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Cáceres Carrera L, Santamaría AM, Castillo AM, Romero L, Urriola E, Torres-Cosme R, Calzada JE. Detection through the use of RT-MqPCR of asymptomatic reservoirs of malaria in samples of patients from the indigenous Comarca of Guna Yala, Panama: Essential method to achieve the elimination of malaria. PLoS One 2024; 19:e0305558. [PMID: 39046959 PMCID: PMC11268588 DOI: 10.1371/journal.pone.0305558] [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: 07/15/2023] [Accepted: 06/02/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Plasmodium vivax is the main causative agent of malaria in Panama. However, the prevalence of asymptomatic infections in the different endemic regions remains unknown. Understanding the epidemiological behavior of asymptomatic infections is essential for the elimination of malaria. This study aimed to determine the prevalence of asymptomatic malarial infections in one of the main endemic regions of Panama using multiplex real-time reverse transcription RT-MqPCR. METHODS A cross-sectional study was conducted in three communities in the Guna Yala Comarca. A total of 551 thick blood smears and their respective samples on filter paper were collected from volunteers of different ages and sexes from June 20 to 25, 2016. Infections by the Plasmodium spp. were diagnosed using microscopy and RT-MqPCR. All statistical analyses were performed using the R software. RESULTS The average prevalence of asymptomatic infections by P. vivax in the three communities detected by RT-MqPCR was 9.3%, with Ukupa having the highest prevalence (13.4%), followed by Aidirgandi (11.1%) and Irgandi (3.3%). A total of 74 samples were diagnosed as asymptomatic infections using RT-MqPCR. Light microscopy (LM) detected that 17.6% (13/74) of the asymptomatic samples and 82.4% (61/74) were diagnosed as false negatives. A 100% correlation was observed between samples diagnosed using LM and RT-MqPCR. A total of 52.7% (39/74) of the asymptomatic patients were female and 85.1% (63/74) were registered between the ages of 1 and 21 years. Factors associated with asymptomatic infection were community (aOR = 0.38 (95% CI 0.17-0.83), p < 0.001) and age aOR = 0.98 (95% CI 0.97-1.00), p < 0.05); F = 5.38; p < 0.05). CONCLUSIONS This study provides novel evidence of the considerable prevalence of asymptomatic P. vivax infections in the endemic region of Kuna Yala, representing a new challenge that requires immediate attention from the National Malaria Program. The results of this study provide essential information for the health authorities responsible for developing new policies. Furthermore, it will allow program administrators to reorient and design effective malaria control strategies that consider asymptomatic infections as a fundamental part of malaria control and move towards fulfilling their commitment to eliminate it.
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Affiliation(s)
- Lorenzo Cáceres Carrera
- Departmento de Entomología Médica del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Ana María Santamaría
- Departmento de Parasitología del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Anakena Margarita Castillo
- Departmento de Entomología Médica del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Luis Romero
- Laboratorio Central de Referencia en Salud Pública del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Eduardo Urriola
- Facultad de Ciencias Biomédicas, Universidad Latina de Panamá, Ciudad de Panamá, Panamá
| | - Rolando Torres-Cosme
- Departmento de Entomología Médica del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - José Eduardo Calzada
- Departmento de Parasitología del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
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Haq IU, Mehmood Z, Khan GA, Kainat B, Ahmed B, Shah J, Sami A, Nazar MS, Xu J, Xiang H. Modeling the effect of climatic conditions and topography on malaria incidence using Poisson regression: a Retrospective study in Bannu, Khyber Pakhtunkhwa, Pakistan. Front Microbiol 2024; 14:1303087. [PMID: 38287956 PMCID: PMC10822983 DOI: 10.3389/fmicb.2023.1303087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024] Open
Abstract
Background Malaria has been identified as a crucial vector-borne disease around the globe. The primary aim of this study was to investigate the incidence of malaria in the district of Bannu and its relationship with climatic conditions such as temperature, rainfall, relative humidity, and topography. Methods Secondary data were obtained from the metrological office and government hospitals across the district for 5 years (2013-2017). A Poisson regression model was applied for the statistical analysis. Results and discussion The number of reported cases of malaria was 175,198. The regression analysis showed that temperature, relative humidity, and rainfall had a significant association (p < 0.05) with malaria incidence. In addition, the topographic variables were significantly associated (p < 0.05) with malaria incidence in the region. The percent variation in the odds ratio of incidence was 4% for every unit increase in temperature and 2% in humidity. In conclusion, this study indicated that the temperature, humidity, rainfall, and topographic variables were significantly associated with the incidence of malaria. Effective malaria control and interventions integrated with climatic factors must be considered to overcome the disease burden.
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Affiliation(s)
- Ijaz Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Zafar Mehmood
- Department of Maths, Stats & Computer Science, The University of Agriculture Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Gausal Azam Khan
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia
| | - Bushra Kainat
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Bilal Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jahan Shah
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Amtul Sami
- Department of Health Biotechnology, Women University, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Subhan Nazar
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Jielian Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - He Xiang
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, W Kazura J, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. Malar J 2023; 22:341. [PMID: 37940948 PMCID: PMC10634149 DOI: 10.1186/s12936-023-04762-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Water resource development projects, such as dams and irrigation schemes, have a positive impact on food security and poverty reduction. However, such projects could increase prevalence of vector borne disease, such as malaria. This study investigate the impact of different agroecosystems and prevalence of malaria infection in Southwest Ethiopia. METHODS Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 study participants from 1449 households in Arjo and 546 households in Gambella enrolled in the study and blood samples were collected, respectively. All blood samples were microscopically examined and a subset of microscopy negative blood samples (n = 2244) were analysed by qPCR. Mixed effect logistic regression and generalized estimating equation were used to determine microscopic and submicroscopic malaria infection and the associated risk factors, respectively. RESULTS Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). On the other hand, of the 1713 and 531 samples analysed by qPCR from Arjo and Gambella the presence of submicroscopic infection was 1.2% and 12.8%, respectively. Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale were identified by qPCR in both sites. Irrigation was a risk factor for submicroscopic infection in both Arjo and Gambella. Irrigation, being a migrant worker, outdoor job, < 6 months length of stay in the area were risk factors for microscopic infection in Gambella. Moreover, school-age children and length of stay in the area for 1-3 years were significant predictors for submicroscopic malaria in Gambella. However, no ITN utilization was a predictor for both submicroscopic and microscopic infection in Arjo. Season was also a risk factor for microscopic infection in Arjo. CONCLUSION The study highlighted the potential importance of different irrigation practices impacting on submicroscopic malaria transmission. Moreover, microscopic and submicroscopic infections coupled with population movement may contribute to residual malaria transmission and could hinder malaria control and elimination programmes in the country. Therefore, strengthening malaria surveillance and control by using highly sensitive diagnostic tools to detect low-density parasites, screening migrant workers upon arrival and departure, ensuring adequate coverage and proper utilization of vector control tools, and health education for at-risk groups residing or working in such development corridors is needed.
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Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch, Ethiopia.
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia.
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch, Ethiopia
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Kassahun Habtamu
- Menelik II Medical & Health Science College, Addis Ababa, Ethiopia
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University, Fort Collins, USA
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dawit Hawaria
- School of Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Arega Tsegaye
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Biology, College of Natural Science, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, OH, USA
- Center for Global Health & Disease School of Medicine Case, Western Reserve University, Cleveland, OH, USA
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
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Hosseini Z, Azizi K, Moghadami M, Hassaniazad M, Shafiei R, Rezaee E, Turki H. Absence of Asymptomatic Malaria Reservoirs in an Area with a Previous History of Local Malaria Transmission: A Successful Experience in Line with the Malaria Elimination Program in Iran. J Arthropod Borne Dis 2023; 17:128-137. [PMID: 37822760 PMCID: PMC10562199 DOI: 10.18502/jad.v17i2.13618] [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: 10/10/2020] [Accepted: 05/17/2023] [Indexed: 10/13/2023] Open
Abstract
Background Asymptomatic malaria is a major challenge to be addressed in the implementation of the malaria elimination program. The main goal of the malaria surveillance system in the elimination phase is to identify reliably all the positive cases of malaria reliably (symptomatic and asymptomatic) in the shortest possible time. This study focused on the monitoring of asymptomatic malaria reservoirs in areas where local transmission had been previously established. Methods It was a case-study approach that was conducted in the Anarestan area. A total of 246 residents and immigrants living in the area at the age range of 4-60 years old were randomly selected to be tested for malaria by microscope, RDT, and nested-PCR techniques. The inclusion criterion for participants to be entered into the study was the absence of specific symptoms of malaria. Moreover, participants who have been taking antimalarials for the last month were excluded from the study. Results The results indicated no positive cases of asymptomatic malaria among the participants tested by all methods. Conclusion The results of this study have shown that, without concerns for asymptomatic parasitic patients, a malaria elimination program has been successfully implemented within the studies area. In addition, the findings emphasized the existence of a strong malaria surveillance system in this area.
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Affiliation(s)
- Zainab Hosseini
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Kourosh Azizi
- Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reza Shafiei
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Elham Rezaee
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habibollah Turki
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Kartal L, Mueller I, Longley RJ. Using Serological Markers for the Surveillance of Plasmodium vivax Malaria: A Scoping Review. Pathogens 2023; 12:791. [PMID: 37375481 DOI: 10.3390/pathogens12060791] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The utilisation of serological surveillance methods for malaria has the potential to identify individuals exposed to Plasmodium vivax, including asymptomatic carriers. However, the application of serosurveillance varies globally, including variations in methodology and transmission context. No systematic review exists describing the advantages and disadvantages of utilising serosurveillance in various settings. Collation and comparison of these results is a necessary first step to standardise and validate the use of serology for the surveillance of P. vivax in specific transmission contexts. A scoping review was performed of P. vivax serosurveillance applications globally. Ninety-four studies were found that met predefined inclusion and exclusion criteria. These studies were examined to determine the advantages and disadvantages of serosurveillance experienced in each study. If studies reported seroprevalence results, this information was also captured. Measurement of antibodies serves as a proxy by which individuals exposed to P. vivax may be indirectly identified, including those with asymptomatic infections, which may be missed by other technologies. Other thematic advantages identified included the ease and simplicity of serological assays compared to both microscopy and molecular diagnostics. Seroprevalence rates varied widely from 0-93%. Methodologies must be validated across various transmission contexts to ensure the applicability and comparability of results. Other thematic disadvantages identified included challenges with species cross-reactivity and determining changes in transmission patterns in both the short- and long-term. Serosurveillance requires further refinement to be fully realised as an actionable tool. Some work has begun in this area, but more is required.
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Affiliation(s)
- Lejla Kartal
- School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
| | - Ivo Mueller
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville 3010, Australia
| | - Rhea J Longley
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville 3010, Australia
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Moss S, Mańko E, Vasileva H, Da Silva ET, Goncalves A, Osborne A, Phelan J, Rodrigues A, Djata P, D'Alessandro U, Mabey D, Krishna S, Last A, Clark TG, Campino S. Population dynamics and drug resistance mutations in Plasmodium falciparum on the Bijagós Archipelago, Guinea-Bissau. Sci Rep 2023; 13:6311. [PMID: 37072433 PMCID: PMC10113324 DOI: 10.1038/s41598-023-33176-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/08/2023] [Indexed: 05/03/2023] Open
Abstract
Following integrated malaria control interventions, malaria burden on the Bijagós Archipelago has significantly decreased. Understanding the genomic diversity of circulating Plasmodium falciparum malaria parasites can assist infection control, through identifying drug resistance mutations and characterising the complexity of population structure. This study presents the first whole genome sequence data for P. falciparum isolates from the Bijagós Archipelago. Amplified DNA from P. falciparum isolates sourced from dried blood spot samples of 15 asymptomatic malaria cases were sequenced. Using 1.3 million SNPs characterised across 795 African P. falciparum isolates, population structure analyses revealed that isolates from the archipelago cluster with samples from mainland West Africa and appear closely related to mainland populations; without forming a separate phylogenetic cluster. This study characterises SNPs associated with antimalarial drug resistance on the archipelago. We observed fixation of the PfDHFR mutations N51I and S108N, associated with resistance to sulphadoxine-pyrimethamine, and the continued presence of PfCRT K76T, associated with chloroquine resistance. These data have relevance for infection control and drug resistance surveillance; particularly considering expected increases in antimalarial drug use following updated WHO recommendations, and the recent implementation of seasonal malaria chemoprevention and mass drug administration in the region.
