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Abbas H, Sajid MS, Rizwan HM, Tahir UB, Farooqi SH, Iqbal Z, Malik MA, Yaseen K, Maqbool M, Raza FA, Raza M, Fouad D, Ataya FS. Exploring mosquito abundance and Plasmodium infection through nested-PCR: implications for disease surveillance and control. Sci Rep 2024; 14:9871. [PMID: 38684775 PMCID: PMC11058852 DOI: 10.1038/s41598-024-60662-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
The Plasmodium is responsible for malaria which poses a major health threat, globally. This study is based on the estimation of the relative abundance of mosquitoes, and finding out the correlations of meteorological parameters (temperature, humidity and rainfall) with the abundance of mosquitoes. In addition, this study also focused on the use of nested PCR (species-specific nucleotide sequences of 18S rRNA genes) to explore the Plasmodium spp. in female Anopheles. In the current study, the percentage relative abundance of Culex mosquitoes was 57.65% and Anopheles 42.34% among the study areas. In addition, the highest number of mosquitoes was found in March in district Mandi Bahauddin at 21 °C (Tmax = 27, Tmin = 15) average temperature, 69% average relative humidity and 131 mm rainfall, and these climatic factors were found to affect the abundance of the mosquitoes, directly or indirectly. Molecular analysis showed that overall, 41.3% of the female Anopheles pools were positive for genus Plasmodium. Among species, the prevalence of Plasmodium (P.) vivax (78.1%) was significantly higher than P. falciparum (21.9%). This study will be helpful in the estimation of future risk of mosquito-borne diseases along with population dynamic of mosquitoes to enhance the effectiveness of vector surveillance and control programs.
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Affiliation(s)
- Haider Abbas
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan.
- Department of Pathobiology (Parasitology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan.
| | - Muhammad S Sajid
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Hafiz M Rizwan
- Department of Pathobiology (Parasitology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Urfa B Tahir
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
| | - Shahid H Farooqi
- Department of Clinical Sciences (Medicine Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Zeeshan Iqbal
- Department of Animal Sciences (Livestock Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Muhammad A Malik
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Kashaf Yaseen
- Institute of Microbiology, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Mahvish Maqbool
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Faiz A Raza
- Health Research Institute, National Institute of Health, Research Centre, , King Edward Medical University, Lahore, 54000, Pakistan
| | - Mohsin Raza
- Department of Basic Sciences (Physiology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Dalia Fouad
- Department of Zoology, College of Science, King Saud University, PO Box 22452, Riyadh, 11495, Saudi Arabia
| | - Farid S Ataya
- Department of Biochemistry, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
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Difference between Microscopic and PCR Examination Result for Malaria Diagnosis and Treatment Evaluation in Sumba Barat Daya, Indonesia. Trop Med Infect Dis 2022; 7:tropicalmed7080153. [PMID: 36006245 PMCID: PMC9412636 DOI: 10.3390/tropicalmed7080153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023] Open
Abstract
Microscopic examination is the backbone of malaria diagnosis and treatment evaluation in Indonesia. This test has limited ability to detect malaria at low parasite density. Inversely, nested polymerase chain reaction (PCR) can detect parasites at a density below the microscopic examination’s detection limit. The objective of this study is to compare microscopic and PCR results when being used to identify malaria in suspected patients and patients who underwent dihydroartemisinin–piperaquine (DHP) therapy in the last 3–8 weeks with or without symptoms in Sumba Barat Daya, Nusa Tenggara Timur, Indonesia. Recruitment was conducted between April 2019 and February 2020. Blood samples were then taken for microscopic and PCR examinations. Participants (n = 409) were divided into three groups: suspected malaria (42.5%), post-DHP therapy with fever (4.9%), and post-DHP therapy without fever (52.6%). Microscopic examination found five cases of P. falciparum + P. vivax infection, while PCR found 346 cases. All microscopic examinations turned negative in the post-DHP-therapy group. Conversely, PCR result from the same group yielded 29 negative results. Overall, our study showed that microscopic examination and PCR generated different results in detecting Plasmodium species, especially in patients with mixed infection and in patients who recently underwent DHP therapy.
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Field Evaluation of a Hemozoin-Based Malaria Diagnostic Device in Puerto Lempira, Honduras. Diagnostics (Basel) 2022; 12:diagnostics12051206. [PMID: 35626361 PMCID: PMC9140950 DOI: 10.3390/diagnostics12051206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
The diagnosis of malaria in Honduras is based mainly on microscopic observation of the parasite in thick smears or the detection of parasite antigens through rapid diagnostic tests when microscopy is not available. The specific treatment of the disease depends exclusively on the positive result of one of these tests. Given the low sensitivity of conventional methods, new diagnostic approaches are needed. This study evaluates the in-field performance of a device (Gazelle™) based on the detection of hemozoin. This was a double-blind study evaluating symptomatic individuals with suspected malaria in the department of Gracias a Dios, Honduras, using blood samples collected from 2021 to 2022. The diagnostic performance of Gazelle™ was compared with microscopy and nested 18ssr PCR as references. The sensitivity and specificity of Gazelle™ were 59.7% and 98.6%, respectively, while microscopy had a sensitivity of 64.9% and a specificity of 100%. The kappa index between microscopy and Gazelle™ was 0.9216 using microscopy as a reference. Both methods show similar effectiveness and predictive values. No statistical differences were observed between the results of the Gazelle™ compared to light microscopy (p = 0.6831). The turnaround time was shorter for Gazelle™ than for microscopy, but the cost per sample was slightly higher for Gazelle™. Gazelle™ showed more false-negative cases when infections were caused by Plasmodium falciparum compared to P. vivax. Conclusions: The sensitivity and specificity of Gazelle™ are comparable to microscopy. The simplicity and ease of use of the Gazelle™, the ability to run on batteries, and the immediacy of its results make it a valuable tool for malaria detection in the field. However, further development is required to differentiate Plasmodium species, especially in those regions requiring differentiated treatment.
