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Forero-Peña DA, Carrión-Nessi FS, Lopez-Perez M, Sandoval-de Mora M, Amaya ID, Gamardo ÁF, Chavero M, Figuera L, Marcano MV, Camejo-Ávila NA, Hidalgo M, Arenas CJ, Arévalo-Herrera M, Herrera S. Seroprevalence of viral and bacterial pathogens among malaria patients in an endemic area of southern Venezuela. Infect Dis Poverty 2023; 12:33. [PMID: 37038195 PMCID: PMC10084699 DOI: 10.1186/s40249-023-01089-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/27/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Malaria remains a leading public health problem worldwide. Co-infections with other pathogens complicate its diagnosis and may modify the disease's clinical course and management. Similarities in malaria clinical presentation with other infections and overlapping endemicity result in underdiagnosis of co-infections and increased mortality. Thus, the aim of this study was to determine the seroprevalence of viral and bacterial pathogens among diagnosed malaria patients in malaria-endemic areas in Venezuela. METHODS A cross-sectional study was conducted on malaria patients attending three reference medical centres in Ciudad Bolivar, Venezuela. Clinical evaluation and laboratory tests for dengue virus (DENV), chikungunya virus (CHIKV), viral hepatitis [hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV)], and leptospirosis (LEP) were performed by enzyme-linked immunosorbent assays. Previous exposure to these pathogens was defined by the presence of specific immunoglobulin (Ig) G, and co-infection or recent exposure (CoRE) was determined by the presence of specific IgM alone or IgM + IgG. Data analysis considered descriptive statistics. Parameter distribution was statistically evaluated using Kolmogorov-Smirnov test and the necessary comparison tests. Odds ratio (OR) for complications was determined according to CoRE presence with a 95% confidence interval (CI). RESULTS A total of 161 malaria patients were studied, 66% infected with Plasmodium vivax, 27% with P. falciparum, and 7.5% harboured P. vivax/P. falciparum mixed infection. Previous exposure to DENV (60%) and CHIKV (25%) was frequent. CoRE was confirmed in 55 of the 161 malaria patients (34%) and were more frequent in P. falciparum (49%) than in P. vivax (29%) and mixed malaria patients (25%) (OR = 2.43, 95% CI: 1.39-4.25, P = 0.018). The most frequent CoRE was DENV (15%), followed by HAV (12%), HBV (6.2%), CHIKV (5.5%), and LEP (3.7%); HCV CoRE was absent. Complicated malaria was significantly more frequent in patients with CoRE (56%) than those without CoRE (36%; OR = 2.31, 95% CI: 1.18-4.92, P = 0.013). CONCLUSIONS We found high CoRE prevalence in malaria patients as determined by serology in the study region; cases were associated with a worse clinical outcome. Further prospective studies with samples from different infection sites and the use of molecular tools are needed to determine the clinical significance of these findings.
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Affiliation(s)
- David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- Internal Medicine Department, "Ruiz y Páez" University Hospital Complex, Ciudad Bolivar, Venezuela.
| | - Fhabián S Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Mary Lopez-Perez
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Marisol Sandoval-de Mora
- Internal Medicine Department, "Ruiz y Páez" University Hospital Complex, Ciudad Bolivar, Venezuela
| | - Iván D Amaya
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Ángel F Gamardo
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Melynar Chavero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Luisamy Figuera
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - María V Marcano
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Natasha A Camejo-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Mariana Hidalgo
- Immunoparasitology Laboratory, Microbiology and Cell Biology Centre, Venezuelan Institute for Scientific Research, Miranda, Venezuela
| | - Cariagne J Arenas
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
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Sahra S, Jahangir A, Iqbal QZ, Mobarakai N, Glaser A, Jahangir A. Co-infection of hepatitis E virus and Plasmodium falciparum malaria: A genuine risk in sub-Saharan Africa. Parasit Vectors 2021; 14:215. [PMID: 33879247 PMCID: PMC8056203 DOI: 10.1186/s13071-021-04723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a high prevalence of malaria and viral hepatitis in South Africa. Co-infection with Plasmodium malaria (leading to cerebral malaria) and hepatitis E virus (HEV) is a rare phenomenon. CASE PRESENTATION A 33-year-old African American male with no past medical history developed altered mental status on his return from Ivory Coast. His blood tests were significant for renal and liver failure and a high Plasmodium parasite burden of 33% on the blood smear. Interestingly, he also had a positive result for hepatitis E IgM. The patient was effectively treated with aggressive hydration and intravenous (IV) artesunate. CONCLUSION Our report is the first to our knowledge in the cerebral malaria literature on a patient with hepatitis E co-infection. This exciting case emphasizes the importance of considering all kinds of endemic infectious diseases when evaluating sick returning travelers presenting to the emergency department.