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Affiliation(s)
- Sophie Moss
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Emilia Mańko
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Hristina Vasileva
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Eunice Teixeira Da Silva
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Ministry of Public Health, Bissau, Guinea-Bissau
| | - Adriana Goncalves
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Ashley Osborne
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jody Phelan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Paulo Djata
- National Malaria Control Programme, Ministry of Public Health, Bissau, Guinea-Bissau
| | | | - David Mabey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sanjeev Krishna
- Clinical Academic Group, Institute for Infection and Immunity, and St. George's University Hospitals NHS Foundation Trust, St. George's University of London, London, UK
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut Für Tropenmedizin Universitätsklinikum Tübingen, Tübingen, Germany
| | - Anna Last
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Taane G Clark
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Susana Campino
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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Khan MI, Qureshi H, Bae SJ, Khattak AA, Anwar MS, Ahmad S, Hassan F, Ahmad S. Malaria prevalence in Pakistan: A systematic review and meta-analysis (2006-2021). Heliyon 2023; 9:e15373. [PMID: 37123939 PMCID: PMC10133748 DOI: 10.1016/j.heliyon.2023.e15373] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Malaria is one of the major public health issues globally. Malaria infection spreads through mosquito bites from infected female Anopheles mosquitoes. This study aims to conduct a systematic review and meta-analysis on malaria prevalence in Pakistan from 2006 to 2021. We searched PubMed, Science Direct, EMBASE, EMCare, and Google Scholar to acquire data on the prevalence of malaria infections. We performed a meta-analysis with a random-effects model to obtain the pooled prevalence of malaria, Plasmodium vivax, and Plasmodium falciparum. Meta-analysis was computed using R 4.1.2 Version statistical software. I2 and time series analysis were performed to identify a possible source of heterogeneity across studies. A funnel plot and the Freeman-Tukey Double Arcsine Transformed Proportion were used to evaluate the presence of publication bias. Out of the 315 studies collected, only 45 full-text articles were screened and included in the final measurable meta-analysis. Pooled malaria prevalence in Pakistan was 23.3%, with Plasmodium vivax, Plasmodium falciparum, and mixed infection rates of 79.13%, 16.29%, and 3.98%, respectively. Similarly, the analysis revealed that the maximum malaria prevalence was 99.79% in Karachi and the minimum was 1.68% in the Larkana district. Amazingly, this systematic review and meta-analysis detected a wide variation in malaria prevalence in Pakistan. Pakistan's public health department and other competent authorities should pay close attention to the large decrease in mosquito populations to curb the infection rate.
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Affiliation(s)
- Muhammad Imran Khan
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
| | - Humera Qureshi
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
| | - Suk Joo Bae
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
- Corresponding author.
| | - Aamer Ali Khattak
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Shahid Anwar
- Department of AI and Software Gachon University Seongnam-si 13120, South Korea
- Corresponding author.
| | - Sadique Ahmad
- EIAS, Data Science and Blockchain Laboratory, College of Computer and Information Sciences, Prince Sultan University, Riyadh, Saudi Arabia
| | - Fazal Hassan
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Shabir Ahmad
- IT Convergence Engineering, Gachon University, Gyonggi-do, Seongnam-si, Sujeong-gu, 13120, Republic of Korea
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Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, Kazura JW, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. RESEARCH SQUARE 2023:rs.3.rs-2692688. [PMID: 36993196 PMCID: PMC10055656 DOI: 10.21203/rs.3.rs-2692688/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background Water resource development projects such as dams and irrigation schemes have a positive impact on food security and poverty reduction but might result in increased prevalence of malaria. Methods Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 blood samples were collected from Arjo and Gambella. A subset of 2244 microscopy negative blood samples were analyzed by PCR. Results Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). Level of education was an individual risk factors associated with infection in Arjo [AOR: 3.2; 95%CI (1.27-8.16)] and in Gambella [AOR: 1.7; 95%CI (1.06-2.82)]. While duration of stay in the area for < 6 months [AOR: 4.7; 95%CI (1.84-12.15)] and being a migrant worker [AOR: 4.7; 95%CI (3.01-7.17)] were risk factors in Gambella. Season [AOR: 15.9; 95%CI (6.01-42.04)], no ITN utilization [AOR: 22.3; 95%CI (7.74-64.34)] were risk factors in Arjo, and irrigation [AOR: 2.4; 95%CI (1.45-4.07)] and family size [AOR: 2.3; 95%CI (1.30-4.09)] risk factors in Gambella. Of the 1713 and 531 randomly selected smear negative samples from Arjo and Gambella and analyzed by PCR the presence of Plasmodium infection was 1.2% and 12.8%, respectively. P. falciparum, P. vivax, and P. ovale were identified by PCR in both sites. Conclusion Strengthening malaria surveillance and control in project development areas and proper health education for at-risk groups residing or working in such development corridors is needed.
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Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch
| | | | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
| | - Dawit Hawaria
- Hawassa University, School of Environmental Health, Hawassa
| | - Arega Tsegaye
- Department of Biology, College of Natural Science, Jimma University
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, Ohio
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
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9
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Duguma T, Tekalign E, Abera M. Asymptomatic Plasmodium Infection and Associated Factors in Selected Districts of the Kaffa Zone, Southwest Ethiopia: A Cross-Sectional Study. J Trop Med 2023; 2023:4144834. [PMID: 37091858 PMCID: PMC10118875 DOI: 10.1155/2023/4144834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/15/2022] [Accepted: 03/31/2023] [Indexed: 04/25/2023] Open
Abstract
Background Malaria remains a serious public health problem, particularly in resource scarce areas of the world. The number of malaria cases has dropped remarkably in Ethiopia over the last decade, and efforts to eliminate the disease are underway. Asymptomatic infections may pose significant challenges to the elimination program. The essence of this study was to assess the prevalence of asymptomatic Plasmodium infection and the associated factors among communities of the selected districts in the Kaffa zone. Materials and Methods April to May and September to October 2021, were the two seasons in which the community-based cross-sectional survey was conducted. Capillary blood from a finger prick was examined by light microscopy (LM) and screened using rapid diagnostic tests (RDTs). The participants' sociodemographic characteristics and malaria prevention measures were collected using a pretested semistructured questionnaire. Data entry and analyses were carried out using EpiData and SPSS version 25.0. Logistic regression (bivariate and multivariable) analyses were carried out to assess the possible associations between the dependent variable and the associated factors. Results 566 study participants were involved in the two cross-sectional surveys, including 234 male and 332 female subjects with a mean age of 18.486 (SD ± 15.167). Thirty-eight blood samples (6.7%) were found to be positive for Plasmodium species tested by both LM and RDT. Last night's use of long-lasting insecticidal net (LLIN) (AOR = 2.448, 95% CI: 1.009 5.938, p=0.048), presence of eave (AOR = 4.144, 95% CI: 1.049-16.363, p=0.043), and house sprayed in the last year (AOR = 5.206, 95% CI: 2.176-12.455, p < 0.001) were among factors that showed significant association with asymptomatic Plasmodium infection. Conclusion The asymptomatic Plasmodium infection prevalence recorded in the study area was low. Last night's LLIN usage, the presence of an eave, a house sprayed in the last year, and the presence of stagnant water near the home of the study participants were among the factors associated with an increased risk of catching the disease.
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Affiliation(s)
- Tadesse Duguma
- Department of Medical Laboratory Science, College of Health Science and Medicine, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Eyob Tekalign
- Department of Medical Laboratory Science, College of Health Science and Medicine, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Mitiku Abera
- Department of Medical Laboratory Science, College of Health Science and Medicine, Mizan- Tepi University, Mizan-Aman, Ethiopia
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10
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Shamseddin J, Ghanbarnejad A, Zakeri A, Abedi F, Khojasteh S, Turki H. Molecular Method Is Essential to Identify Asymptomatic Malaria Reservoirs: A Successful Experience in the Malaria Elimination Program in Iran. Diagnostics (Basel) 2022; 12:diagnostics12123025. [PMID: 36553032 PMCID: PMC9777330 DOI: 10.3390/diagnostics12123025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background: The accurate diagnosis of malaria cases, especially asymptotic and low-parasitemia patients, using robust molecular methods (nested-PCR) have been emphasized. The goal of this study was to detect active cases of malaria in areas with a history of local malaria transmission focusing on the use of molecular tools to ensure that the malaria elimination program has been implemented successfully. Methods: In this cross-sectional study, 816 blood samples were taken from immigrants and local residents of malaria-endemic areas in Hormozgan province, Iran. In order to identify asymptomatic malaria parasite reservoirs, the samples were examined using microscopic, RDT, and nested-PCR techniques. Results: About twelve positive asymptomatic malaria cases were identified when the molecular method (nested-PCR) was used. The positivity rates among immigrants and local residents were 2.07% and 0.93%, respectively. No positive cases were detected using microscopic and RDT methods. Conclusions: The finding of the research emphasize that in addition to microscopy and RDTs methods, sensitive molecular tools as a standard and essential strategy are needed in the diagnosis and detection of asymptomatic parasite reservoir.
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Affiliation(s)
- Jebreil Shamseddin
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7916613885, Iran
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7919693116, Iran
| | - Amin Ghanbarnejad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan, University of Medical Sciences, Bandar Abbas 7919916753, Iran
| | - Abdoljabbar Zakeri
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7919693116, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan, University of Medical Sciences, Bandar Abbas 7919916753, Iran
| | - Farshid Abedi
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Shaghayegh Khojasteh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7916613885, Iran
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7919693116, Iran
| | - Habibollah Turki
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7916613885, Iran
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas 7919693116, Iran
- Correspondence:
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11
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The Impact of Submicroscopic Parasitemia on Malaria Rapid Diagnosis in Northeastern Tanzania, an Area with Diverse Transmission Patterns. Infect Dis Rep 2022; 14:798-809. [PMID: 36412740 PMCID: PMC9680434 DOI: 10.3390/idr14060082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022] Open
Abstract
Global malaria epidemiology has changed in the last decade with a substantial increase in cases and deaths being recorded. Tanzania accounts for about 4% of all cases and deaths reported in recent years. Several factors contribute to the resurgence of malaria, parasite resistance to antimalarials and mosquito resistance to insecticides being at the top of the list. The presence of sub-microscopic infections poses a significant challenge to malaria rapid diagnostic tests (mRDT). Our cross-sectional surveys in Handeni and Moshi, Tanzania assessed the effect of low parasite density on mRDT. Handeni had higher malaria prevalence by mRDT (39.6%), light microscopy (LM) (16.9%) and polymerase chain reaction (PCR) (18.5%), compared to Moshi with prevalence of 0.2%, 1.3% and 2.3%, respectively. A significant difference (p ˂ 0.001) in malaria prevalence by mRDT, LM and nested PCR was found among age groups. In comparison to all other groups, school-age children (5-15 years) had the highest prevalence of malaria. Our results show that mRDT may miss up to 6% of cases of malaria mainly due to low-density parasitemia when compared to LM and PCR. Routinely used mRDT will likely miss the sub-microscopic parasitemia which will ultimately contribute to the spread of malaria and hinder efforts of elimination.
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12
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Qureshi H, Khan MI, Ahmad A, Awan UA, Khattak AA, Khan AA, Sun Y. Passive Surveillance of Malaria in Pregnant Women, Non-pregnant Women and Children Under 5 Years of Age in Bannu District, Khyber Pakhtunkhwa Pakistan. Front Med (Lausanne) 2021; 8:751456. [PMID: 34869444 PMCID: PMC8636730 DOI: 10.3389/fmed.2021.751456] [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: 08/01/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Malaria among pregnant women is one of the major causes of maternal and infant mortality and morbidity, especially in high-risk areas. Therefore, our study identified the burden of malaria for pregnant women, non-pregnant women, and children under 5 years of age, and malaria service health facilities in Bannu district, Khyber Pakhtunkhwa, Pakistan. Methods: A cross-sectional study was conducted. In this survey, 15,650 individuals were surveyed, and 1,283 were malaria-positive detected. The data were collected from 80 different healthcare centers. SPSS version 23 was used for data analysis. ArcGIS version 10.8 was used for study area mapping. Results: Malaria was detected in 23.3% of children under five, 4.4% of pregnant women, and 72.3% of non-pregnant women, respectively. Moreover, P. falciparum, P. vivax, and mixed infection had a prevalence of 2.1, 96.8, and 1.1%. The most often used and effective medications to treat malaria were chloroquine (29.7%) and primaquine (69.4%). Conclusion: This study's findings depict that malaria's prevalence in the non-pregnant women's group was high. Additionally, P. vivax infection was found to be more prevalent than other types of malaria infection. Due to the scarcity of healthcare facilities in this endemic region, special attention should be directed to strengthening the malaria surveillance and eradication programs.
