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Maher SP, Bakowski MA, Vantaux A, Flannery EL, Andolina C, Gupta M, Antonova-Koch Y, Argomaniz M, Cabrera-Mora M, Campo B, Chao AT, Chatterjee AK, Cheng WT, Chuenchob E, Cooper CA, Cottier K, Galinski MR, Harupa-Chung A, Ji H, Joseph SB, Lenz T, Lonardi S, Matheson J, Mikolajczak SA, Moeller T, Orban A, Padín-Irizarry V, Pan K, Péneau J, Prudhomme J, Roesch C, Ruberto AA, Sabnis SS, Saney CL, Sattabongkot J, Sereshki S, Suriyakan S, Ubalee R, Wang Y, Wasisakun P, Yin J, Popovici J, McNamara CW, Joyner CJ, Nosten F, Witkowski B, Le Roch KG, Kyle DE. A Drug Repurposing Approach Reveals Targetable Epigenetic Pathways in Plasmodium vivax Hypnozoites. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.01.31.526483. [PMID: 36778461 PMCID: PMC9915689 DOI: 10.1101/2023.01.31.526483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Radical cure of Plasmodium vivax malaria must include elimination of quiescent 'hypnozoite' forms in the liver; however, the only FDA-approved treatments are contraindicated in many vulnerable populations. To identify new drugs and drug targets for hypnozoites, we screened the Repurposing, Focused Rescue, and Accelerated Medchem (ReFRAME) library and a collection of epigenetic inhibitors against P. vivax liver stages. From both libraries, we identified inhibitors targeting epigenetics pathways as selectively active against P. vivax and P. cynomolgi hypnozoites. These include DNA methyltransferase (DNMT) inhibitors as well as several inhibitors targeting histone post-translational modifications. Immunofluorescence staining of Plasmodium liver forms showed strong nuclear 5-methylcystosine signal, indicating liver stage parasite DNA is methylated. Using bisulfite sequencing, we mapped genomic DNA methylation in sporozoites, revealing DNA methylation signals in most coding genes. We also demonstrated that methylation level in proximal promoter regions as well as in the first exon of the genes may affect, at least partially, gene expression in P. vivax. The importance of selective inhibitors targeting epigenetic features on hypnozoites was validated using MMV019721, an acetyl-CoA synthetase inhibitor that affects histone acetylation and was previously reported as active against P. falciparum blood stages. In summary, our data indicate that several epigenetic mechanisms are likely modulating hypnozoite formation or persistence and provide an avenue for the discovery and development of improved radical cure antimalarials.
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Affiliation(s)
- S. P. Maher
- Center for Tropical & Emerging Global Disease, University of Georgia; Athens, GA, 30602, USA
| | - M. A. Bakowski
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - A. Vantaux
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - E. L. Flannery
- Novartis Institute for Tropical Diseases, Novartis Institutes for Biomedical Research; Emeryville, CA, 94608, USA
| | - C. Andolina
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit; Mae Sot, Tak, 63110, Thailand
| | - M. Gupta
- Department of Molecular, Cell, and Systems Biology, University of California; Riverside, CA, 92521, USA
| | - Y. Antonova-Koch
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - M. Argomaniz
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
| | - M. Cabrera-Mora
- International Center for Malaria Research, Education and Development, Emory Vaccine Center, Emory National Primate Research Center, Emory University; Atlanta, GA, 30329, USA
| | - B. Campo
- Medicines for Malaria Venture (MMV); Geneva, 1215, Switzerland
| | - A. T. Chao
- Novartis Institute for Tropical Diseases, Novartis Institutes for Biomedical Research; Emeryville, CA, 94608, USA
| | - A. K. Chatterjee
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - W. T. Cheng
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
| | - E. Chuenchob
- Novartis Institute for Tropical Diseases, Novartis Institutes for Biomedical Research; Emeryville, CA, 94608, USA
| | - C. A. Cooper
- Center for Tropical & Emerging Global Disease, University of Georgia; Athens, GA, 30602, USA
| | | | - M. R. Galinski
- International Center for Malaria Research, Education and Development, Emory Vaccine Center, Emory National Primate Research Center, Emory University; Atlanta, GA, 30329, USA
- Division of Infectious Diseases, Department of Medicine, Emory University; Atlanta, GA, 30329, USA
| | - A. Harupa-Chung
- Novartis Institute for Tropical Diseases, Novartis Institutes for Biomedical Research; Emeryville, CA, 94608, USA
| | - H. Ji
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
| | - S. B. Joseph
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - T. Lenz
- Department of Molecular, Cell, and Systems Biology, University of California; Riverside, CA, 92521, USA
| | - S. Lonardi
- Department of Computer Science and Engineering, University of California; Riverside, CA, 92521, USA
| | - J. Matheson
- Department of Microbiology and Immunology, University of Otago; Dunedin, 9016, New Zealand
| | - S. A. Mikolajczak
- Novartis Institute for Tropical Diseases, Novartis Institutes for Biomedical Research; Emeryville, CA, 94608, USA
| | | | - A. Orban
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - V. Padín-Irizarry
- Center for Tropical & Emerging Global Disease, University of Georgia; Athens, GA, 30602, USA