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What Will Happen to Biomedical Research in Low-and-Middle Income Countries in the PostCOVID-19 World? CURRENT TROPICAL MEDICINE REPORTS 2021; 8:1-5. [PMID: 33425655 PMCID: PMC7781421 DOI: 10.1007/s40475-020-00223-0] [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] [Accepted: 11/20/2020] [Indexed: 11/09/2022]
Abstract
Scientific research is essential for a nation’s development and is vital for generating solutions to population’s health. Individual country’s capacities to prevent and respond to public health issues, including health crises, is built with long-term investment in highly qualified professionals, infrastructure, and uninterrupted operating funding. Most Latin American countries, especially those at the bottom of the human development list, have limited capacity even though they are hot spots for tropical and other emerging infectious diseases. This weakness deepens these countries’ dependence on nations with higher development and corresponding scientific capacity. The current COVID-19 pandemic has wreaked havoc on the health of the world’s population and the global economy. Countries that lagged behind prior to the pandemic now face a myriad of additional challenges. On a more optimistic note, the pandemic could serve as a wake-up call for governments and funding agencies to strengthen scientific capacity around the world, so that we are better prepared to address the public health issues caused by current and prevalent diseases and by future diseases of pandemic potential.
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Escobar D, Ascencio K, Ortiz A, Palma A, Sánchez A, Fontecha G. Blood Meal Sources of Anopheles spp. in Malaria Endemic Areas of Honduras. INSECTS 2020; 11:insects11070450. [PMID: 32708582 PMCID: PMC7412045 DOI: 10.3390/insects11070450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 11/18/2022]
Abstract
Malaria remains a life-threatening disease in many tropical countries. Honduras has successfully reduced malaria transmission as different control methods have been applied, focusing mainly on indoor mosquitoes. The selective pressure exerted by the use of insecticides inside the households could modify the feeding behavior of the mosquitoes, forcing them to search for available animal hosts outside the houses. These animal hosts in the peridomicile could consequently become an important factor in maintaining vector populations in endemic areas. Herein, we investigated the blood meal sources and Plasmodium spp. infection on anophelines collected outdoors in endemic areas of Honduras. Individual PCR reactions with species-specific primers were used to detect five feeding sources on 181 visibly engorged mosquitoes. In addition, a subset of these mosquitoes was chosen for pathogen analysis by a nested PCR approach. Most mosquitoes fed on multiple hosts (2 to 4), and 24.9% of mosquitoes had fed on a single host, animal or human. Chicken and bovine were the most frequent blood meal sources (29.5% and 27.5%, respectively). The average human blood index (HBI) was 22.1%. None of the mosquitoes were found to be infected with Plasmodium spp. Our results show the opportunistic and zoophilic behavior of Anopheles mosquitoes in Honduras.
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Affiliation(s)
- Denis Escobar
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (K.A.); (A.O.); (A.P.)
| | - Krisnaya Ascencio
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (K.A.); (A.O.); (A.P.)
| | - Andrés Ortiz
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (K.A.); (A.O.); (A.P.)
| | - Adalid Palma
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (K.A.); (A.O.); (A.P.)
| | - Ana Sánchez
- Department of Health Sciences, Brock University, St. Catharines, ON L2V 5A2, Canada;
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (K.A.); (A.O.); (A.P.)
- Correspondence: ; Tel.: +504-33935443
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Fontecha G, Pinto A, Escobar D, Matamoros G, Ortiz B. Genetic variability of Plasmodium falciparum histidine-rich proteins 2 and 3 in Central America. Malar J 2019; 18:31. [PMID: 30704496 PMCID: PMC6357481 DOI: 10.1186/s12936-019-2668-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/27/2019] [Indexed: 01/17/2023] Open
Abstract
Background Malaria is an important disease in many tropical countries. Rapid diagnostic tests (RDTs) are valuable tools for diagnosing malaria in remote areas. The majority of RDTs used for the diagnosis of Plasmodium falciparum are based on the detection of the specific histidine-rich proteins (PfHRP2 and PfHRP3). During the last decade, the threat posed by the lack of expression of these antigens and the variability of the proteins on the diagnosis of malaria has been widely discussed. The aim of this study was to evaluate the genetic diversity of pfhrp2 and pfhrp3 of P. falciparum isolates collected in three Central American countries. Methods DNA samples were amplified and sequenced to assess the diversity of nucleotides and amino acids. A search for known epitopes within the amino acid sequence was carried out, and the sensitivity of the sequences was evaluated according to a predictive model. A phylogenetic analysis was carried out including homologous sequences from different regions of the world. Protein structures were predicted in silico. Results Five different patterns for PfHRP2 and one pattern for PfHRP3 were identified. Isolates from Central America show a high level of genetic diversity in pfhrp2; however, the amino acid sequences seem to contain enough motifs to be detected by the RDTs currently available. Conclusion It is unlikely that the variability of the pfhrp2 and pfhrp3 genes has a significant impact on the ability of the RDTs to detect the PfHRP antigens in Central America. Electronic supplementary material The online version of this article (10.1186/s12936-019-2668-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gustavo Fontecha
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras.
| | - Alejandra Pinto
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Denis Escobar
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Gabriela Matamoros
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Bryan Ortiz
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
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SHARMA S, MANN R, KUMAR S, MISHRA N, SRIVASTAVA B, VALECHA N, ANVIKAR AR. A Simple and Cost-Effective Freeze-Thaw Based Method for Plasmodium DNA Extraction from Dried Blood Spot. IRANIAN JOURNAL OF PARASITOLOGY 2019; 14:29-40. [PMID: 31123466 PMCID: PMC6511605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Available DNA isolation methods for Plasmodium involve numerous processing steps, adding to the cost and conferring risk of contamination. Here we devise a simple and cost-effective method for direct extraction of Plasmodium DNA from dried filter paper spot (DBS), appropriate for resource-limited setups. METHODS The protocol involves simple freezing and thawing of DBS, neither involves any purification step nor any chemical reagent. The method was assessed in terms of DNA quantity, PCR detection sensitivity, time requirement, cost effectiveness, labor intensiveness and degree of shearing. The reliability of this method was confirmed by comparing it with other in use methods for Plasmodium DNA isolation. RESULTS Pure DNA was obtained with this method, as exemplified by the absorbance ratio (260nm /280nm) of 1.2. The protocol produced digestible, PCR-grade genomic DNA, also found to be suitable for sequencing. DNA isolated remained stable and retained its integrity after storage for one month at 4 °C. CONCLUSION Our process substantiated as efficient, reproducible, simple, fast, and inexpensive. Development of this optimized freeze-thaw based DNA extraction method for malaria parasite may provide a valuable tool for molecular analysis in resource-limited setups. This is the first report of DNA extraction from DBS of Plasmodium utilizing freeze-thaw.