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Affiliation(s)
- Humera Qureshi
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Muhammad Imran Khan
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Akhlaq Ahmad
- Gungdong Provincial Key Laboratory of Allergy and Clinical Immunology, The State Key Laboratory of Respiratory Disease, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Usman Ayub Awan
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Pakistan
| | - Aamer Ali Khattak
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Pakistan
| | - Ayesha Ali Khan
- Department of Biochemistry and Molecular Biology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Yaqiong Sun
- Department of Imaging, Southern University of Science and Technology Hospital, Shenzhen, China
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13
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Mensah BA, Myers-Hansen JL, Obeng Amoako E, Opoku M, Abuaku BK, Ghansah A. Prevalence and risk factors associated with asymptomatic malaria among school children: repeated cross-sectional surveys of school children in two ecological zones in Ghana. BMC Public Health 2021; 21:1697. [PMID: 34535112 PMCID: PMC8447720 DOI: 10.1186/s12889-021-11714-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 08/29/2021] [Indexed: 11/27/2022] Open
Abstract
Background Asymptomatic Plasmodium infections significantly drive malaria transmission and impact control and elimination strategies, but are largely uncharacterized. We investigated the prevalence and risk factors of asymptomatic malaria infections to inform malaria control strategies in Ghana. Method Five cross-sectional surveys were conducted at the end of the peak transmission season (August–September) on 4892 school children aged between 6 and 14 years in two distinct ecological settings in Ghana between 2013 and 2017. The study sites were Begoro (forest ecology) and Cape Coast (coastal ecology). The children were screened for malaria parasites by microscopic examination of Giemsa-stained thin and thick blood films. Hemoglobin levels were measured using the Hemocue HB analyzer. In addition, height was measured and the height-for-age z-scores estimated from the reference population defined by WHO to determine children who were stunted. Proportions of categorical and means of continuous variables were compared using Chi-square test and Student’s t-test respectively, and multivariable logistic regression was done to assess risk factors associated with asymptomatic infections. Results The overall prevalence of asymptomatic malaria in the school children was higher in Begoro compared to Cape Coast (27% (95% CI: 17, 24%) vs. 24% (95% CI: 17, 24%), p value = 0.04). The study recorded three species of Plasmodium (Plasmodia falciparum, malariae, and ovale) in both sites. Plasmodium falciparum was the predominant species, accounting for about 85% of infections in both study sites. The asymptomatic school children were more likely to be anaemic (OR = 2.01, p value< 0.001) and stunted in growth (OR = 1.46, p value< 0.001). Males carried more asymptomatic infection than females (OR = 1.18, p value = 0.015). School children aged 12–14 years had more asymptomatic infections than those aged 6–8 years (OR = 1.28, p value = 0.005). Conclusion There is a considerable burden of asymptomatic malaria in the two regions of Ghana, which is associated with males, older children, anaemia, and stunted growth in children, and may have implications for malaria control and elimination strategies in Ghana.
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Affiliation(s)
- B A Mensah
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - J L Myers-Hansen
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - E Obeng Amoako
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - M Opoku
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - B K Abuaku
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A Ghansah
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana. .,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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14
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A Comprehensive Survey of Asymptomatic Malaria Cases in an Endemic Focus in Iran: A Successful Experience on the Road to Eliminate Malaria. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.103728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Malaria is one of the important infectious blood diseases caused by the protozoan parasite of the genus Plasmodium and transmitted by female Anopheles mosquito bites. A malaria elimination plan is currently being followed in Hormozgan Province. The robust malaria surveillance system with appropriate active case findings, especially asymptomatic cases, plays an important role in the malaria elimination program. Objectives: The main objectives of this research were to determine the presence and prevalence of asymptomatic malaria cases and monitor asymptomatic parasitic reservoirs in Jask District, Hormozgan Province. Methods: This cross-sectional study aimed to evaluate and monitor asymptomatic cases in the Jask District. The purpose and stages of the study were explained to all participants/parents, and written informed consent was obtained. A total of 230 asymptomatic residents (124 females and 86 males) were randomly selected, and their blood samples (3 mL) were taken to assess Plasmodium infection using microscopic, RDT, and molecular (18ssrRNA) methods. Results: Of the 230 studied cases, 54.8% were females, and 454.2% were males. The age range was four to 65 years old, and the mean age was 24.5. None of the diagnostic methods, including the microscopic, serological, and molecular techniques, could find asymptomatic malaria cases in the study area. Conclusions: It can be concluded that Malaria Elimination Program is feasible in the Jask Region irrespective of asymptomatic parasitic reservoirs. The results also emphasize a robust and efficient malaria surveillance system to diagnose and treat positive cases and monitor treated cases successfully. Ongoing and continuous studies are recommended in the high-risk malarious area of Hormozgan Province to monitor asymptomatic cases of malaria.
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15
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Keshavarz H, Hassanpour G, Tohidinik H, Mohebali M, Sanjar M. Prediction of malaria cases in the southeastern Iran using climatic variables: An 18-year SARIMA time series analysis. ASIAN PAC J TROP MED 2021. [DOI: 10.4103/1995-7645.329008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Ouma FF, Nateghpour M, Haghi AM, Mohebali M, Farivar L, Hosseini-Safa A, Mosawi SH. Application of High-Resolution Melting (HRM) Technique towards the Detection of Asymptomatic Malaria in a Malaria Endemic Area of Southeastern Iran under Elimination Program. J Arthropod Borne Dis 2020; 14:353-362. [PMID: 33954209 PMCID: PMC8053073 DOI: 10.18502/jad.v14i4.5272] [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: 09/30/2018] [Accepted: 12/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Asymptomatic malaria, which usually exists in low parasitemia, acts as the Plasmodium species reservoirs contributing towards malaria transmission. This situation hinders malaria elimination programs in endemic areas, thus necessitating an active case detection with a high sensitive method and treatment of cases. This is why we used a High Resolution Melting (HRM) assay to monitor the trend of asymptomatic malaria in a malaria endemic area of Iran which is under elimination program. Methods: The peripheral blood was sampled from 271 clinically approved non-febrile individuals from a malaria endemic zone of southeastern Iran for asymptomatic malaria prevalence detection by microscopy, Rapid Diagnostic Tests (RDTs) and HRM methods. The HRM assay was done based on the amplification of 18S SSU rRNA gene. Results: The HRM assay revealed infections from three individuals out of 271 (1.1% asymptomatic malaria prevalence) from the participants, two Iranian natives with Plasmodium vivax infection and one Pakistani immigrant with P. falciparum infection. Neither microscopy nor RDTs detected Plasmodium spp infections from the 271 non-febrile individuals. The nucleotide sequencing analysis of the positive controls used in this study showed a close homology with the reference gene bank sequences of P. falciparum 3D7 (CPO16995.1) and P. vivax Sal-1(UO3079.1). Conclusion: This study revealed a low frequency of asymptomatic malaria trend within malaria endemic areas of southeastern Iran which are under intense elimination program and also the ability of HRM assay in detecting low Plasmodium spp parasitemia beyond the limits of microscopy and RDTs.
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Affiliation(s)
- Francan Felix Ouma
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nateghpour
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Motevalli Haghi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Farivar
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hosseini-Safa
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Hussain Mosawi
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
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17
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Askari S, Nateghpour M, Motevalli Haghi A, Farivar L, Raeisi A, Mohebali M. Situation of Asymptomatic Malaria among Iranian Native and Afghan and Pakistani Immigrants in a Malarious Area under the National Malaria Elimination Program of Iran. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:530-536. [PMID: 33884010 PMCID: PMC8039483 DOI: 10.18502/ijpa.v15i4.4858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background This study was designed to detect, if there are asymptomatic malaria infections amongst native and immigrant population from Afghanistan and Pakistan countries in Sistan & Baluchistan Province of Iran, where is under the national malaria elimination program. Methods This cross-sectional study was performed among native individuals and resident immigrants in the southeastern province of Sistan & Baluchistan from May 2016 to Jul 2017. A total of 271 individuals were considered in this cross-sectional study based on microscopical method, Rapid Diagnostic Tests (RDTs) and PCR techniques. Out of 271 native and immigrant participants 140 (52%) and 131 (48%) were male and female, respectively. Results None of the prepared samples was diagnosed as malaria positive case when was considered via above mentioned three techniques. Conclusion Neither native nor immigrant individuals had asymptomatic malaria, hinting that national malaria elimination program is performed according to planned schedule in the studied areas.
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Affiliation(s)
- Setareh Askari
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nateghpour
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Motevalli Haghi
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Farivar
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Raeisi
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology & Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Assefa A, Ahmed AA, Deressa W, Wilson GG, Kebede A, Mohammed H, Sassine M, Haile M, Dilu D, Teka H, Murphy MW, Sergent S, Rogier E, Zhiyong Z, Wakeman BS, Drakeley C, Shi YP, Von Seidlein L, Hwang J. Assessment of subpatent Plasmodium infection in northwestern Ethiopia. Malar J 2020; 19:108. [PMID: 32131841 PMCID: PMC7057598 DOI: 10.1186/s12936-020-03177-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/22/2020] [Indexed: 12/30/2022] Open
Abstract
Background Ethiopia has set a goal for malaria elimination by 2030. Low parasite density infections may go undetected by conventional diagnostic methods (microscopy and rapid diagnostic tests) and their contribution to malaria transmission varies by transmission settings. This study quantified the burden of subpatent infections from samples collected from three regions of northwest Ethiopia. Methods Sub-samples of dried blood spots from the Ethiopian Malaria Indicator Survey 2015 (EMIS-2015) were tested and compared using microscopy, rapid diagnostic tests (RDTs), and nested polymerase chain reaction (nPCR) to determine the prevalence of subpatent infection. Paired seroprevalence results previously reported along with gender, age, and elevation of residence were explored as risk factors for Plasmodium infection. Results Of the 2608 samples collected, the highest positive rate for Plasmodium infection was found with nPCR 3.3% (95% CI 2.7–4.1) compared with RDT 2.8% (95% CI 2.2–3.5) and microscopy 1.2% (95% CI 0.8–1.7). Of the nPCR positive cases, Plasmodium falciparum accounted for 3.1% (95% CI 2.5–3.8), Plasmodium vivax 0.4% (95% CI 0.2–0.7), mixed P. falciparum and P. vivax 0.1% (95% CI 0.0–0.4), and mixed P. falciparum and Plasmodium malariae 0.1% (95% CI 0.0–0.3). nPCR detected an additional 30 samples that had not been detected by conventional methods. The majority of the nPCR positive cases (61% (53/87)) were from the Benishangul-Gumuz Region. Malaria seropositivity had significant association with nPCR positivity [adjusted OR 10.0 (95% CI 3.2–29.4), P < 0.001]. Conclusion Using nPCR the detection rate of malaria parasites increased by nearly threefold over rates based on microscopy in samples collected during a national cross-sectional survey in 2015 in Ethiopia. Such subpatent infections might contribute to malaria transmission. In addition to strengthening routine surveillance systems, malaria programmes may need to consider low-density, subpatent infections in order to accelerate malaria elimination efforts.
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Affiliation(s)
- Ashenafi Assefa
- Ethiopian Public Health Institute, Arbegnoch Street, Mail Box: 19922, Addis Ababa, Ethiopia. .,School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Ahmed Ali Ahmed
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wakgari Deressa
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - G Glenn Wilson
- Department of Biology, University of Southern Denmark, 5230, Odense M, Denmark
| | - Amha Kebede
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Hussein Mohammed
- Ethiopian Public Health Institute, Arbegnoch Street, Mail Box: 19922, Addis Ababa, Ethiopia
| | - Maruon Sassine
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mebrahtom Haile
- Disease Prevention and Control Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Dereje Dilu
- Disease Prevention and Control Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Hiwot Teka
- U.S. President's Malaria Initiative, United States Agency for International Development, Addis Ababa, Ethiopia
| | - Matthew W Murphy
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, U.S. President's Malaria Initiative, Addis Ababa, Ethiopia
| | - Sheila Sergent
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zhou Zhiyong
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian S Wakeman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ya Ping Shi
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jimee Hwang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, U.S. President's Malaria Initiative, Atlanta, GA, USA
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Immigrants: Big Challenge and Silent Threat to Implement Malaria Elimination Program in Hormozgan Province, Iran. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.99725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Surendra H, Supargiyono, Ahmad RA, Kusumasari RA, Rahayujati TB, Damayanti SY, Tetteh KKA, Chitnis C, Stresman G, Cook J, Drakeley C. Using health facility-based serological surveillance to predict receptive areas at risk of malaria outbreaks in elimination areas. BMC Med 2020; 18:9. [PMID: 31987052 PMCID: PMC6986103 DOI: 10.1186/s12916-019-1482-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/09/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In order to improve malaria burden estimates in low transmission settings, more sensitive tools and efficient sampling strategies are required. This study evaluated the use of serological measures from repeated health facility-based cross-sectional surveys to investigate Plasmodium falciparum and Plasmodium vivax transmission dynamics in an area nearing elimination in Indonesia. METHODS Quarterly surveys were conducted in eight public health facilities in Kulon Progo District, Indonesia, from May 2017 to April 2018. Demographic data were collected from all clinic patients and their companions, with household coordinates collected using participatory mapping methods. In addition to standard microscopy tests, bead-based serological assays were performed on finger-prick bloodspot samples from 9453 people. Seroconversion rates (SCR, i.e. the proportion of people in the population who are expected to seroconvert per year) were estimated by fitting a simple reversible catalytic model to seroprevalence data. Mixed effects logistic regression was used to examine factors associated with malaria exposure, and spatial analysis was performed to identify areas with clustering of high antibody responses. RESULTS Parasite prevalence by microscopy was extremely low (0.06% (95% confidence interval 0.03-0.14, n = 6) and 0 for P. vivax and P. falciparum, respectively). However, spatial analysis of P. vivax antibody responses identified high-risk areas that were subsequently the site of a P. vivax outbreak in August 2017 (62 cases detected through passive and reactive detection systems). These areas overlapped with P. falciparum high-risk areas and were detected in each survey. General low transmission was confirmed by the SCR estimated from a pool of the four surveys in people aged 15 years old and under (0.020 (95% confidence interval 0.017-0.024) and 0.005 (95% confidence interval 0.003-0.008) for P. vivax and P. falciparum, respectively). The SCR estimates in those over 15 years old were 0.066 (95% confidence interval 0.041-0.105) and 0.032 (95% confidence interval 0.015-0.069) for P. vivax and P. falciparum, respectively. CONCLUSIONS These findings demonstrate the potential use of health facility-based serological surveillance to better identify and target areas still receptive to malaria in an elimination setting. Further implementation research is needed to enable integration of these methods with existing surveillance systems.