- School of Sciences, Clayton State University; Morrow, GA, 30260, USA
| | - K. Pan
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - J. Péneau
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - J. Prudhomme
- Department of Molecular, Cell, and Systems Biology, University of California; Riverside, CA, 92521, USA
| | - C. Roesch
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - A. A. Ruberto
- Center for Tropical & Emerging Global Disease, University of Georgia; Athens, GA, 30602, USA
| | - S. S. Sabnis
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
| | - C. L. Saney
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
| | - J. Sattabongkot
- Mahidol Vivax Research Unit, Mahidol University; Bangkok, 10400, Thailand
| | - S. Sereshki
- Department of Computer Science and Engineering, University of California; Riverside, CA, 92521, USA
| | - S. Suriyakan
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit; Mae Sot, Tak, 63110, Thailand
| | - R. Ubalee
- Department of Entomology, Armed Forces Research Institute of Medical Sciences (AFRIMS); Bangkok, 10400, Thailand
| | - Y. Wang
- Department of Chemistry, University of California; Riverside, CA, 92521
- Environmental Toxicology Graduate Program, University of California; Riverside, CA, 92521, USA
| | - P. Wasisakun
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit; Mae Sot, Tak, 63110, Thailand
| | - J. Yin
- Environmental Toxicology Graduate Program, University of California; Riverside, CA, 92521, USA
| | - J. Popovici
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - C. W. McNamara
- Calibr, a division of The Scripps Research Institute; La Jolla, CA, 92037, USA
| | - C. J. Joyner
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia; Athens, GA, 30602, USA
- International Center for Malaria Research, Education and Development, Emory Vaccine Center, Emory National Primate Research Center, Emory University; Atlanta, GA, 30329, USA
| | - F. Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit; Mae Sot, Tak, 63110, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford; Oxford, OX3 7LG, UK
| | - B. Witkowski
- Malaria Molecular Epidemiology Unit, Institute Pasteur of Cambodia; Phnom Penh, 120 210, Cambodia
| | - K. G. Le Roch
- Department of Molecular, Cell, and Systems Biology, University of California; Riverside, CA, 92521, USA
| | - D. E. Kyle
- Center for Tropical & Emerging Global Disease, University of Georgia; Athens, GA, 30602, USA
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Pepey A, Souris M, Kim S, Obadia T, Chy S, Ea M, Ouk S, Remoue F, Sovannaroth S, Mueller I, Witkowski B, Vantaux A. Comparing malaria risk exposure in rural Cambodia population using GPS tracking and questionnaires. Malar J 2024; 23:75. [PMID: 38475843 DOI: 10.1186/s12936-024-04890-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The Great Mekong Subregion has attained a major decline in malaria cases and fatalities over the last years, but residual transmission hotspots remain, supposedly fueled by forest workers and migrant populations. This study aimed to: (i) characterize the fine-scale mobility of forest-goers and understand links between their daily movement patterns and malaria transmission, using parasites detection via real time polymerase chain reaction (RT PCR) and the individual exposure to Anopheles bites by quantification of anti-Anopheles saliva antibodies via enzyme-linked immunosorbent assay; (ii) assess the concordance of questionnaires and Global Positioning System (GPS) data loggers for measuring mobility. METHODS Two 28 day follow-ups during dry and rainy seasons, including a GPS tracking, questionnaires and health examinations, were performed on male forest goers representing the population at highest risk of infection. Their time spent in different land use categories and demographic data were analyzed in order to understand the risk factors driving malaria in the study area. RESULTS Malaria risk varied with village forest cover and at a resolution of only a few kilometers: participants from villages outside the forest had the highest malaria prevalence compared to participants from forest fringe's villages. The time spent in a specific environment did not modulate the risk of malaria, in particular the time spent in forest was not associated with a higher probability to detect malaria among forest-goers. The levels of antibody response to Anopheles salivary peptide among participants were significantly higher during the rainy season, in accordance with Anopheles mosquito density variation, but was not affected by sociodemographic and mobility factors. The agreement between GPS and self-reported data was only 61.9% in reporting each kind of visited environment. CONCLUSIONS In a context of residual malaria transmission which was mainly depicted by P. vivax asymptomatic infections, the implementation of questionnaires, GPS data-loggers and quantification of anti-saliva Anopheles antibodies on the high-risk group were not powerful enough to detect malaria risk factors associated with different mobility behaviours or time spent in various environments. The joint implementation of GPS trackers and questionnaires allowed to highlight the limitations of both methodologies and the benefits of using them together. New detection and follow-up strategies are still called for.