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Avalos S, Mejia RE, Banegas E, Salinas C, Gutierrez L, Fajardo M, Galo S, Pinto A, Mejia A, Fontecha G. G6PD deficiency, primaquine treatment, and risk of haemolysis in malaria-infected patients. Malar J 2018; 17:415. [PMID: 30409136 PMCID: PMC6225638 DOI: 10.1186/s12936-018-2564-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/01/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The incidence of malaria in the Americas has decreased markedly in recent years. Honduras and the other countries of Mesoamerica and the island of Hispaniola have set the goal of eliminating native malaria by the year 2020. To achieve this goal, Honduras has recently approved national regulations to expand the possibilities of a shortened double dose primaquine (PQ) treatment for vivax malaria. Considering this new shortened anti-malarial treatment, the high frequency of G6PDd genotypes in Honduras, and the lack of routinely assessment of the G6PD deficiency status, this study aimed at investigating the potential association between the intake of PQ and haemolysis in malaria-infected G6PDd subjects. METHODS This was a prospective cohort and open-label study. Participants with malaria were recruited. Plasmodium vivax infection was treated with 0.25 mg/kg of PQ daily for 14 days. Safety and signs of haemolysis were evaluated by clinical criteria and laboratory values before and during the 3rd and 7th day of PQ treatment. G6PD status was assessed by a rapid test (CareStart™) and two molecular approaches. RESULTS Overall 55 participants were enrolled. The frequency of G6PD deficient genotypes was 7/55 (12.7%), where 5/7 (71.4%) were hemizygous A- males and 2/7 (28.6%) heterozygous A- females. Haemoglobin concentrations were compared between G6PD wild type (B) and G6PDd A- subjects, showing a significant difference between the means of both groups in the 3rd and 7th days. Furthermore, a statistically significant difference was evident in the change in haemoglobin concentration between the 3rd day and the 1st day for both genotypes, but there was no statistical difference for the change in haemoglobin concentration between the 7th day and the 1st day. Besides these changes in the haemoglobin concentrations, none of the patients showed signs or symptoms associated with severe haemolysis, and none needed to be admitted to a hospital for further medical attention. CONCLUSIONS The findings support that the intake of PQ during 14 days of treatment against vivax malaria is safe in patients with a class III variant of G6PDd. In view of the new national regulations in the shortened treatment of vivax malaria for 7 days, it is advisable to be alert of potential cases of severe haemolysis that could occur among G6PD deficient hemizygous males with a class II mutation such as the Santamaria variant, previously reported in the country.
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Affiliation(s)
- Sara Avalos
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Rosa E Mejia
- Pan American Health Organization, Tegucigalpa, Honduras
| | - Engels Banegas
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | - Cesar Salinas
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | - Lester Gutierrez
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | - Marcela Fajardo
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | - Suzeth Galo
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | - Alejandra Pinto
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Angel Mejia
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Gustavo Fontecha
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras.
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Fontecha G, Mejía RE, Banegas E, Ade MP, Mendoza L, Ortiz B, Sabillón I, Alvarado G, Matamoros G, Pinto A. Deletions of pfhrp2 and pfhrp3 genes of Plasmodium falciparum from Honduras, Guatemala and Nicaragua. Malar J 2018; 17:320. [PMID: 30170596 PMCID: PMC6119307 DOI: 10.1186/s12936-018-2470-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/27/2018] [Indexed: 01/02/2023] Open
Abstract
Background Malaria remains a public health problem in some countries of Central America. Rapid diagnostic tests (RDTs) are one of the most useful tools to assist in the diagnosis of malaria in remote areas. Since its introduction, a wide variety of RDTs have been developed for the detection of different parasite antigens. PfHRP2 is the most targeted antigen for the detection of Plasmodium falciparum infections. Genetic mutations and gene deletions are important factors influencing or affecting the performance of rapid diagnostic tests. Methods In order to demonstrate the presence or absence of the pfhrp2 and pfhrp3 genes and their flanking regions, a total of 128 blood samples from patients with P. falciparum infection from three Central American countries were analysed through nested or semi-nested PCR approaches. Results In total, 25.8 and 91.4% of the isolates lacked the region located between exon 1 and exon 2 of pfhrp2 and pfhrp3 genes, respectively. Parasites from the three countries showed deletions of one or both genes. The highest proportion of pfhrp2 deletions was found in Nicaragua while the isolates from Guatemala revealed the lowest number of pfhrp2 deletions. Parasites collected from Honduras showed the highest proportion of phfrp3 absence (96.2%). Twenty-one percent of isolates were double negative mutants for the exon 1–2 segment of both genes, and 6.3% of isolates lacked the full-length coding region of both genes. Conclusions This study provides molecular evidence of the existence of P. falciparum isolates lacking the pfhrp2 and pfhrp3 genes, and their flanking regions, in Honduras, Guatemala and Nicaragua. This finding could hinder progress in the control and elimination of malaria in Central America. Continuous evaluation of RDTs and molecular surveillance would be recommended.
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Affiliation(s)
- Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras.
| | - Rosa E Mejía
- Panamerican Health Organization, Tegucigalpa, Honduras
| | - Engels Banegas
- National Department of Surveillance, Ministry of Health, Tegucigalpa, Honduras
| | | | - Lisandro Mendoza
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Bryan Ortiz
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Isaac Sabillón
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Gerardo Alvarado
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Gabriela Matamoros
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Alejandra Pinto
- Microbiology Research Institute, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
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Mirahmadi H, Shahrakipour A, Mehravaran A, Khorashad AS, Rahmati-Balaghaleh M, Zarean M. Evaluation of malaria multiplex/nested PCR performance at low parasite densities and mixed infection in Iran: A country close to malaria elimination. INFECTION GENETICS AND EVOLUTION 2018; 65:283-287. [PMID: 30096462 DOI: 10.1016/j.meegid.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Malaria is still a major public health problem in subtropical and tropical regions. The rapid and accurate diagnosis of malaria remains a challenge in most of the endemic areas. The primary objective of the present study was to evaluate the performance of multiplex/nested PCR in detecting Plasmodium falciparum at low parasite densities and mixed infection. METHODS The study was performed in the Sistan-Baluchestan province of the southeastern Iran, from May 2015 to July 2016. A total of 105 patients suspected to malaria infection were enrolled in the study. The obtained DNA products, extracted from the thick/thin films, were analyzed by multiplex/nested PCR using genus-specific primers and compared with light microscopy. RESULTS 43 samples were confirmed to be infected by microscopic examination. Among 43 microscopically diagnosed P. falciparum cases, 11.4% (12/105) were confirmed by multiplex/nested PCR, 36.2% (38/105) were confirmed as P. vivax, 1.9% (2/105) had mixed infections with P. falciparum and P. vivax. Among microscopy-negative samples, 10 samples turned malaria-positive in nPCR. In multiplex/nested PCR, the rate of mixed infections was 8.6% (9/105). When compared to LM, the sensitivity, specificity, positive predictive value and negative predictive value of multiplex/nested PCR were calculated to be 82.8, 91.5, 92.3 and 81.1%, respectively. CONCLUSION In this study, we showed that microscopic examination of blood smears does not reliably distinguish Plasmodium species in the case of mixed infections. Therefore, it seems that multiplex/nested PCR is a good candidate for examining the presence of malaria parasites in clinically suspected but microscopically negative cases.