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Affiliation(s)
- Henry Surendra
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
| | - Supargiyono
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | - Riris A. Ahmad
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | - Rizqiani A. Kusumasari
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Medika, Yogyakarta, 55281 Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, 55281 Indonesia
| | | | - Siska Y. Damayanti
- District Health Office of Kulon Progo, Jln. Suparman No 1, Wates, 55611 Indonesia
| | - Kevin K. A. Tetteh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | | | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - Jackie Cook
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
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MOSAWI SH, DALIMI A, SAFI N, GHAFFARIFAR F, SADRAEI J. Evaluation of Asymptomatic Malaria Status in Eastern of Afghanistan Using High Resolution Melting Analysis. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:177-186. [PMID: 32595707 PMCID: PMC7311817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Malaria is threatening more than half of Afghanistan population. Asymptomatic malaria is notable problem against malaria controlling strategies. In this study we evaluated the asymptomatic malaria status in Nangarhar Province, Afghanistan in 2017. METHODS Overall, 296 finger blood samples were taken on DNA Banking Cards and microscopic slides from asymptomatic individuals in Jalalabad city. We used a novel post real time PCR high resolution melting analysis beside microscopy and semi-nested multiplex PCR to evaluate status of asymptomatic malaria in this city. RESULTS The prevalence of asymptomatic malaria in Jalalabad city was determined 1.7% (5/296), 7.43% (22/296) and 7.78% (26/296) by microscopy, Seminested multiplex PCR and qRT-PCR-HRM, respectively. Out of 26 positive cases were detected by qRT-PCR-HRM, 21, 1 and 4 cases were detected P. falciparum, P. vivax and mixed infection of P. falciparum and P. vivax, respectively. CONCLUSION Our data indicating on existence of significant number of asymptomatic reservoirs that assists in prolonged endemicity of the disease. On the other hand, the molecular methods are better alternatives for microscopy especially for monitoring of asymptomatic cases of malaria.
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Affiliation(s)
- Sayed Hussain MOSAWI
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Abdolhossein DALIMI
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Correspondence
| | - Najibullah SAFI
- World Health Organization Country Office, Kabul, Afghanistan
| | - Fatemeh GHAFFARIFAR
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Javid SADRAEI
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Umunnakwe FA, Idowu ET, Ajibaye O, Etoketim B, Akindele S, Shokunbi AO, Otubanjo OA, Awandare GA, Amambua-Ngwa A, Oyebola KM. High cases of submicroscopic Plasmodium falciparum infections in a suburban population of Lagos, Nigeria. Malar J 2019; 18:433. [PMID: 31856852 PMCID: PMC6924037 DOI: 10.1186/s12936-019-3073-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asymptomatic malaria parasites are significant sources of infections for onward malaria transmission. Conventional tools for malaria diagnosis such as microscopy and rapid diagnostic test kits (RDT) have relatively low sensitivity, hence the need for alternative tools for active screening of such low-density infections. METHODS This study tested var acidic terminal sequence-based (varATS) quantitative polymerase chain reaction (qPCR) for screening asymptomatic Plasmodium falciparum infections among dwellers of a sub-urban community in Lagos, Nigeria. Clinically healthy participants were screened for malaria using microscopy, RDT and varATS qPCR techniques. Participants were stratified into three age groups: 1-5, 6-14 and > 14 years old. RESULTS Of the 316 participants screened for asymptomatic malaria infection, 78 (24.68%) were positive by microscopy, 99 (31.33%) were positive by RDT and 112 (35.44%) by varATS qPCR. Participants aged 6-14 years had the highest prevalence of asymptomatic malaria, with geometric means of ~ 116 parasites/µL and ~ 6689 parasites/µL as detected by microscopy and varATS, respectively. CONCLUSION This study has revealed high prevalence of asymptomatic malaria in the study population, with varATS detecting additional sub-microscopic infections. The highest concentration of asymptomatic malaria was observed among school-age children between 6 and 14 years old. A large-scale screening to identify other potential hotspots of asymptomatic parasites in the country is recommended.
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Affiliation(s)
- Florence A Umunnakwe
- Parasitology and Bioinformatics Unit, Department of Zoology, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria
| | - Emmanuel T Idowu
- Parasitology and Bioinformatics Unit, Department of Zoology, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria
| | - Olusola Ajibaye
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Blessed Etoketim
- Medical Research Council at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Samuel Akindele
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Aminat O Shokunbi
- Parasitology and Bioinformatics Unit, Department of Zoology, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria
| | - Olubunmi A Otubanjo
- Parasitology and Bioinformatics Unit, Department of Zoology, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Alfred Amambua-Ngwa
- Medical Research Council at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Kolapo M Oyebola
- Parasitology and Bioinformatics Unit, Department of Zoology, Faculty of Science, University of Lagos, Akoka, Lagos, Nigeria. .,Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria. .,Medical Research Council at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia. .,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana.
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Chanda E, Arshad M, Khaloua A, Zhang W, Namboze J, Uusiku P, Angula AH, Gausi K, Tiruneh D, Islam QM, Kolivras K, Haque U. An investigation of the Plasmodium falciparum malaria epidemic in Kavango and Zambezi regions of Namibia in 2016. Trans R Soc Trop Med Hyg 2019; 112:546-554. [PMID: 30252108 DOI: 10.1093/trstmh/try097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/10/2018] [Indexed: 01/26/2023] Open
Abstract
Background Namibia is one of the countries among the eight that are targeting malaria elimination in southern Africa. However, the country has encountered malaria epidemics in recent years. The objective of this study was to investigate malaria epidemics and to contribute to strengthening malaria surveillance and control in an effort to move Namibia toward eliminating malaria. Method Malaria epidemiology data for 2014-2015 were collected from the weekly surveillance system. All consenting household members within a 100-m radius of index households were screened in 2016 using a Carestart malaria HRP2/pLDH combined rapid diagnostic test after epidemics. All houses within this radius were sprayed in 2016 with the pyrethroid deltamethrin and K-Othrine WG 250. Anopheles mosquito-positive breeding sites were identified and treated with the organophosphate larvicide temephos. Insecticide susceptibility and bioassay tests were conducted. Results During the epidemic response period in 2016, 56 parasitologically confirmed Plasmodium falciparum malaria cases in the Zambezi region were detected from active screening. The majority of those cases (83%) were asymptomatic infections. In the Kavango region, the malaria epidemic persisted, with 228 P. falciparum malaria cases recorded, but only 97 were investigated. In Namibia, malaria vector susceptibility was detected to 4% dichlorodiphenyltrichloroethane. Indoor residual spraying was conducted in 377 (90%) of the targeted households along with community awareness through health education of 1499 people and distribution of more than 2000 information, education and communication materials. The P. falciparum malaria cases in the Zambezi decreased from 122 in week 9 to 97 after week 15. Conclusions Malaria epidemics along with the persistence of asymptomatic reservoir infections pose a serious challenge in Namibia's elimination effort. The country needs to ensure sustainable interventions to target asymptomatic reservoir infections and prevent epidemics in order to successfully achieve its goal of eliminating malaria.
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Affiliation(s)
- Emmanuel Chanda
- World Health Organization, Regional Office for Africa, Cite du Djoue, Brazzaville, Republic of the Congo
| | - Mohd Arshad
- Department of Statistics and Operations Research, Aligarh Muslim University, Aligarh, India
| | - Asmaa Khaloua
- Department of Computer Science and Engineering, 1155 Union Circle #311366 Denton, Texas, USA
| | - Wenyi Zhang
- Institute of Disease Control and Prevention of PLA, NO. 20 Dong-Da-Jie Street, Fengtai District, Beijing, PR China
| | - Josephine Namboze
- World Health Organization, Country Office, Geza Banda-Adi Yacob St 178, Asmara 291-1, Eritrea
| | - Pentrina Uusiku
- Ministry of Health and Social Services, National Vector-borne Diseases Control Programme, Florence Nightingale Street, Windhoek, Namibia
| | - Andreas H Angula
- Ministry of Health and Social Services, National Vector-borne Diseases Control Programme, Florence Nightingale Street, Windhoek, Namibia
| | - Khoti Gausi
- World Health Organization, East and Southern Africa Inter-country Support Team, Causeway Harare, Zimbabwe
| | - Desta Tiruneh
- World Health Organization, Country Office, Windhoek, Namibia
| | - Quazi M Islam
- World Health Organization, Country Office, Windhoek, Namibia
| | - Korine Kolivras
- Department of Geography, Virginia Tech, 220 Stanger St, 115 Major Williams Hall, Blacksburg, VA, USA
| | - Ubydul Haque
- Department of Geography, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
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Wangchuk S, Gyeltshen S, Dorji K, Wangdi T, Dukpa T, Namgay R, Dorjee S, Tobgay T, Chaijaroenkul W, Na-Bangchang K. Malaria elimination in Bhutan: asymptomatic malaria cases in the Bhutanese population living in malaria-risk areas and in migrant workers from India. Rev Inst Med Trop Sao Paulo 2019; 61:e52. [PMID: 31531630 PMCID: PMC6746194 DOI: 10.1590/s1678-9946201961052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/31/2019] [Indexed: 11/28/2022] Open
Abstract
In 2018, Bhutan reported 54 cases of malaria, of which six were indigenous, 14 introduced and 34 imported. Considering the continuous reduction in the number of indigenous cases, Bhutan plans to eliminate malaria by 2025 under the Bhutan Malaria Elimination Strategy. The study was conducted to assess the presence of asymptomatic plasmodial infection in both, Bhutanese population living in malaria-risk areas and in migrant workers to guide the elimination strategies. A cross-sectional study was conducted from April to May 2016 in 750 Bhutanese people and 473 migrant workers. Plasmodium falciparum and Plasmodium vivax infections were investigated by using a rapid diagnostic test (RDT) and the polymerase chain reaction (PCR). Prevalence of asymptomatic plasmodial infection based on PCR was 0.27% (95% CI: 0.05–1.07%) among Bhutanese people with a mean age of 43 years old. The proportions of males and females were 45% and 55%, respectively. Among migrant workers, the prevalence of asymptomatic plasmodial infection was 0.42% (95% CI: 0.07–1.69%) with a mean age of 30 years old. The majority of migrant workers were from the neighboring Indian State of West Bengal (57.51%), followed by Assam (12.26%). RDT in both study groups did not detect any plasmodial infection. The presence of a low prevalence of asymptomatic plasmodial infection indicates that the current elimination strategies and interventions are effective.
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Affiliation(s)
- Sonam Wangchuk
- Bhutan Ministry of Health, Royal Center for Disease Control, Thimphu, Bhutan
| | - Sonam Gyeltshen
- Bhutan Ministry of Health, Royal Center for Disease Control, Thimphu, Bhutan
| | - Kunzang Dorji
- Bhutan Ministry of Health, Royal Center for Disease Control, Thimphu, Bhutan
| | - Tenzin Wangdi
- Bhutan Ministry of Health, Department of Public Health, Vector Borne Disease Control Programme, Thimphu, Bhutan
| | - Tobgyel Dukpa
- Bhutan Ministry of Health, Department of Public Health, Vector Borne Disease Control Programme, Thimphu, Bhutan
| | - Rinzin Namgay
- Bhutan Ministry of Health, Department of Public Health, Vector Borne Disease Control Programme, Thimphu, Bhutan
| | - Sithar Dorjee
- Bhutan Agriculture and Food Regulatory Authority, Thimphu, Bhutan.,Khesar Gyalpo University of Medical Science, Thimphu, Bhutan
| | - Tashi Tobgay
- Khesar Gyalpo University of Medical Science, Thimphu, Bhutan
| | - Wanna Chaijaroenkul
- Thammasat University, Cholangiocarcinoma, Chulabhorn International College of Medicine, Center of Excellence in Pharmacology and Molecular Biology of Malaria, Pathumthani, Thailand
| | - Kesara Na-Bangchang
- Thammasat University, Cholangiocarcinoma, Chulabhorn International College of Medicine, Center of Excellence in Pharmacology and Molecular Biology of Malaria, Pathumthani, Thailand
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25
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Jiram AI, Ooi CH, Rubio JM, Hisam S, Karnan G, Sukor NM, Artic MM, Ismail NP, Alias NW. Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia. Malar J 2019; 18:156. [PMID: 31046769 PMCID: PMC6498596 DOI: 10.1186/s12936-019-2786-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/22/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Malaysia has declared its aim to eliminate malaria with a goal of achieving zero local transmission by the year 2020. However, targeting the human reservoir of infection, including those with asymptomatic infection is required to achieve malaria elimination. Diagnosing asymptomatic malaria is not as straightforward due to the obvious lack of clinical manifestations and often subpatent level of parasites. Accurate diagnosis of malaria is important for providing realistic estimates of malaria burden and preventing misinformed interventions. Low levels of parasitaemia acts as silent reservoir of transmission thus remains infectious to susceptible mosquito vectors. Hence, the aim of this study is to investigate the prevalence of asymptomatic submicroscopic malaria (SMM) in the District of Belaga, Sarawak. METHODS In 2013, a total of 1744 dried blood spots (DBS) were obtained from residents of 8 longhouses who appeared healthy. Subsequently, 251 venous blood samples were collected from residents of 2 localities in 2014 based on the highest number of submicroscopic cases from prior findings. Thin and thick blood films were prepared from blood obtained from all participants in this study. Microscopic examination were carried out on all samples and a nested and nested multiplex PCR were performed on samples collected in 2013 and 2014 respectively. RESULTS No malaria parasites were detected in all the Giemsa-stained blood films. However, of the 1744 samples, 29 (1.7%) were positive for Plasmodium vivax by PCR. Additionally, of the 251 samples, the most prevalent mono-infection detected by PCR was Plasmodium falciparum 50 (20%), followed by P. vivax 39 (16%), P. knowlesi 9 (4%), and mixed infections 20 (8%). CONCLUSIONS This research findings conclude evidence of Plasmodium by PCR, among samples previously undetectable by routine blood film microscopic examination, in local ethnic minority who are clinically healthy. SMM in Belaga district is attributed not only to P. vivax, but also to P. falciparum and P. knowlesi. In complementing efforts of programme managers, there is a need to increase surveillance for SMM nationwide to estimate the degree of SMM that warrant measures to block new transmission of malaria.