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Affiliation(s)
- Syeda Sahra
- Staten Island University Hospital, Staten Island, NY, 10305, USA. .,Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY, 10305, USA.
| | | | | | | | - Allison Glaser
- Staten Island University Hospital, Staten Island, NY, 10305, USA
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Kamdem SD, Kuemkon EM, Kamguia LM, Tchanana GK, Konhawa F, Nche F, Oumarou A, Hamza M, Essomba RG, Kengne M, Ondigui BE, Assoumou MCO, Brombacher F, Nono JK. An ultrasound-based referential of body height-adjusted normal liver organometry in school children from Bokito in rural Cameroon. Sci Rep 2020; 10:2773. [PMID: 32066761 PMCID: PMC7026466 DOI: 10.1038/s41598-020-59613-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/22/2020] [Indexed: 11/16/2022] Open
Abstract
The grading system for ultrasonographic assessment of Schistosoma mansoni morbidity is crucial for evaluation of control programs. This requires prior definition of normal liver organometric ranges in the population from the endemic area. A cross-sectional study was conducted in a S. mansoni endemic area in rural Cameroon. 1002 Participants were screened and 234 of them, free from all common liver-affecting diseases in the area (schistosomiasis, malaria, hepatitis B and C) and with no ultrasonographic signs of liver disease were selected and their liver parameters measured by ultrasonography. All statistics were considered significant for p-values < 0.05. Normal dimensions of livers lobe sizes, portal vein wall thickness and portal vein diameters are reported. The liver organometric data are presented for the entire study population as a whole and separately for males and females as prediction plots, with observed values and fitted regression line with 95% confidence. Reference ranges for liver parameters (size, portal vein thickness and diameter) adjusted for body height established in the current study are novel for Cameroon. The prediction plots generated should improve the accuracy of the assessment of liver morbidity by ultrasonography in the region.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
- CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of medicine and biomedical sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
- National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.
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Kamdem SD, Konhawa F, Kuemkon EM, Meyo Kamguia L, Tchanana GK, Nche F, Oumarou A, Hamza M, Ouratou Y, Tcheutchoua MN, Ghislain Essomba R, Ngogang MP, Kengne M, Netongo PM, Ondigui BE, Okomo Assoumou MC, Brombacher F, Nono JK. Negative Association of Interleukin-33 Plasma Levels and Schistosomiasis Infection in a Site of Polyparasitism in Rural Cameroon. Front Immunol 2019; 10:2827. [PMID: 31849991 PMCID: PMC6901687 DOI: 10.3389/fimmu.2019.02827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background: This study aimed to investigate the association of plasma levels of IL-33, a mucosal alarmin known to elicit type-2 immunity, with infection and liver fibrosis profiles of school children from an endemic area for Schistosoma mansoni, malaria and hepatitis (B & C) in rural Cameroon. Methods: A cross-sectional study enrolling schoolchildren from 5 public schools was conducted. Single schistosomiasis, malaria and hepatitis infections or co-infections were assessed by kato katz, microscopy, and rapid diagnostic tests, respectively. Hepatic fibrosis was assessed by ultrasound according to WHO Niamey guidelines and plasma levels of Interleukin 33 were determined by ELISA. All statistics were performed using R studio software. Principal findings: We found a prevalence of 13.5% (37/275), 18.2% (50/275), and 8% (22/275), respectively for schistosomiasis, malaria and hepatitis (B or C) single infections. Only 7.6% (21/275) of co-infections were reported. Although Plasma IL-33 showed a minimal negative risk for schistosomiasis infection (AOR 0.99; 95% CI 0.97–1.01), S. mansoni infected participants had lower levels of plasma IL-33 (p = 0.003) which decreased significantly as eggs burdens increased (p = 0.01) with a negative Pearson coefficient of r = −0.22. Hepatic fibrosis occurred in 47.3% (130/275) of our study population independently from plasma levels of IL-33 (AOR 1.00; 95% CI 0.99–1.01). Conclusion/Significance: Our data failed to show an association between plasma IL-33 levels and liver disease but convincingly report on a negative association between plasma IL-33 levels and schistosomiasis infection and egg burden in school children from a polyparasitic schistosomiasis endemic area.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Yasmine Ouratou
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | | | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Palmer Masumbe Netongo
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Biochemistry, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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