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Affiliation(s)
- Hadi Mirahmadi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azam Shahrakipour
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ahmad Mehravaran
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Salami Khorashad
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansour Rahmati-Balaghaleh
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mehdi Zarean
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Seesui K, Imtawil K, Chanetmahun P, Laummaunwai P, Boonmars T. An Alternative Method for Extracting Plasmodium DNA from EDTA Whole Blood for Malaria Diagnosis. THE KOREAN JOURNAL OF PARASITOLOGY 2018. [PMID: 29529847 PMCID: PMC5858669 DOI: 10.3347/kjp.2018.56.1.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Molecular techniques have been introduced for malaria diagnosis because they offer greater sensitivity and specificity than microscopic examinations. Therefore, DNA isolation methods have been developed for easy preparation and cost effectiveness. The present study described a simple protocol for Plasmodium DNA isolation from EDTA-whole blood. This study demonstrated that after heating infected blood samples with Tris–EDTA buffer and proteinase K solution, without isolation and purification steps, the supernatant can be used as a DNA template for amplification by PCR. The sensitivity of the extracted DNA of Plasmodium falciparum and Plasmodium vivax was separately analyzed by both PCR and semi-nested PCR (Sn-PCR). The results revealed that for PCR the limit of detection was 40 parasites/μl for P. falciparum and 35.2 parasites/μl for P. vivax, whereas for Sn-PCR the limit of detection was 1.6 parasites/μl for P. falciparum and 1.4 parasites/μl for P. vivax. This new method was then verified by DNA extraction of whole blood from 11 asymptomatic Myanmar migrant workers and analyzed by Sn-PCR. The results revealed that DNA can be extracted from all samples, and there were 2 positive samples for Plasmodium (P. falciparum and P. vivax). Therefore, the protocol can be an alternative method for DNA extraction in laboratories with limited resources and a lack of trained technicians for malaria diagnosis. In addition, this protocol can be applied for subclinical cases, and this will be helpful for epidemiology and control.
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Affiliation(s)
- Krongkaew Seesui
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Kanokwan Imtawil
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | | | - Porntip Laummaunwai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.,Neglected, Zoonosis and Vector-Borne Disease Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Thidarut Boonmars
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.,Neglected, Zoonosis and Vector-Borne Disease Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
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K BP, Panigrahi AK, Singh V, Singh SG. Nonlithographic Fabrication of Plastic-Based Nanofibers Integrated Microfluidic Biochip for Sensitive Detection of Infectious Biomarker. ACS APPLIED MATERIALS & INTERFACES 2017; 9:39994-40005. [PMID: 29087171 DOI: 10.1021/acsami.7b11331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report fabrication of a fully integrated plastic based microfluidic biochip for biosensing application. The microfluidic channels were fabricated by tune transfer method and integrated with the prefunctionalized sensing platform. This approach to assembling microchannels into prefunctionalized sensing substrate facilitates controlled functionalization and prevents damages on the functionalized surface. The sensing platform comprised a three-electrode system, in which the sensing electrode was integrated with antibody immobilized carbon nanotubes-zinc oxide (C-ZnO) nanofibers. Electrospinning technique was used to synthesize C-ZnO nanofibers and the surface of the nanofibers was covalently conjugated with histidine rich protein II antibodies (AntiHRP II) toward detection of infectious malarial specific antigen, namely histidine-rich protein II (HRP II). The analytical performance of the fabricated biochip was evaluated by differential pulse voltammetry method. The device exhibited a high sensitivity of 1.19 mA/((g mL-1)/cm2) over a wide detection range (10 fg/mL to 100 μg/mL) with a low detection limit of 7.5 fg/mL toward HRP II detection. This fully integrated biochip offers a promising cost-effective approach for detection of several other infectious disease biomarkers.
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Affiliation(s)
| | | | - Vikrant Singh
- School of Medicine, University of California Davis, California 95616, United States
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13
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Yang D, Subramanian G, Duan J, Gao S, Bai L, Chandramohanadas R, Ai Y. A portable image-based cytometer for rapid malaria detection and quantification. PLoS One 2017; 12:e0179161. [PMID: 28594960 PMCID: PMC5464641 DOI: 10.1371/journal.pone.0179161] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/24/2017] [Indexed: 11/18/2022] Open
Abstract
Increasing resistance by malaria parasites to currently used antimalarials across the developing world warrants timely detection and classification so that appropriate drug combinations can be administered before clinical complications arise. However, this is often challenged by low levels of infection (referred to as parasitemia) and presence of predominantly young parasitic forms in the patients' peripheral blood. Herein, we developed a simple, inexpensive and portable image-based cytometer that detects and numerically counts Plasmodium falciparum infected red blood cells (iRBCs) from Giemsa-stained smears derived from infected blood. Our cytometer is able to classify all parasitic subpopulations by quantifying the area occupied by the parasites within iRBCs, with high specificity, sensitivity and negligible false positives (~ 0.0025%). Moreover, we demonstrate the application of our image-based cytometer in testing anti-malarial efficacy against a commercial flow cytometer and demonstrate comparable results between the two methods. Collectively, these results highlight the possibility to use our image-based cytometer as a cheap, rapid and accurate alternative for antimalarial testing without compromising on efficiency and minimal processing time. With appropriate filters applied into the algorithm, to rule out leukocytes and reticulocytes, our cytometer may also be used for field diagnosis of malaria.