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Affiliation(s)
- Adela Ida Jiram
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia.
| | - Choo Huck Ooi
- Vector Borne Diseases Section, Sarawak Health Department, Ministry of Health Malaysia, Diplomatik Road, Off Bako Road, Petra Jaya, 93050, Kuching, Sarawak, Malaysia
| | - José Miguel Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology, Instituto de Salud Carlos III (ISCIII), Carretera de Majadahonda - Pozuelo, km. 2,200, Majadahonda, 28220, Madrid, Spain
| | - Shamilah Hisam
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Govindarajoo Karnan
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Nurnadiah Mohd Sukor
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Mohd Mafie Artic
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Nor Parina Ismail
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Nor Wahida Alias
- Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
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Follow-Up and Monitoring of Malaria Treated Cases Toward Malaria Elimination Program in Bashagard District, Hormozgan Province, Iran, in 2016. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.85267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Amoah LE, Abagna HB, Akyea-Mensah K, Lo AC, Kusi KA, Gyan BA. Characterization of anti-EBA175RIII-V in asymptomatic adults and children living in communities in the Greater Accra Region of Ghana with varying malaria transmission intensities. BMC Immunol 2018; 19:34. [PMID: 30453898 PMCID: PMC6245760 DOI: 10.1186/s12865-018-0271-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background Antibodies against Region III-V of the erythrocyte binding antigen (EBA) 175 (EBA175RIII-V) have been suggested to provide protection from malaria in a natural infection. However, the quality and quantity of naturally induced antibodies to EBA175RIII-V has not been fully characterized in different cohorts of Ghanaians. This study sought to determine the characteristics of antibodies against EBA175RIII-V in asymptomatic adults and children living in two communities of varying P. falciparum parasite prevalence in southern Ghana. Methods Microscopic evaluation of thick and thin blood smears was used to identify asymptomatic Plasmodium falciparum carriage and indirect enzyme linked immunosorbent (ELISA) used to assess antibody concentrations and avidity. Results Parasite carriage estimated by microscopy in Obom was 35.6% as opposed to 3.5% in Asutsuare. Levels of IgG, IgG1, IgG2, IgG3 and IgG4 against EBA175RIII-V in the participants from Obom were significantly higher (P < 0.05, Dunn’s Multiple Comparison test) than those in Asutsuare. However the relative avidity of IgG antibodies against EBA175RIII-V was significantly higher (P < 0.0001, Mann Whitney test) in Asutsuare than in Obom. Conclusions People living in communities with limited exposure to P. falciparum parasites have low quantities of high avidity antibodies against EBA175RIII-V whilst people living in communities with high exposure to the parasites have high quantities of age-dependent but low avidity antibodies against EBA175RIII-V. Electronic supplementary material The online version of this article (10.1186/s12865-018-0271-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L E Amoah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - H B Abagna
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - K Akyea-Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A C Lo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,Present address: University Cheikh Anta DIOP, Dakar, Senegal
| | - K A Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - B A Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Zhao Y, Zeng J, Zhao Y, Liu Q, He Y, Zhang J, Yang Z, Fan Q, Wang Q, Cui L, Cao Y. Risk factors for asymptomatic malaria infections from seasonal cross-sectional surveys along the China-Myanmar border. Malar J 2018; 17:247. [PMID: 29973194 PMCID: PMC6032786 DOI: 10.1186/s12936-018-2398-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Border malaria, a shared phenomenon in the Greater Mekong Sub-region of Southeast Asia, is a major obstacle for regional malaria elimination. Along the China-Myanmar border, an additional problem arose as a result of the settlement of internally displaced people (IDP) in the border region. Since asymptomatic malaria significantly impacts transmission dynamics, assessment of the prevalence, dynamics and risk factors of asymptomatic malaria infections is necessary. METHODS Cross-sectional surveys were carried out in 3 seasons (March and April, July and November) and 2 sites (villages and IDP camps) in 2015. A total of 1680 finger-prick blood samples were collected and used for parasite detection by microscopy and nested RT-PCR (nRT-PCR). Logistic regression models were used to explore the risk factors associated with asymptomatic malaria at individual and household levels. RESULTS The prevalence of asymptomatic Plasmodium infections was 23.3% by nRT-PCR, significantly higher than that detected by microscopy (1.5%). The proportions of Plasmodium vivax, Plasmodium falciparum and mixed-species infections were 89.6, 8.1 and 2.3%, respectively. Asymptomatic infections showed obvious seasonality with higher prevalence in the rainy season. Logistic regression analysis identified males and school children (≤ 15 years) as the high-risk populations. Vector-based interventions, including bed net and indoor residual spray, were found to have significant impacts on asymptomatic Plasmodium infections, with non-users of these measures carrying much higher risks of infection. In addition, individuals living in poorly constructed households or farther away from clinics were more prone to asymptomatic infections. CONCLUSIONS Sub-microscopic Plasmodium infections were highly prevalent in the border human populations from IDP camps and surrounding villages. Both individual- and household-level risk factors were identified, which provides useful information for identifying the high-priority populations to implement targeted malaria control.
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Affiliation(s)
- Yan Zhao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Jie Zeng
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Yonghong Zhao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Qingyang Liu
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Yang He
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Jiaqi Zhang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Zhaoqing Yang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Qi Fan
- Dalian Institute of Biotechnology, Dalian, Liaoning, China
| | - Qinghui Wang
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China.
| | - Liwang Cui
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China. .,Department of Entomology, Pennsylvania State University, University Park, State College, PA, 16802, USA.
| | - Yaming Cao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122, Liaoning, China.
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Martins-Campos KM, Kuehn A, Almeida A, Duarte APM, Sampaio VS, Rodriguez ÍC, da Silva SGM, Ríos-Velásquez CM, Lima JBP, Pimenta PFP, Bassat Q, Müller I, Lacerda M, Monteiro WM, Barbosa Guerra MDGV. Infection of Anopheles aquasalis from symptomatic and asymptomatic Plasmodium vivax infections in Manaus, western Brazilian Amazon. Parasit Vectors 2018; 11:288. [PMID: 29728152 PMCID: PMC5935932 DOI: 10.1186/s13071-018-2749-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/26/2018] [Indexed: 12/22/2022] Open
Abstract
Background Asymptomatic individuals are one of the major challenges for malaria elimination programs in endemic areas. In the absence of clinical symptoms and with a lower parasite density they constitute silent reservoirs considered important for maintaining transmission of human malaria. Studies from Brazil have shown that infected individuals may carry these parasites for long periods. Results Patients were selected from three periurban endemic areas of the city of Manaus, in the western Brazilian Amazon. Symptomatic and asymptomatic patients with positive thick blood smear and quantitative real-time PCR (qPCR) positive for Plasmodium vivax were invited to participate in the study. A standardised pvs25 gene amplification by qPCR was used for P. vivax gametocytes detection. Anopheles aquasalis were fed using membrane feeding assays (MFA) containing blood from malaria patients. Parasitemia of 42 symptomatic and 25 asymptomatic individuals was determined by microscopic examination of blood smears and qPCR. Parasitemia density and gametocyte density were assessed as determinants of infection rates and oocysts densities. A strong correlation between gametocyte densities (microscopy and molecular techniques) and mosquito infectivity (P < 0.001) and oocysts median numbers (P < 0.05) was found in both groups. The ability to infect mosquitoes was higher in the symptomatic group (41%), but infectivity in the asymptomatic group was also seen (1.42%). Conclusions Although their infectivity to mosquitoes is relatively low, given the high prevalence of P. vivax asymptomatic carriers they are likely to play and important role in malaria transmission in the city of Manaus. The role of asymptomatic infections therefore needs to be considered in future malaria elimination programs in Brazil. Electronic supplementary material The online version of this article (10.1186/s13071-018-2749-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keillen M Martins-Campos
- Programa de Pós Graduação em Medicina Tropical, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.,Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Andrea Kuehn
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Anne Almeida
- Programa de Pós Graduação em Medicina Tropical, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.,Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Ana Paula M Duarte
- Programa de Pós Graduação em Medicina Tropical, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.,Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | - Íria C Rodriguez
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Sara G M da Silva
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | | | - Paulo Filemon Paolucci Pimenta
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - Quique Bassat
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Ivo Müller
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Walter and Eliza Hall Institute, Parkville, Australia
| | - Marcus Lacerda
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Instituto de Pesquisas Leônidas & Maria Deane, Fiocruz, Manaus, Brazil
| | - Wuelton M Monteiro
- Programa de Pós Graduação em Medicina Tropical, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.,Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Maria das Graças V Barbosa Guerra
- Programa de Pós Graduação em Medicina Tropical, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil. .,Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
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Gbalégba CGN, Ba H, Silué KD, Ba O, Tia E, Chouaibou M, Tian-Bi NTY, Yapi GY, Koné B, Utzinger J, Koudou BG. Distribution of Plasmodium spp. infection in asymptomatic carriers in perennial and low seasonal malaria transmission settings in West Africa. Infect Dis Poverty 2018; 7:39. [PMID: 29690913 PMCID: PMC5926534 DOI: 10.1186/s40249-018-0412-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
Abstract
Background Since 2000, substantial progress has been made in reducing malaria worldwide. However, some countries in West Africa remain a hotspot for malaria with all age groups at risk. Asymptomatic carriers of Plasmodium spp. are important sources of infections for malaria vectors and thus contribute to the anchoring of the disease in favourable eco-epidemiological settings. The objective of this study was to assess the asymptomatic malaria case rates in Korhogo and Kaedi, two urban areas in northern Côte d’Ivoire and southern Mauritania, respectively. Methods Cross-sectional surveys were carried out during the rainy season in 2014 and the dry season in 2015 in both settings. During each season, 728 households were randomly selected and a household-based questionnaire was implemented to collect demographic and epidemiological data, including of malaria preventive methods used in communities. Finger-prick blood samples were obtained for biological examination using microscopy and rapid diagnostic tests (RDTs). Results Overall, 2672 households and 15 858 consenting participants were surveyed. Plasmodium spp. infection was confirmed in 12.4% (n = 832) and 0.3% (n = 22) of the assessed individuals in Korhogo and Kaedi, respectively. In Korhogo, the prevalence of asymptomatic malaria was 10.5% (95% CI: 9.7–11.2) as determined by microscopy and 9.3% (95% CI: 8.6–10.0%) when assessed by RDT. In Kaedi, asymptomatic malaria prevalence was 0.2% (95% CI: 0.1–0.4%) according to microscopy, while all RDTs performed were negative (n = 8372). In Korhogo, asymptomatic malaria infection was significantly associated with age and season, with higher risk within the 5–14 years-old, and during the rainy season. In Kaedi, the risk of asymptomatic malaria infection was associated with season only (higher during the dry season; crude OR (cOR): 6.37, 95% CI: 1.87–21.63). P. falciparum was the predominant species identified in both study sites representing 99.2% (n = 825) in Korhogo and 59.1% (n = 13) in Kaedi. Gametocytes were observed only in Korhogo and only during the rainy season at 1.3% (95% CI: 0.7–2.4%). Conclusions Our findings show a low prevalence of clinical malaria episodes with a significant proportion of asymptomatic carriers in both urban areas. National policies for malaria infections are focused on treatment of symptomatic cases. Malaria control strategies should be designed for monitoring and managing malaria infections in asymptomatic carriers. Additional measures, including indoor residual spraying, effective use of long-lasting insecticidal nets is strongly needed to reduce the number of Plasmodium spp. infections in Korhogo and Kaedi. Electronic supplementary material The online version of this article (10.1186/s40249-018-0412-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Constant G N Gbalégba
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 B.P. 801, Abidjan, 02, Côte d'Ivoire. .,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.
