research (Field Station), Guwahati, Assam, India
| | - V P Sharma
- Centre for Rural Development and Technology, Indian Institute of Technology, New Delhi, India
| | - K Barman
- National Vector Borne Disease Control Programme, National Health Mission, Government of Assam, Guwahati, Assam, India
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Masilamani V, Devanesan S, Ravikumar M, Perinbam K, AlSalhi MS, Prasad S, Palled S, Ganesh KM, Alsaeed AH. Fluorescence spectral diagnosis of malaria: a preliminary study. Diagn Pathol 2014; 9:182. [PMID: 25322673 PMCID: PMC4206706 DOI: 10.1186/s13000-014-0182-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/07/2014] [Indexed: 08/23/2023] Open
Abstract
Background Malaria is the most common disease transmitted by the bite by an infected female anopheles mosquito and caused by the plasmodium parasite. It is mostly prevalent in subtropical regions receiving abundant rain and supporting copious mosquito breeding. This disease is generally detected by the microscopic examination of blood films or antigen based rapid diagnostic test. Only occasionally the parasite DNA is detected using polymerase chain reaction in certain advanced, expensive laboratories. Methods An innovative spectral detection method based on the fluorescence spectra of a set of blood plasma biomolecules [tyrosine, tryptophan, nicotinamide adenine dinucleotide (NAD), and flavin adenine dinucleotide (FAD)] and red blood cell (RBC)-associated porphyrin is being evolved by our group. Results The research so far has exhibited sensitivity and specificity values exceeding 90% based on the spectral features of blood components of 14 malaria patients and 20 numbers of age adjusted normal controls. The fluorescent biomolecules go out of proportion when the malarial parasite breaks down the hemoglobin of blood. Conclusion This technique has the potential to be used as an alternative diagnostic procedure for malaria since the instrumentation involved is portable and inexpensive. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_182
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