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Affiliation(s)
- Dahou Yang
- Pillar of Engineering Product Development, Singapore University of Technology and Design, Singapore, Singapore
| | - Gowtham Subramanian
- Pillar of Engineering Product Development, Singapore University of Technology and Design, Singapore, Singapore
| | - Jinming Duan
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Shaobing Gao
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Bai
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Rajesh Chandramohanadas
- Pillar of Engineering Product Development, Singapore University of Technology and Design, Singapore, Singapore
- * E-mail: (RC); (YA)
| | - Ye Ai
- Pillar of Engineering Product Development, Singapore University of Technology and Design, Singapore, Singapore
- * E-mail: (RC); (YA)
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Bouiba L, Gassen B, Gasmi M, Hammadi D, Harrat Z. [Contribution of nested PCR in the diagnosis of imported malaria in southern Algeria]. BULLETIN DE LA SOCIETE DE PATHOLOGIE EXOTIQUE (1990) 2016; 109:381-385. [PMID: 27933559 DOI: 10.1007/s13149-016-0536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Abstract
The nested PCR was used to estimate its inputs in malaria diagnosis and in the performance of the microscope operators involved in the surveillance of malaria in remote areas of South Algeria. For the period 2010 to 2015, 112 patients (93 febrile and 19 asymptomatic) coming from sub-Saharan Africa were tested for malaria in the hospital of Tamanrasset. One part of the blood taken from fingertip was used for blood smears and the second part was absorbed in filter paper for molecular diagnosis. Overall, the infection was detected by nested PCR in 63 samples versus 53 by direct examination. In addition, 11 mixed infections and 6 positive asymptomatic cases not detected by microscopy were diagnosed by PCR. Moreover, two negative samples in nested PCR were tested positive by direct examination. The molecular tool is more sensitive than the direct examination in detecting infra-microscopic parasitaemia and mixed infections...
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Affiliation(s)
- L Bouiba
- Laboratoire d'éco-épidémiologie parasitaire et génétique des populations., Institut Pasteur d'Algérie, Route du petit Staoueli, Dely-Ibrahim Alger, Algérie.
| | - B Gassen
- Service d'épidémiologie et de médecine préventive, établissement publique hospitalier de Tamanrasset, Tamanrasset, Algérie
| | - M Gasmi
- Laboratoire de référence national du paludisme, Institut national de santé publique, El Biar, Algérie
| | - D Hammadi
- Laboratoire de référence national du paludisme, Institut national de santé publique, El Biar, Algérie
| | - Z Harrat
- Laboratoire d'éco-épidémiologie parasitaire et génétique des populations., Institut Pasteur d'Algérie, Route du petit Staoueli, Dely-Ibrahim Alger, Algérie
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15
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Echeverry DF, Deason NA, Davidson J, Makuru V, Xiao H, Niedbalski J, Kern M, Russell TL, Burkot TR, Collins FH, Lobo NF. Human malaria diagnosis using a single-step direct-PCR based on the Plasmodium cytochrome oxidase III gene. Malar J 2016; 15:128. [PMID: 26928594 PMCID: PMC4772515 DOI: 10.1186/s12936-016-1185-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/20/2016] [Indexed: 01/29/2023] Open
Abstract
Background Nested PCRs based on the Plasmodium 18s-rRNA gene have been extensively used for human malaria diagnosis. However, they are not practical when large quantities of samples need to be processed, further there have been challenges in the performance and when interpreting results, especially when submicroscopic infections are analysed. Here the use of “direct PCR” was investigated with the aim of improving diagnosis in the malaria elimination era. Methods The performance of the Plasmodium cytochrome oxidase III gene (COX-III) based novel malaria detection strategies (direct nested PCR and direct single PCR) were compared using a 18s-rRNA direct nested PCR as a reference tool. Evaluations were based on sensitivity, specificity and the ability to detect mixed infections using control blood spot samples and field collected blood samples with final species diagnosis confirmation by sequencing. Results The COX-III direct PCR (limit of detection: 0.6–2 parasites/μL) was more sensitive than the 18s-rRNA direct nested PCR (limit of detection: 2–10 parasites/μL). The COX-III direct PCR identified all 21 positive controls (no mixed infections detected) while the 18s-rRNA direct nested PCR identified 18/21 (including four mixed infections). Different concentrations of simulated mixed infections (Plasmodium vivax and Plasmodium falciparum) suggest that the COX-III direct PCR detects only the predominant species. When the 18s-rRNA direct nested PCR was used to detect Plasmodium in field collected bloods spots (n = 3833), there was discrepancy in the results from the genus PCR (16 % positive) and the species-specific PCR (5 % positive). Further, a large portion of a subset of these positive samples (93 % for genus and 60 % for P. vivax), did not align with Plasmodium sequences. In contrast, the COX-III direct PCR clearly identified (single bands confirmed with sequencing) 2 % positive Plasmodium samples including P. vivax, P. falciparum, Plasmodium malariae and Plasmodium ovalewallikeri. Conclusions The COX-III single direct PCR is an alternative method for accurate detection of Plasmodium microscopic and submicroscopic infections in humans, especially when a large number of samples require screening. This PCR does not require DNA isolation, is sensitive, quick, produces confident/clear results, identifies all the Plasmodium species infecting humans, and is cost-effective.
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Affiliation(s)
- Diego F Echeverry
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Nicholas A Deason
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Jenna Davidson
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Victoria Makuru
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Honglin Xiao
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Julie Niedbalski
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Marcia Kern
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Tanya L Russell
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4870, Australia.
| | - Thomas R Burkot
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4870, Australia.
| | - Frank H Collins
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
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16
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Brince Paul K, Kumar S, Tripathy S, Vanjari SRK, Singh V, Singh SG. A highly sensitive self assembled monolayer modified copper doped zinc oxide nanofiber interface for detection of Plasmodium falciparum histidine-rich protein-2: Targeted towards rapid, early diagnosis of malaria. Biosens Bioelectron 2016; 80:39-46. [PMID: 26803412 DOI: 10.1016/j.bios.2016.01.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 12/21/2022]
Abstract
Rapid, ultrasensitive diagnostic/triaging kits for early detection of malarial parasites are critical for prevention of malarial epidemic, especially in developing and tropical countries. Unlike traditional microscopic diagnosis, these kits rely on the detection of antigens specific to malarial parasites. One such antigen which is routinely used in these diagnostic kits is Histidine-rich protein-2; a protein synthesized and released into the blood stream by the parasite Plasmodium falciparum. In this paper, we demonstrate an ultrasensitive nanobiosensor detection platform for Histidine-rich protein-2 having a limit of detection of attogram/ml. This nanobiosensor platform comprises of Mercaptopropylphosphonic acid functionalized copper doped zinc oxide nanofibers synthesized by electrospinning technique. Ultrasensitivity of attogram/ml can be attributed to the complimentary effects of Mercaptopropylphosphonic acid and copper doping in zinc oxide. Mercaptopropylphosphonic acid enhances the functional groups required for immobilizing antibody. Copper doping in zinc oxide not only increases the conductivity of the nanofibers but also pre-concentrates the target analyte onto the Mercaptopropylphosphonic acid treated nanofiber surface due to inherent electric field generated at the copper/zinc oxide heterojunction interface. The impedimetric detection response of copper-doped zinc oxide nanofiber modified electrode shows excellent sensitivity (28.5 kΩ/(gm/ml)/cm(2)) in the detection ranges of 10 ag/ml-10 µg/ml, and a detection limit of 6 attogram/ml. In addition, the proposed biosensor is highly selective to targeted HRP2 protein with a relative standard deviation of 1.9% in the presence of various interference of nonspecific molecules. To the best of our knowledge, this biosensor shows the lowest detection limit of malarial parasites reported in the literature spanning different nanomaterials and different detection mechanisms. Since the nanobiosensor platform is based on immunoassay technique, with a little modification, it can be extended for developing point-of-care diagnostic devices for several biomarkers of importance.