| | - Hampâté Ba
- Laboratoire de Parasitologie - Mycologie, Institut National de Recherches en Santé Publique , B.P. 695, Nouakchott, Mauritania
| | - Kigbafori D Silué
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 B.P. 582, Abidjan, 22, Côte d'Ivoire
| | - Ousmane Ba
- Laboratoire de Parasitologie - Mycologie, Institut National de Recherches en Santé Publique , B.P. 695, Nouakchott, Mauritania
| | - Emmanuel Tia
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, 27 B.P. 529, Abidjan, 27, Côte d'Ivoire
| | - Mouhamadou Chouaibou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire
| | - Nathan T Y Tian-Bi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 B.P. 582, Abidjan, 22, Côte d'Ivoire
| | - Grégoire Y Yapi
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, 27 B.P. 529, Abidjan, 27, Côte d'Ivoire
| | - Brama Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Université Péléforo Gon Coulibaly, B.P. 1328, Korhogo, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute , P.O. Box, CH- 4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Benjamin G Koudou
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 B.P. 801, Abidjan, 02, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool, L3 5QA, UK
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Carmona-Fonseca J, Agudelo OM, Arango EM. Asymptomatic plasmodial infection in Colombian pregnant women. Acta Trop 2017; 172:97-101. [PMID: 28460834 DOI: 10.1016/j.actatropica.2017.04.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 11/15/2022]
Abstract
Information about asymptomatic plasmodial infection is scarce in the world, and the current antimalarial program goals (control, elimination, and eradication) demand this evidence to be well documented in different populations and malaria transmission settings. This study aimed to measure the prevalence of API in Colombian pregnant women at delivery. A retrospective prevalence survey was used. Women were recruited at hospital obstetric facility in each of the municipalities of Turbo, Necoclí in Antioquia department, and Puerto Libertador in Córdoba department. Malaria infection was tested by thick blood smear (TBS) and real-time quantitative PCR (qPCR). Ninety-six pregnant women at delivery were studied: 95% were asymptomatic (91/96), 45% had asymptomatic plasmodial infection (API) by qPCR (41/91), and only 8% (7/91) had API by microscopy. The prevalence of submicroscopic infections (TBS negative and qPCR positive) was very high, 37% (34/91) in asymptomatic women and 41% (39/96) in total women studied (91 asymptomatic and 5 symptomatic). The prevalence of API in Colombian pregnant women is much higher than which is expected for a country that does not have the level of malaria transmission as Sub-Saharan African countries.
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Affiliation(s)
| | - Olga M Agudelo
- Grupo Salud y Comunidad-César Uribe Piedrahíta, Universidad de Antioquia, Colombia
| | - Eliana M Arango
- Grupo Salud y Comunidad-César Uribe Piedrahíta, Universidad de Antioquia, Colombia.
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Hassanpour G, Mohebali M, Zeraati H, Raeisi A, Keshavarz H. Asymptomatic Malaria and its Challenges in the Malaria Elimination Program in Iran: a Systematic Review. J Arthropod Borne Dis 2017; 11:172-181. [PMID: 29062842 PMCID: PMC5641606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 05/21/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The objective of this study was to find an appropriate approach to asymptomatic malaria in elimination setting through a systematic review. METHODS A broad search was conducted to find articles with the words 'malaria' in their titles and 'asymptomatic' or 'submicroscopic' in their texts, irrespective of the type of study conducted. The Cochrane, Medline/Pub Med, and Scopus databases, as well as Google Scholar were systematically searched for English articles and reports and Iran's databases-Iran Medex, SID and Magiran were searched for Persian reports and articles, with no time limitation. The study was qualitatively summarized if it contained precise information on the role of asymptomatic malaria in the elimination phase. RESULTS Six articles were selected from the initial 2645 articles. The results all re-emphasize the significance of asymptomatic malaria in the elimination phase, and emphasize the significance of diagnostic tests of higher sensitivity to locate these patients and perform interventions to reduce the asymptomatic parasitic reservoirs particularly in regions of low transmission. However, we may infer from the results that the current evidence cannot yet specify an accurate strategy on the role of asymptomatic malaria in the elimination phase. CONCLUSION To eliminate malaria, alongside vector control, and treatment of symptomatic and asymptomatic patients, active and inactive methods of case detection need to be employed. The precise monitoring of asymptomatic individuals and submicroscopic cases of malaria through molecular assays and valid serological methods, especially in regions where seasonal and low transmission exists can be very helpful at this phase.
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Affiliation(s)
- Gholmreza Hassanpour
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Raeisi
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Dr Hossein Keshavarz, E-mail:
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Zaw MT, Thant M, Hlaing TM, Aung NZ, Thu M, Phumchuea K, Phusri K, Saeseu T, Yorsaeng R, Nguitragool W, Felger I, Kaewkungwal J, Cui L, Sattabongkot J. Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar. Malar J 2017; 16:138. [PMID: 28376883 PMCID: PMC5381021 DOI: 10.1186/s12936-017-1789-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background Myanmar has the heaviest burden of
malaria in the Greater Mekong Sub-region. Asymptomatic Plasmodium spp. infections are common in this region and may represent an important reservoir of transmission that must be targeted for malaria elimination. Methods A mass blood survey was conducted among 485 individuals from six villages in Kayah State, an area of endemic but low transmission malaria in eastern Myanmar. Malaria infection was screened by rapid diagnostic test (RDT), light microscopy and real-time polymerase chain reaction (PCR), and its association with demographic factors was explored. Results The prevalence of asymptomatic Plasmodium spp. infection was 2.3% (11/485) by real-time PCR. Plasmodium vivax accounted for 72.7% (8/11) and Plasmodium falciparum for 27.3% (3/11) of infections. Men were at greater risk of infection by Plasmodium spp. than women. Individuals who worked as farmers or wood and bamboo cutters had an increased risk of infection. Conclusion A combination of RDT, light microscopy and PCR diagnostics were used to identify asymptomatic malaria infection, providing additional information on asymptomatic cases in addition to the routine statistics on symptomatic cases, so as to determine the true burden of disease in the area. Such information and risk factors can improve malaria risk stratification and guide decision-makers towards better design and delivery of targeted interventions in small villages, representative of Kayah State.
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Affiliation(s)
- Myo Thiha Zaw
- Defence Services Medical Research Centre (DSMRC), Nay Pyi Taw, Myanmar.,Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Myo Thant
- Defence Services Medical Research Centre (DSMRC), Nay Pyi Taw, Myanmar
| | - Tin Maung Hlaing
- Defence Services Medical Research Centre (DSMRC), Nay Pyi Taw, Myanmar
| | - Naing Zin Aung
- Defence Services Medical Research Centre (DSMRC), Nay Pyi Taw, Myanmar.,Loikaw Military Hospital, Loikaw, Kayah, Myanmar
| | - Min Thu
- Loikaw Military Hospital, Loikaw, Kayah, Myanmar
| | - Kanit Phumchuea
- Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kanokwan Phusri
- Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Teerawat Saeseu
- Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ritthideach Yorsaeng
- Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wang Nguitragool
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ingrid Felger
- Department of Medical Parasitology and Infection Biology, Swiss Tropical & Public Health Institute, Basel, Switzerland
| | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Liwang Cui
- Department of Entomology, The Pennsylvania State University, 501 ASI Building, University Park, PA, 16801, USA.
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Chourasia MK, Kamaraju R, Kleinschmidt I, Bhatt RM, Swain DK, Knox TB, Valecha N. Impact of long-lasting insecticidal nets on prevalence of subclinical malaria among children in the presence of pyrethroid resistance in Anopheles culicifacies in Central India. Int J Infect Dis 2017; 57:123-129. [PMID: 28268096 PMCID: PMC5384434 DOI: 10.1016/j.ijid.2017.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Subclinical (asymptomatic) cases of malaria could be a major barrier to the success of malaria elimination programs. This study has evaluated the impact of long-lasting insecticidal nets (LLINs) on the prevalence of subclinical malaria in the presence of pyrethroid resistance in the main malaria vector Anopheles culicifacies on malaria transmission among a cohort of children in villages of the Keshkal sub-district in Chhattisgarh state. METHODS A cohort of 6582 children ages less than 14 years was enrolled from 80 study clusters. Post monsoon survey was carried out at baseline before LLIN distribution, and 5862 children were followed up in the subsequent year. Study outcomes included assessment of subclinical malarial infections and use of LLINs among the study cohort in the presence of varied levels of pyrethroid resistance. FINDINGS In the baseline survey, the proportion of subclinical malaria was 6·1%. LLIN use during the previous night was 94·8%. Overall, prevalence of subclinical malaria was significantly reduced to 1% (p<0·001) in the second survey. LLIN users were protected from malaria (OR: 0·25, 95% CI=0·12-0·52, p<0.001) and subclinical malaria (OR: 0·25, 95% CI=0·11-0·58, p=0·001) despite the presence of pyrethroid resistance in the study area. INTERPRETATION In this low transmission area, sleeping under LLINs significantly reduced the burden of malaria among children. In the presence of pyrethroid resistant malaria vector, a high LLIN use of 94·5% was observed to have significantly brought down the proportion of subclinical malaria among the cohort children.
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Affiliation(s)
- Mehul Kumar Chourasia
- National Institute of Malaria Research (ICMR) IIR-WHO Project, Field Unit, Kondagaon, Chhattisgarh, India.
| | - Raghavendra Kamaraju
- National Institute of Malaria Research (ICMR), Sector-8, Dwarka, New Delhi 110077, India.
| | - Immo Kleinschmidt
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | - Rajendra M Bhatt
- National Institute of Malaria Research (ICMR), Field Unit, Lalpur, Raipur Chhattisgarh, India.
| | - Dipak Kumar Swain
- National Institute of Malaria Research (ICMR) IIR-WHO Project, Field Unit, Kondagaon, Chhattisgarh, India.
| | | | - Neena Valecha
- National Institute of Malaria Research (ICMR), Sector-8, Dwarka, New Delhi 110077, India.
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Kalantari M, Soltani Z, Ebrahimi M, Yousefi M, Amin M, Shafiei A, Azizi K. Monitoring of Plasmodium infection in humans and potential vectors of malaria in a newly emerged focus in southern Iran. Pathog Glob Health 2017; 111:49-55. [PMID: 28078947 DOI: 10.1080/20477724.2016.1271094] [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: 12/07/2022] Open
Abstract
Despite control programs, which aim to eliminate malaria from Iran by 2025, transmission of malaria has not been removed from the country. This study aimed to monitor malaria from asymptomatic parasitaemia and clinical cases from about one year of active case surveillance and potential vectors of malaria in the newly emerged focus of Mamasani and Rostam, southern Iran during 2014-2015. Samples were collected and their DNAs were extracted for Polymerase Chain Reaction (PCR) assay using specific primers for detection of Plasmodium species. The Annual Parasite Incidence rate (API) was three cases per 1,000 population from 2,000 individuals in three villages. Parasites species were detected in 9 out of the 4,000 blood smear samples among which, 6 cases were indigenous and had no history of travels to endemic areas of malaria. Also, the prevalence rate of asymptomatic parasites was about 0.3%. Overall, 1073 Anopheles spp. were caught from 9 villages. Totally, 512 female samples were checked by PCR, which indicated that none of them was infected with Plasmodium. Despite new malaria local transmission in humans in Mamasani and Rostam districts, no infection with Plasmodium was observed in Anopheles species. Because of neighboring of the studied area to the re-emerged focus in Fars province (Kazerun) and important endemic foci of malaria in other southern provinces, such as Hormozgan and Kerman, monitoring of the vectors and reservoir hosts of Plasmodium species would be unavoidable. Application of molecular methods, such as PCR, can simplify access to the highest level of accuracy in malaria researches.
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Affiliation(s)
- Mohsen Kalantari
- a Research Centre for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health , Shiraz University of Medical Sciences , Shiraz , Iran.,b Department of Health, Mamasani Higher Education Complex for Health , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Zahra Soltani
- c Centre for Disease Control , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mostafa Ebrahimi
- c Centre for Disease Control , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Masoud Yousefi
- b Department of Health, Mamasani Higher Education Complex for Health , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Masoumeh Amin
- a Research Centre for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Ayda Shafiei
- a Research Centre for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Kourosh Azizi
- a Research Centre for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health , Shiraz University of Medical Sciences , Shiraz , Iran
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PIRAHMADI S, ZAKERI S, RAEISI A. Absence of Asymptomatic Malaria Infection in a Cross-sectional Study in Iranshahr District, Iran under Elimination Programmes. IRANIAN JOURNAL OF PARASITOLOGY 2017; 12:90-100. [PMID: 28761465 PMCID: PMC5522703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Asymptomatic malaria infection provides a reservoir of parasites, causing the persistence of malaria transmission. It accounts an important challenge for successful management of the control, elimination, and eradication programmes in any malaria-endemic region. This investigation was designed to assess the presence and the prevalence of asymptomatic carriers in Iranshahr district of Sistan and Baluchistan Province (2013-2014), with a considerable population movement, during the malaria elimination phase in Iran. METHODS Finger-prick blood samples were collected from symptomless (n=250) and febrile (n=50) individuals residing in Iranshahr district, easthern Iran (Hoodian, Mand, Chah-e Giji, Jolgehashem, Esfand, Dalgan and Chahshour) during Jan 2013 to Dec 2014, and Plasmodium infections were detected using light microscopic and highly sensitive nested-PCR techniques. RESULTS Thick and thin Giemsa-stained blood smears were negative for Plasmodium parasites. In addition, based on nested-PCR analysis, no P. vivax, P. falciparum, and P. malariae parasites were detected among the studied individuals. CONCLUSION Investigation the absence of asymptomatic carriers in Iranshahr district was illustrated and achieving malaria elimination in this area is feasible in a near future.