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Affiliation(s)
- K Brince Paul
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, India
| | - Sanni Kumar
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, India
| | - Suryasnata Tripathy
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, India
| | | | - Vikrant Singh
- School of Medicine, University of California, Davis, USA
| | - Shiv Govind Singh
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, India.
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17
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Efficiency of Nested-PCR in Detecting Asymptomatic Cases toward Malaria Elimination Program in an Endemic Area of Iran. IRANIAN JOURNAL OF PARASITOLOGY 2015; 10:39-45. [PMID: 25904944 PMCID: PMC4403538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 09/23/2014] [Indexed: 11/02/2022]
Abstract
BACKGROUND The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. METHODS Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to inspect malaria parasite. RESULTS The results showed no Plasmodium parasite in subjects by means of microscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. CONCLUSION Microscopy as the gold standard method and RDT correctly identified 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nested-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.
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JAHJA NE, HUWAE IR, B. NARA M, HARLEY A, WIDANINGRUM T, FITRI LE. Comparison of nested polymerase chain reaction and microscopy as diagnostic tools in congenital malaria: a study at tjark corneile hillers hospital maumere, indonesia. Malays J Med Sci 2014; 21:17-23. [PMID: 25977629 PMCID: PMC4418121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 07/20/2014] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Microscopic detection is the conventional method for detecting malaria parasites. Although it is efficient and inexpensive, it has its limitations. In recent years, polymeras chain reaction (PCR) has been considered superior to microscopy in detecting mixed Plasmodium infections or infections with low parasite density. To determine whether microscopic or nested PCR (nPCR) is better at detecting congenital malaria (CM). METHODS Blood smear examination and nPCR were performed with blood samples taken from mothers and their newborns, who were likely to be suffering from CM and in whom one of the symptoms was low birth weight (LBW). The sensitivity and specificity of each method were then compared. RESULTS During one year of study, the prevalence of CM among 92 LBW newborns was determined to be 6.8% using microscopy and 7.8% using nPCR. Among the 92 mother-infant paired subjects, CM was detected in 34 subjects (37%) by microscopy and in 39 subjects (42.4%) by nPCR. nPCR was more sensitive (76.5% vs 66.7%) but less specific (77.6% vs 84.9%) than microscopy. When the two methods were compared, nPCR gave significantly better results in diagnosing CM (AUC = 0.770; P < 0.001). CONCLUSION Although microscopy remains the most appropriate method for the diagnosis of CM in remote areas, nPCR can be considered a complementary test.
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Affiliation(s)
- Natalia Erica JAHJA
- Department of Pediatrics, Dr. Saiful Anwar Hospital/Faculty of Medicine, University of Brawijaya, Jalan J.A Suprapto No. 2 Malang, East Java
65141, Indonesia
| | - Irene Ratridewi HUWAE
- Department of Pediatrics, Dr. Saiful Anwar Hospital/Faculty of Medicine, University of Brawijaya, Jalan J.A Suprapto No. 2 Malang, East Java
65141, Indonesia
| | - Mario B. NARA
- Department of Pediatrics, Dr. TC. Hillers Hospital, Jalan Wairklau Maumere, East Nusa Tenggara 86111, Indonesia
| | - Adinda HARLEY
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802 Munich, German
| | - Tarina WIDANINGRUM
- Laboratory of Biomedic, Faculty of Medicine, University of Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
| | - Loeki Enggar FITRI
- Department of Parasitology, Faculty of Medicine, University of Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia
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Waggoner JJ, Abeynayake J, Balassiano I, Lefterova M, Sahoo MK, Liu Y, Vital-Brazil JM, Gresh L, Balmaseda A, Harris E, Banaei N, Pinsky BA. Multiplex nucleic acid amplification test for diagnosis of dengue fever, malaria, and leptospirosis. J Clin Microbiol 2014; 52:2011-8. [PMID: 24671788 PMCID: PMC4042768 DOI: 10.1128/jcm.00341-14] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 03/21/2014] [Indexed: 01/24/2023] Open
Abstract
Dengue, leptospirosis, and malaria are among the most common etiologies of systemic undifferentiated febrile illness (UFI) among travelers to the developing world, and these pathogens all have the potential to cause life-threatening illness in returned travelers. The current study describes the development of an internally controlled multiplex nucleic acid amplification test for the detection of dengue virus (DENV) and Leptospira and Plasmodium species, with a specific callout for Plasmodium falciparum (referred to as the UFI assay). During analytical evaluation, the UFI assay displayed a wide dynamic range and a sensitive limit of detection for each target, including all four DENV serotypes. In a clinical evaluation including 210 previously tested samples, the sensitivities of the UFI assay were 98% for DENV (58/59 samples detected) and 100% for Leptospira and malaria (65/65 and 20/20 samples, respectively). Malaria samples included all five Plasmodium species known to cause human disease. The specificity of the UFI assay was 100% when evaluated with a panel of 66 negative clinical samples. Furthermore, no amplification was observed when extracted nucleic acids from related pathogens were tested. Compared with whole-blood samples, the UFI assay remained positive for Plasmodium in 11 plasma samples from patients with malaria (parasitemia levels of 0.0037 to 3.4%). The syndrome-based design of the UFI assay, combined with the sensitivities of the component tests, represents a significant improvement over the individual diagnostic tests available for these pathogens.
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Affiliation(s)
- Jesse J Waggoner
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Janaki Abeynayake
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Ilana Balassiano
- Laboratório de Zoonoses Bacterianas, Centro de Referência Nacional para Leptospirose, Coleção de Leptospira, WHO/PAHO Centro Colaborador para Leptospirose, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Martina Lefterova
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Malaya K Sahoo
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Yuanyuan Liu
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Juliana Magalhães Vital-Brazil
- Laboratório de Zoonoses Bacterianas, Centro de Referência Nacional para Leptospirose, Coleção de Leptospira, WHO/PAHO Centro Colaborador para Leptospirose, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Angel Balmaseda
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
| | - Niaz Banaei
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Benjamin A Pinsky
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
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Comparison of three PCR-based assays for the non-invasive diagnosis of malaria: detection of Plasmodium parasites in blood and saliva. Eur J Clin Microbiol Infect Dis 2014; 33:1631-9. [PMID: 24792127 DOI: 10.1007/s10096-014-2121-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
The conventional molecular diagnosis of malaria uses 18S rRNA-based PCR assay employing blood samples. This assay presents limitation in terms of long turnaround time and increased chances of false-positive results. Here, we evaluated one-step singleplex or multiplex PCR assay based on high copy species-specific consensus repeat sequences (CRS) along with standard 18S rRNA nested PCR (18S n-PCR) assay to detect P. falciparum and P. vivax infection using blood and saliva samples from Indian febrile patients. Out of 327 patients, 187 were found to be positive for malaria parasites by microscopic examination of peripheral blood smears. Among these 130 were P. vivax and 57 were P. falciparum cases. The 18S n-PCR assay and CRS PCR assay identified 186 out of 187 cases (99.4 %). Multiplex CRS PCR assay detected Plasmodium in 176 out of 187 cases (94.1 %). Both singleplex and multiplex CRS PCR assay identified 6 mixed infection cases, while 18S n-PCR assay detected 10 mixed infection cases of P. vivax and P. falciparum, which were not recognized by microscopy. Non-invasive Plasmodium detection rate with DNA derived from saliva samples was highest for 18S n-PCR (87.36 %), followed by singleplex CRS (81 %) and multiplex CRS PCR assay (70.5 %). Specificity for P. vivax and P. falciparum detection for all assays was 98.48 % and 100 % respectively. Detection rate for P. vivax in saliva correlated with parasite density for CRS target-based assays. The species-specific CRS PCR, either as a singleplex or multiplex assay, can have an impact on diagnosis and epidemiological studies in malaria.
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Mekonnen SK, Aseffa A, Medhin G, Berhe N, Velavan TP. Re-evaluation of microscopy confirmed Plasmodium falciparum and Plasmodium vivax malaria by nested PCR detection in southern Ethiopia. Malar J 2014; 13:48. [PMID: 24502664 PMCID: PMC4011513 DOI: 10.1186/1475-2875-13-48] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 02/04/2014] [Indexed: 11/11/2022] Open
Abstract
Background With 75% of the Ethiopian population at risk of malaria, accurate diagnosis is crucial for malaria treatment in endemic areas where Plasmodium falciparum and Plasmodium vivax co-exist. The present study evaluated the performance of regular microscopy in accurate identification of Plasmodium spp. in febrile patients visiting health facilities in southern Ethiopia. Methods A cross-sectional study design was employed to recruit study subjects who were microscopically positive for malaria parasites and attending health facilities in southern Ethiopia between August and December 2011. Of the 1,416 febrile patients attending primary health facilities, 314 febrile patients, whose slides were positive for P. falciparum, P. vivax or mixed infections using microscopy, were re-evaluated for their infection status by PCR. Finger-prick blood samples were used for parasite genomic DNA extraction. Phylogenetic analyses were performed to reconstruct the distribution of different Plasmodium spp. across the three geographical areas. Results Of the 314 patients with a positive thick blood smear, seven patients (2%) were negative for any of the Plasmodium spp. by nested PCR. Among 180 microscopically diagnosed P. falciparum cases, 111 (61.7%) were confirmed by PCR, 44 (24.4%) were confirmed as P. vivax, 18 (10%) had mixed infections with P. falciparum and P. vivax and two (1.1%) were mixed infections with P. falciparum and P. malariae and five (2.8%) were negative for any of the Plasmodium spp. Of 131 microscopically diagnosed P. vivax cases, 110 (84%) were confirmed as P. vivax, 14 (10.7%) were confirmed as P. falciparum, two (1.5%) were P. malariae, three (2.3%) with mixed infections with P. falciparum and P. vivax and two (1.5%) were negative for any of the Plasmodium spp. Plasmodium falciparum and P. vivax mixed infections were observed. Plasmodium malariae was detected as mono and mixed infections in four individuals. Conclusion False positivity, under-reporting of mixed infections and a significant number of species mismatch needs attention and should be improved for appropriate diagnosis. The detection of substantial number of false positive results by molecular methodologies may provide the accurate incidence of circulating Plasmodium species in the geographical region and has important repercussions in understanding malaria epidemiology and subsequent control.
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Affiliation(s)
| | | | | | | | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
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Larrañaga N, Mejía RE, Hormaza JI, Montoya A, Soto A, Fontecha GA. Genetic structure of Plasmodium falciparum populations across the Honduras-Nicaragua border. Malar J 2013; 12:354. [PMID: 24093629 PMCID: PMC3851272 DOI: 10.1186/1475-2875-12-354] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/02/2013] [Indexed: 01/01/2023] Open
Abstract
Background The Caribbean coast of Central America remains an area of malaria transmission caused by Plasmodium falciparum despite the fact that morbidity has been reduced in recent years. Parasite populations in that region show interesting characteristics such as chloroquine susceptibility and low mortality rates. Genetic structure and diversity of P. falciparum populations in the Honduras-Nicaragua border were analysed in this study. Methods Seven neutral microsatellite loci were analysed in 110 P. falciparum isolates from endemic areas of Honduras (n = 77) and Nicaragua (n = 33), mostly from the border region called the Moskitia. Several analyses concerning the genetic diversity, linkage disequilibrium, population structure, molecular variance, and haplotype clustering were conducted. Results There was a low level of genetic diversity in P. falciparum populations from Honduras and Nicaragua. Expected heterozigosity (He) results were similarly low for both populations. A moderate differentiation was revealed by the FST index between both populations, and two putative clusters were defined through a structure analysis. The main cluster grouped most of samples from Honduras and Nicaragua, while the second cluster was smaller and included all the samples from the Siuna community in Nicaragua. This result could partially explain the stronger linkage disequilibrium (LD) in the parasite population from that country. These findings are congruent with the decreasing rates of malaria endemicity in Central America.
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Affiliation(s)
- Nerea Larrañaga
- Instituto de Investigacion en Microbiologia, Escuela de Microbiologia, UNAH, Tegucigalpa, Honduras.