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Affiliation(s)
- Sakineh PIRAHMADI
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Tehran, Iran
| | - Sedigheh ZAKERI
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Tehran, Iran,Correspondence
| | - Ahmad RAEISI
- National Programme Manager for Malaria Control, Ministry of Health and Medical Education, Tehran, Iran
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Barrios EDD, Russomando G, Puerto FD. Absence of asymptomatic cases of malaria in a historically endemic indigenous locality of the Department of Caaguazú, Paraguay: moving toward elimination. Rev Soc Bras Med Trop 2016; 49:637-640. [PMID: 27812662 DOI: 10.1590/0037-8682-0197-2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/05/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Paraguay was among the 16 countries that reported zero indigenous malaria cases in 2014. METHODS: A cross-sectional observational descriptive study was performed in 100 adults from Santa Teresa, Paraguay. Parasite detection was carried out using seminested multiplex polymerase chain reaction (PCR) and microscopy. RESULTS Among the participants, 44% were female and 56% were male, and 89% had a malaria history. No parasites were detected with either of the methods. CONCLUSIONS: There were no asymptomatic cases in Santa Teresa, and this finding is very promising. A longitudinal study should be performed to confirm that there are no asymptomatic cases in this locality.
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Affiliation(s)
| | - Graciela Russomando
- Departamento de Biología Molecular y Biotecnología. Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Paraguay
| | - Florencia Del Puerto
- Departamento de Medicina Tropical, Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Asunción, Paraguay
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Norouzinejad F, Ghaffari F, Raeisi A, norouzinejad A. Epidemiological status of malaria in Iran, 2011–2014. ASIAN PAC J TROP MED 2016; 9:1055-1061. [DOI: 10.1016/j.apjtm.2016.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/20/2016] [Accepted: 09/02/2016] [Indexed: 10/20/2022] Open
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Hussain I, Qureshi NA, Afzal M, Shaheen N, Ali A, Ashraf A. Prevalence and distribution of human Plasmodium infection in Federally Administrative Tribal Areas of Pakistan. Acta Parasitol 2016; 61:537-43. [PMID: 27447217 DOI: 10.1515/ap-2016-0071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 03/09/2016] [Indexed: 11/15/2022]
Abstract
About 3.6 million Pashtun and over 1.5 million immigrants from Afghanistan live in the federally administered tribal areas (FATA) on the border between Pakistan's Khyber Pakhtunkhwa Province and southern Afghanistan. Although malaria cases are common in FATA, no detailed studies have yet been performed to reveal the actual status of malaria in the local population and epidemiological data are insufficient to elucidate the actual incidence. A malariometric survey of 691 patients of all ages and genders in seven agencies (districts) in FATA was carried out in 2013 using whole blood samples. Microscopically confirmed positive species were subjected to nested-PCR for the reconfirmation and detection of four species of Plasmodium causing human malaria. Of the 626 PCR positive cases, 81.1% were P. vivax, 13.8% P. falciparum and 4.9% mixed species containing both P. vivax and P. falciparum. P. malariae and P. ovale and were not found in any analysis. Sixty-five microscopic positive samples were identified as negative by PCR. The incidence of P. vivax ranged from 10.4% in Orakzai Agency to 22.8% in North Waziristan Agency. The prevalence of P. falciparum ranged from 1.3% in Orakzai Agency to 4.7% in North Waziristan, and Khyber Agency had the highest prevalence of 1.7% of mixed species. In FATA, P. vivax and P. falciparum are the main causative agents of malaria, while mixed species infections are also prevalent with varying transmission intensities. In addition, Estimates of malaria incidence shows that variation in the incidence, frequency and species composition of malarial parasites is high.
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Zakeri S, van den Hoogen LL, Mehrizi AA, Karimi F, Raeisi A, Drakeley C. Anti-malarial seroprevalence assessment during an elimination programme in Chabahar District, south-eastern Iran. Malar J 2016; 15:382. [PMID: 27448606 PMCID: PMC4957887 DOI: 10.1186/s12936-016-1432-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/06/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Iran has achieved a substantial decline in malaria incidence over the past decades. A common feature of malaria-endemic settings is the requirement for more sensitive techniques to describe levels of low transmission. In this study, serological and parasitological methods were used to measure transmission levels of Plasmodium falciparum and Plasmodium vivax during an elimination programme (2012) in Chabahar District, Sistan and Baluchistan Province, south-eastern Iran. METHODS Participants were randomly selected from 64 different geographical clusters in Chabahar city and surrounding villages. Antibody responses to P. falciparum and P. vivax blood-stage antigens were assessed by ELISA, while microscopy and molecular testing were used to determine parasite carriage by species. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCR). RESULTS There was no evidence of recent transmission in the study areas, indicated by an absence of parasite infections in all ages and low or absent serological responses to either species in young children. The best model for age P. falciparum seroconversion was one with a change in exposure 21 years before sampling was done in Chabahar city (P = 0.018) and 4 years in the villages (P = 0.039). There was a higher level of recent P. vivax transmission compared to P. falciparum, based on the SCRs, in both the city and village settings. CONCLUSION Serological analysis identified a decline in P. falciparum transmission in the urban areas of Chabahar, consistent with a previously described decrease in malaria in the early 1990s, demonstrating the utility of this approach to reconstruct exposure history. At present, it remains unclear whether the P. vivax antibody responses reflect active transmission due to new infections or relapse infections. The absence of parasitological and serological evidence of recent malaria transmission in Chabahar District is viable evidence for certification of elimination.
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MESH Headings
- Adolescent
- Adult
- Aged
- Antibodies, Protozoan/blood
- Child
- Child, Preschool
- Cross-Sectional Studies
- DNA, Protozoan/analysis
- DNA, Protozoan/genetics
- Disease Eradication
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Iran/epidemiology
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/immunology
- Malaria, Falciparum/parasitology
- Malaria, Vivax/epidemiology
- Malaria, Vivax/immunology
- Malaria, Vivax/parasitology
- Male
- Microscopy
- Middle Aged
- Plasmodium falciparum/immunology
- Plasmodium falciparum/isolation & purification
- Plasmodium vivax/immunology
- Plasmodium vivax/isolation & purification
- Polymerase Chain Reaction
- Seroepidemiologic Studies
- Urban Population
- Young Adult
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Affiliation(s)
- Sedigheh Zakeri
- />Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BCR), Pasteur Institute, P.O. Box: 1316943551, Tehran, Iran
| | | | - Akram Abouie Mehrizi
- />Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BCR), Pasteur Institute, P.O. Box: 1316943551, Tehran, Iran
| | - Fatemh Karimi
- />Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BCR), Pasteur Institute, P.O. Box: 1316943551, Tehran, Iran
| | - Ahmad Raeisi
- />National Programme Manager for Malaria Control, Ministry of Health and Medical Education, Tehran, Iran
- />School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Chris Drakeley
- />Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
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Chihanga S, Haque U, Chanda E, Mosweunyane T, Moakofhi K, Jibril HB, Motlaleng M, Zhang W, Glass GE. Malaria elimination in Botswana, 2012-2014: achievements and challenges. Parasit Vectors 2016; 9:99. [PMID: 26911433 PMCID: PMC4765051 DOI: 10.1186/s13071-016-1382-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/16/2016] [Indexed: 12/25/2022] Open
Abstract
Background Botswana significantly reduced its malaria burden between 2000 and 2012. Incidence dropped from 0.99 to 0.01 % and deaths attributed to malaria declined from 12 to 3. The country initiated elimination strategies in October 2012. We examine the progress and challenges during implementation and identify future needs for a successful program in Botswana. Methods A national, rapid notification and response strategy was developed. Cases detected through the routine passive surveillance system at health facilities were intended to initiate screening of contacts around a positive case during follow up. Positive cases were reported to district health management teams to activate district rapid response teams (DRRT). The health facility and the DRRT were to investigate the cases, and screen household members within 100 m of case households within 48 h of notification using rapid diagnostic tests (RDT) and microscopy. Positive malaria cases detected in health facilities were used for spatial analysis. Results There were 1808 malaria cases recorded in Botswana during 26 months from October, 2012 to December, 2014. Males were more frequently infected (59 %) than females. Most cases (60 %) were reported from Okavango district which experienced an outbreak in 2013 and 2014. Among the factors creating challenges for malaria eradication, only 1148 cases (63.5 %) were captured by the required standardized notification forms. In total, 1080 notified cases were diagnosed by RDT. Of the positive malaria cases, only 227 (12.6 %) were monitored at the household level. One hundred (8.7 %) cases were associated with national or transnational movement of patients. Local movements of infected individuals within Botswana accounted for 31 cases while 69 (6.01 %) cases were imported from other countries. Screening individuals in and around index households identified 37 additional, asymptomatic infections. Oscillating, sporadic and new malaria hot-spots were detected in Botswana during the study period. Conclusion Botswana’s experience shows some of the practical challenges of elimination efforts. Among them are the substantial movements of human infections within and among countries, and the persistence of asymptomatic reservoir infections. Programmatically, challenges include improving the speed of communicating and improving the thoroughness when responding to newly identified cases. The country needs further sustainable interventions to target infections if it is to successfully achieve its elimination goal.
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Affiliation(s)
- Simon Chihanga
- National Malaria Programme, Ministry of Health, Gaborone, Botswana.
| | - Ubydul Haque
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA. .,Department of Geography, University of Florida, Gainesville, Florida, USA.
| | - Emmanuel Chanda
- Vector Control Specialist/Consultant, 11 Granite Street, Plot 33421/917 Kamwa South, Lusaka, Zambia.
| | | | | | | | - Mpho Motlaleng
- National Malaria Programme, Ministry of Health, Gaborone, Botswana.
| | - Wenyi Zhang
- Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China.
| | - Gregory E Glass
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA. .,Department of Geography, University of Florida, Gainesville, Florida, USA.
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AMIRSHEKARI MB, NATEGHPOUR M, RAEISI A, MOTEVALLI HAGHI A, FARIVAR L, EDRISSIAN G. Determination of Asymptomatic Malaria among Afghani and Pakistani Immigrants and Native Population in South of Kerman Province, Iran. IRANIAN JOURNAL OF PARASITOLOGY 2016; 11:247-252. [PMID: 28096860 PMCID: PMC5236103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study was proposed to monitor the situation of asymptomatic malaria among the native population and Afghani and Pakistani immigrants in Kahnooj and Ghale-Ganj districts from Kerman Province, Southeastern Iran. METHODS A number of 180 and 120 individuals from Kahnooj and Ghale-Ganj respectively were registered and considered based on a cross-sectional surveillance method. From 300 registered cases, 200 individuals (66.7%) were selected among Afghani and Pakistani immigrants and the rest (33.3%) were native resident individuals. All samples were processed with employing microscopical examination, Rapid Diagnostic Tests (RDTs) and Semi- nested Multiplex PCR techniques. RESULTS None of the samples collected from native residents showed any malaria parasite, but among Afghani immigrants, one asymptomatic vivax malaria was detected in a 12 yr old girl with 280 parasites per microliter of blood. Moreover, one symptomatic vivax malaria was detected from a Pakistani immigrant with 47560 parasites per microliter of blood. All results obtained via microscopical method, confirmed by RDTs and PCR techniques. CONCLUSION To achieve the malaria elimination program different studies are needed that to be performed. Monitoring the asymptomatic malaria in all over the malaria endemic areas especially among the immigrant individuals is the most crucial necessity.
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Affiliation(s)
- Mohammad Bagher AMIRSHEKARI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi NATEGHPOUR
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Center for Research of Endemic Parasites in Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran,Correspondence
| | - Ahmad RAEISI
- Center for Disease Control and Management, Ministry of Health &Medical Education, Tehran, Iran
| | - Afsaneh MOTEVALLI HAGHI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila FARIVAR
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamhosein EDRISSIAN
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Population-Based Seroprevalence of Malaria in Hormozgan Province, Southeastern Iran: A Low Transmission Area. Malar Res Treat 2015; 2015:174570. [PMID: 26543662 PMCID: PMC4620240 DOI: 10.1155/2015/174570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/13/2015] [Accepted: 09/21/2015] [Indexed: 11/18/2022] Open
Abstract
The seroepidemiological condition of malaria in three main districts of Hormozgan Province, a low transmission area in southeast of Iran, was investigated. Methods. Sera samples (803) were collected from healthy volunteers from the three main districts (Bandar Lengeh in the west, Bandar Abbas in the center, and Bandar Jask in the east) of Hormozgan Province. A questionnaire was used to record the sociodemographic features of the participants during sample collecting. An in-house ELISA test, using crude antigens obtained from cell culture of Plasmodium falciparum, was adapted and used to detect anti-malaria antibodies in the sera. Results. The overall seroprevalence of malaria was 8.7% (70 out of 803 samples). A significant correlation was found between seropositivity and place of residence, where the highest rate of seropositivity was seen in Bandar Lengeh (west of the province). The highest seroprevalence of malaria (13.2%) was seen in the age group of 11-20 years and also in low educated individuals. Correlation between seropositivity and gender, age, and educational levels of the participants was statistically significant (P < 0.05). Conclusion. Findings of this study indicate that the rate of seropositivity to malaria in this area is not high and this might be linked to the success of malaria control programs during the last decades in the region.