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Serebrennikova YM, Patel J, Milhous WK, Garcia-Rubio LH, Huffman DE, Smith JM. Spectrophotometric detection of susceptibility to anti-malarial drugs. Malar J 2013; 12:305. [PMID: 23992478 PMCID: PMC3849014 DOI: 10.1186/1475-2875-12-305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 08/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With malaria drug resistance increasing in prevalence and severity, new technologies are needed to aid and improve the accuracy and clinical relevance of laboratory or field testing for malaria drug resistance. This study presents a method based on simple and reagentless spectroscopic measurements coupled with comprehensive spectral interpretation analysis that provides valuable quantitative information on the morphological and compositional responses of Plasmodium falciparum and infected red blood cells (IRBCs) to anti-malarial treatment. METHODS The changes in the size, internal structure, nucleotide and haemozoin composition of the parasites as well as the morphology (size and shape) and haemoglobin composition of the IRBCs treated with dihydroartemisinin (DHA) and mefloquine (MFQ) were investigated using a spectral interpretation analysis. RESULTS DHA treatment reduced the sizes of the parasites and their structural organelles. The haemoglobin composition of the host IRBCs determined from spectroscopic analysis changed negligibly following DHA treatment. MFQ treated parasites grew to the same size as those from parallel non-treated cultures but lacked haemozoin. Lesser deformation of the cell shape and no haemoglobin depletion were detected for the IRBCs of MFQ treated cultures. CONCLUSIONS The spectroscopic analysis method proved to be sensitive for recognition of the effects of anti-malarial treatment on the structure and composition of the parasites and IRBCs. The method can have significant potential for research and clinical applications such as evaluating patient specimens for drug action, drug effects or for therapeutic monitoring.
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Affiliation(s)
- Yulia M Serebrennikova
- College of Public Health, University of South Florida, 13201 Bruce B, Downs Blvd,, Tampa, FL 33612, USA.
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Rulisa S, Kateera F, Bizimana JP, Agaba S, Dukuzumuremyi J, Baas L, de Dieu Harelimana J, Mens PF, Boer KR, de Vries PJ. Malaria prevalence, spatial clustering and risk factors in a low endemic area of Eastern Rwanda: a cross sectional study. PLoS One 2013; 8:e69443. [PMID: 23936018 PMCID: PMC3720654 DOI: 10.1371/journal.pone.0069443] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 06/13/2013] [Indexed: 11/19/2022] Open
Abstract
Background Rwanda reported significant reductions in malaria burden following scale up of control intervention from 2005 to 2010. This study sought to; measure malaria prevalence, describe spatial malaria clustering and investigate for malaria risk factors among health-centre-presumed malaria cases and their household members in Eastern Rwanda. Methods A two-stage health centre and household-based survey was conducted in Ruhuha sector, Eastern Rwanda from April to October 2011. At the health centre, data, including malaria diagnosis and individual level malaria risk factors, was collected. At households of these Index cases, a follow-up survey, including malaria screening for all household members and collecting household level malaria risk factor data, was conducted. Results Malaria prevalence among health centre attendees was 22.8%. At the household level, 90 households (out of 520) had at least one malaria-infected member and the overall malaria prevalence for the 2634 household members screened was 5.1%. Among health centre attendees, the age group 5–15 years was significantly associated with an increased malaria risk and a reported ownership of ≥4 bednets was significantly associated with a reduced malaria risk. At the household level, age groups 5–15 and >15 years and being associated with a malaria positive index case were associated with an increased malaria risk, while an observed ownership of ≥4 bednets was associated with a malaria risk-protective effect. Significant spatial malaria clustering among household cases with clusters located close to water- based agro-ecosystems was observed. Conclusions Malaria prevalence was significantly higher among health centre attendees and their household members in an area with significant household spatial malaria clustering. Circle surveillance involving passive case finding at health centres and proactive case detection in households can be a powerful tool for identifying household level malaria burden, risk factors and clustering.
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Affiliation(s)
- Stephen Rulisa
- University Teaching Hospital of Kigali, National University of Rwanda, Kigali, Rwanda
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
| | - Fredrick Kateera
- Academic Medical Center, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, The Netherlands
- Medical Research Centre, Rwanda Biomedical Centre, Kigali, Rwanda
- * E-mail:
| | - Jean Pierre Bizimana
- Geography Department, Faculty of Science, National University of Rwanda, Butare, Rwanda
| | - Steven Agaba
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
| | - Javier Dukuzumuremyi
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
| | - Lisette Baas
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
| | | | - Petra F. Mens
- Academic Medical Center, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
- Royal Tropical Institute/Koninklijk Instituutvoor de Tropen (KIT), KIT Biomedical Research, Amsterdam, The Netherlands
| | - Kimberly R. Boer
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
- Royal Tropical Institute/Koninklijk Instituutvoor de Tropen (KIT), KIT Biomedical Research, Amsterdam, The Netherlands
| | - Peter J. de Vries
- Academic Medical Center, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, INTERACT Project, Kigali, Rwanda
- Department of Internal Medicine, Tergooiziekenhuizen, Hilversum, The Netherlands
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Mejia Torres RE, Banegas EI, Mendoza M, Diaz C, Bucheli STM, Fontecha GA, Alam MT, Goldman I, Udhayakumar V, Zambrano JON. Efficacy of chloroquine for the treatment of uncomplicated Plasmodium falciparum malaria in Honduras. Am J Trop Med Hyg 2013; 88:850-4. [PMID: 23458957 DOI: 10.4269/ajtmh.12-0671] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Chloroquine (CQ) is officially used for the primary treatment of Plasmodium falciparum malaria in Honduras. In this study, the therapeutic efficacy of CQ for the treatment of uncomplicated P. falciparum malaria in the municipality of Puerto Lempira, Gracias a Dios, Honduras was evaluated using the Pan American Health Organization-World Health Organization protocol with a follow-up of 28 days. Sixty-eight patients from 6 months to 60 years of age microscopically diagnosed with uncomplicated P. falciparum malaria were included in the final analysis. All patients who were treated with CQ (25 mg/kg over 3 days) cleared parasitemia by day 3 and acquired no new P. falciparum infection within 28 days of follow-up. All the parasite samples sequenced for CQ resistance mutations (pfcrt) showed only the CQ-sensitive genotype (CVMNK). This finding shows that CQ remains highly efficacious for the treatment of uncomplicated P. falciparum malaria in Gracias a Dios, Honduras.
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Affiliation(s)
- Rosa Elena Mejia Torres
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health, Honduras.
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