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A systematic review of sub-microscopic Plasmodium vivax infection. Malar J 2015; 14:360. [PMID: 26390924 PMCID: PMC4578340 DOI: 10.1186/s12936-015-0884-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/02/2015] [Indexed: 12/26/2022] Open
Abstract
Background An accurate estimate of Plasmodiumvivax prevalence is essential for the successful implementation of malaria control and elimination programmes. Prevalence estimates both inform control strategies and are used in their evaluation. Light microscopy is the main method for detecting Plasmodium parasitaemia in the peripheral blood, but compared to molecular diagnostics, such as polymerase chain reaction (PCR), has limited sensitivity. Methods A systematic review and meta-analysis was conducted to assess the effect of detection method on the prevalence of P.vivax and to quantify the extent to which P. vivax infections are undetected by microscopy. Embase, Medline and the Cochrane Database were searched for studies reporting prevalence by PCR and by microscopy and that contained all of the following key words: vivax, PCR, and malaria. Prevalence estimates and study meta-data were extracted systematically from each publication. Combined microscopy:PCR prevalence ratios were estimated by random effects meta-analysis. Sensitivity and specificity of microscopy were calculated using PCR as the gold standard. Results Of 874 studies reviewed, 40 met the criteria for inclusion contributing 54 prevalence pairs. The prevalence of P.vivax infection measured by PCR was consistently higher than the prevalence measured by microscopy with sub-patent parasitaemia. The mean prevalence of infection detected by microscopy was 67 % (95 % CI 59–73 %) lower than the prevalence detected by PCR. The detection of sub-patent parasitaemia did not vary according to the microscopy method (thick or, thick and thin smears), the PCR prevalence (as a measure of the true P.vivax prevalence), the type of blood used or DNA extraction method. Conclusions Quantifying P. vivax parasitaemia by PCR rather than microscopy consistently increased prevalence estimates by a factor of 2.3. Whilst the sensitivity of microscopy can be improved by better methods, molecular methods have potential to be scaled up to improve the detection of P. vivax transmission reservoirs. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0884-z) contains supplementary material, which is available to authorized users.
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Dhiman S, Goswami D, Rabha B, Yadav K, Chattopadhyay P, Veer V. Absence of asymptomatic malaria in a cohort of 133 individuals in a malaria endemic area of Assam, India. BMC Public Health 2015; 15:919. [PMID: 26384971 PMCID: PMC4575429 DOI: 10.1186/s12889-015-2294-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 09/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria in northeast India affects children and adults annually. The number of malaria cases reported has declined over the past few years. Nevertheless, it is not clear whether there is an actual decline in parasitaemia or whether asymptomatic malaria infections are on the rise, especially in forested and forest-fringed areas. Asymptomatic malaria forms a parasite reservoir that acts as an epicentre for malaria spread during high-transmission season. Therefore it is important to understand the quantum of asymptomatic malaria infections among the vulnerable population. METHOD Four forest fringed historically malaria endemic villages were selected for the study. A total of 133 individuals without a fever history in the past four weeks were tested for malaria parasite using rapid diagnostic test (RDT), microscopy and polymerase chain reaction (PCR) assay during January - February 2014. Indoor resting Anopheles vectors were collected, identified and tested for sporozoite using VectorTest™ panel assay during October 2013 to March 2014, which is a low transmission season for malaria. Social and demographic data were recorded during the study. RESULTS Mean age (± SEM) of the participants was 16.1 ± 1.2 years (95 % CI: 13.8-18.4). All participants (100 %) reported to use mosquito nets. Altogether, 43.6 % of participants had education below primary level and only 9 % reported a travel history during the past four weeks. All RDT, microscopy and PCR assays were found negative indicating no asymptomatic malaria parasitaemia. Seven known malaria vector species namely, Anopheles nivipes, An. minimus, An. annularis, An. vagus, An. aconitus, An. philippinensis and An. culicifacies, were recorded in the present study. VectorTest™ sporozoite panel assay conducted on 45 pools (N = 224) of vector mosquitoes were found negative for Plasmodium sporozoite. DISCUSSION Northeastern states of India report asymptomatic malaria parasitemia along with high malaria transmission. An. minimus and An. dirus are recognised as efficient vectors, but An. culicifacies, An. philippinensis and An. annularis also play role in malaria transmission. Currently all participants were found negative for asymptomatic malaria, however the small sample size may restrict the scope of present results to the population living in more remote areas. CONCLUSION No cases of asymptomatic malaria infections parasitaemia was found in the present study conducted during a low transmission season indicating that asymptomatic malaria parasitaemia may not be prevalent in the region. Mosquito specimens were tested negative for the malaria sporozoites. Study findings encourage the ongoing malaria intervention efforts and recommends similar investigations in different ecological areas involving large populations.
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Affiliation(s)
- Sunil Dhiman
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
| | - Diganta Goswami
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
| | - Bipul Rabha
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
| | - Kavita Yadav
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
| | - Pronobesh Chattopadhyay
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
| | - Vijay Veer
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India, 784 001.
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Mathema VB, Na-Bangchang K. A brief review on biomarkers and proteomic approach for malaria research. ASIAN PAC J TROP MED 2015; 8:253-62. [DOI: 10.1016/s1995-7645(14)60327-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Talha AA, Pirahmadi S, Mehrizi AA, Djadid ND, Nour BYM, Zakeri S. Molecular genetic analysis of Plasmodium vivax isolates from Eastern and Central Sudan using pvcsp and pvmsp-3α genes as molecular markers. INFECTION GENETICS AND EVOLUTION 2015; 32:12-22. [PMID: 25721363 DOI: 10.1016/j.meegid.2015.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Abstract
In Sudan, Plasmodium vivax accounts for approximately 5-10% of malaria cases. This study was carried out to determine the genetic diversity of P. vivax population from Sudan by analyzing the polymorphism of P. vivax csp (pvcsp) and pvmsp-3α genes. Blood samples (n=76) were taken from suspected malaria cases from 2012-2013 in three health centers of Eastern and Central Sudan. Parasite detection was performed by microscopy and molecular techniques, and genotyping of both genes was performed by PCR-RFLP followed by DNA sequence for only pvcsp gene (n=30). Based on microscopy analysis, 76 (%100) patients were infected with P. vivax, whereas nested-PCR results showed that 86.8% (n=66), 3.9% (n=3), and 3.9% (n=3) of tested samples had P. vivax as well as Plasmodium falciparum mono- and mixed infections, respectively. Four out of 76 samples had no results in molecular diagnosis. All sequenced samples were found to be of VK210 (100%) genotype with six distinct amino acid haplotypes, and 210A (66.7%) was the most prevalent haplotype. The Sudanese isolates displayed variations in the peptide repeat motifs (PRMs) ranging from 17 to 19 with GDRADGQPA (PRM1), GDRAAGQPA (PRM2) and DDRAAGQPA (PRM3). Also, 54 polymorphic sites with 56 mutations were found in repeat and post-repeat regions of the pvcsp and the overall nucleotide diversity (π) was 0.02149±0.00539. A negative value of dN-dS (-0.0344) was found that suggested a significant purifying selection of Sudanese pvcsp, (Z test, P<0.05). Regarding pvmsp-3α, three types were detected: types A (94.6%, 52/55), type C (3.6%, 2/55), and type B (1.8%, 1/55). No multiclonal infections were detected, and RFLP analysis identified 13 (Hha I, A1-A11, B1, and C1) and 16 (Alu I, A1-A14, B1, and C1) distinct allelic forms. In conclusion, genetic investigation among Sudanese P. vivax isolates indicated that this antigen showed limited antigenic diversity.
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Affiliation(s)
- Albadawi Abdelbagi Talha
- Department of Parasitology, Blue Nile National Institute for Communicable Diseases, University of Gezira, P.O. Box 20, Wad Medani, Sudan; Department of Parasitology, Faculty of Medical Laboratory Sciences, University of Gezira, P.O. Box 20, Wad Medani, Sudan
| | - Sekineh Pirahmadi
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Pasteur Avenue, P.O. Box 1316943551, Tehran, Iran
| | - Akram Abouie Mehrizi
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Pasteur Avenue, P.O. Box 1316943551, Tehran, Iran
| | - Navid Dinparast Djadid
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Pasteur Avenue, P.O. Box 1316943551, Tehran, Iran
| | - Bakri Y M Nour
- Department of Parasitology, Blue Nile National Institute for Communicable Diseases, University of Gezira, P.O. Box 20, Wad Medani, Sudan; Department of Parasitology, Faculty of Medical Laboratory Sciences, University of Gezira, P.O. Box 20, Wad Medani, Sudan
| | - Sedigheh Zakeri
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Pasteur Avenue, P.O. Box 1316943551, Tehran, Iran.
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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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Lucchi NW, Karell MA, Journel I, Rogier E, Goldman I, Ljolje D, Huber C, Mace KE, Jean SE, Akom EE, Oscar R, Buteau J, Boncy J, Barnwell JW, Udhayakumar V. PET-PCR method for the molecular detection of malaria parasites in a national malaria surveillance study in Haiti, 2011. Malar J 2014; 13:462. [PMID: 25428550 PMCID: PMC4289323 DOI: 10.1186/1475-2875-13-462] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/19/2014] [Indexed: 12/30/2022] Open
Abstract
Background Recently, a real-time PCR assay known as photo-induced electron transfer (PET)-PCR which relies on self-quenching primers for the detection of Plasmodium spp. and Plasmodium falciparum was described. PET-PCR assay was found to be robust, and easier to use when compared to currently available real-time PCR methods. The potential of PET-PCR for molecular detection of malaria parasites in a nationwide malaria community survey in Haiti was investigated. Methods DNA from the dried blood spots was extracted using QIAGEN methodology. All 2,989 samples were screened using the PET-PCR assay in duplicate. Samples with a cycle threshold (CT) of 40 or less were scored as positive. A subset of the total samples (534) was retested using a nested PCR assay for confirmation. In addition, these same samples were also tested using a TaqMan-based real-time PCR assay. Results A total of 12 out of the 2,989 samples screened (0.4%) were found to be positive by PET-PCR (mean CT value of 35.7). These same samples were also found to be positive by the nested and TaqMan-based methods. The nested PCR detected an additional positive sample in a subset of 534 samples that was not detected by either PET-PCR or TaqMan-based PCR method. Conclusion While the nested PCR was found to be slightly more sensitive than the PET-PCR, it is not ideal for high throughput screening of samples. Given the ease of use and lower cost than the nested PCR, the PET-PCR provides an alternative assay for the rapid screening of a large number of samples in laboratory settings.
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Affiliation(s)
- Naomi W Lucchi
- Centers for Disease Control and Prevention, Center for Global Health, Division of Parasitic Diseases and Malaria, Malaria Branch, Atlanta, GA, USA.
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Teboh-Ewungkem MI, Mohammed-Awel J, Baliraine FN, Duke-Sylvester SM. The effect of intermittent preventive treatment on anti-malarial drug resistance spread in areas with population movement. Malar J 2014; 13:428. [PMID: 25398463 PMCID: PMC4289180 DOI: 10.1186/1475-2875-13-428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/25/2014] [Indexed: 11/30/2022] Open
Abstract
Background The use of intermittent preventive treatment in pregnant women (IPTp), children (IPTc) and infant (IPTi) is an increasingly popular preventive strategy aimed at reducing malaria risk in these vulnerable groups. Studies to understand how this preventive intervention can affect the spread of anti-malarial drug resistance are important especially when there is human movement between neighbouring low and high transmission areas. Because the same drug is sometimes utilized for IPTi and for symptomatic malaria treatment, distinguishing their individual roles on accelerating the spread of drug resistant malaria, with or without human movement, may be difficult to isolate experimentally or by analysing data. A theoretical framework, as presented here, is thus relevant as the role of IPTi on accelerating the spread of drug resistance can be isolated in individual populations and when the populations are interconnected and interact. Methods A previously published model is expanded to include human movement between neighbouring high and low transmission areas, with focus placed on the malaria parasites. Parasite fitness functions, determined by how many humans the parasites can infect, are used to investigate how fast resistance can spread within the neighbouring communities linked by movement, when the populations are at endemic equilibrium. Results Model simulations indicate that population movement results in resistance spreading fastest in high transmission areas, and the more complete the anti-malarial resistance the faster the resistant parasite will tend to spread through a population. Moreover, the demography of infection in low transmission areas tends to change to reflect the demography of high transmission areas. Additionally, when regions are strongly connected the rate of spread of partially resistant parasites (R1) relative to drug sensitive parasites (RS), and fully resistant parasites (R2) relative to partially resistant parasites (R1) tend to behave the same in both populations, as should be expected. Conclusions In fighting anti-malarial drug resistance, different drug resistance monitoring and management policies are needed when the area in question is an isolated high or low transmission area, or when it is close and interacting with a neighbouring high or low transmission area, with human movement between them. Electronic supplementary material The online version of this article (doi:10.1186/1475-2875-13-428) contains supplementary material, which is available to authorized users.
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