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Affiliation(s)
- Anaïs Pepey
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia.
| | - Marc Souris
- UMR Unité des Virus Emergents, UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU 5 Méditerranée Infection, 13005, Marseille, France
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
| | - Thomas Obadia
- Institut Pasteur, G5 Infectious Disease Epidemiology and Analytics, Université Paris Cité, 75015, Paris, France
- Institut Pasteur, Bioinformatics and Biostatistics Hub, Université Paris Cité, 75015, Paris, France
| | - Sophy Chy
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
| | - Malen Ea
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
| | - Sivkeng Ouk
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
| | - Franck Remoue
- UMR MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
| | - Siv Sovannaroth
- National Centre for Parasitology Entomology and Malaria Control (CNM), Phnom Penh 120 801, Phnom Penh, Cambodia
| | - Ivo Mueller
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
- Genetic and Biology of Plasmodium Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, 5 Blvd Monivong, Phnom Penh 120 210, Phnom Penh, BP983, Cambodia
- Genetic and Biology of Plasmodium Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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Rajkonwar J, Shende V, Maji AK, Pandey A, Sharma PK, Gunasekaran K, Subbarao SK, Bhattacharyya DR, Raghavendra K, Pebam R, Mayakrishnan V, Gogoi P, Senapati S, Sarkar P, Biswas S, Debbarma D, Nirmolia T, Jena SR, Bayan B, Talukder P, Sihag AK, Bharali HS, Verma A, Mahanta K, Sumer G, Karmakar R, Patgiri SJ, Chaudhuri S, Ganguli S, Kaur H, Bhattacharyya TK, Joshi PL, Goswami B, Baruah K, Pati S, Narain K, Bhowmick IP. First Report of Anopheles annularis s.l., An. maculatus s.s., and An. culicifacies s.l. as Malaria Vectors and a New Occurrence Record for An. pseudowillmori and An. sawadwongporni in Alipurduar District Villages, West Bengal, India. Microorganisms 2024; 12:95. [PMID: 38257922 PMCID: PMC10818895 DOI: 10.3390/microorganisms12010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
A comprehensive entomological survey was undertaken in Alipurduar District, West Bengal, from 2018 to 2020 and in 2022. This study was prompted by reported malaria cases and conducted across nine villages, seven Sub-Centres, and three Primary Health Centres (PHCs). Mosquitoes were hand-collected with aspirators and flashlights from human dwellings and cattle sheds during the daytime. Both morphological and molecular techniques were used for species identification. Additionally, mosquitoes were tested for Plasmodium parasites and human blood presence. Mosquito species such as An. barbirostris s.l., An. hyrcanus s.l., An. splendidus, and An. vagus were morphologically identified. For species like An. annularis s.l., An. minimus s.s., An. culicifacies s.l., and An. maculatus s.s., a combination of morphological and molecular techniques was essential. The mitochondrial cytochrome c oxidase gene subunit 1 (CO1) was sequenced for An. annularis s.l., An. maculatus s.s., An. culicifacies s.l., An. vagus, and some damaged samples, revealing the presence of An. pseudowillmori and An. fluviatilis. The major Anopheles species were An. annularis s.l., An. culicifacies s.l., and An. maculatus s.s., especially in Kumargram and Turturi PHCs. Plasmodium positivity was notably high in An. annularis s.l. and An. maculatus s.s. with significant human blood meal positivity across most species. Morphological, molecular, and phylogenetic analyses are crucial, especially for archived samples, to accurately identify the mosquito fauna of a region. Notably, this study confirms the first occurrence of An. pseudowillmori and An. sawadwongporni in West Bengal and implicates An. maculatus s.s., An. culicifacies s.l., and An. annularis s.l. as significant vectors in the Alipurduar region.
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Affiliation(s)
- Jadab Rajkonwar
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Varun Shende
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Ananta Kumar Maji
- District Health & Family Welfare Samiti, Alipurduar 736121, India; (A.K.M.); (S.C.); (S.G.)
| | - Apoorva Pandey
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, New Delhi 110029, India; (A.P.); (H.K.)
| | - Puran K. Sharma
- Department of Health & Family Welfare, Govt of West Bengal, Alipurduar 736121, India;
| | | | - Sarala K. Subbarao
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India;
| | - Dibya Ranjan Bhattacharyya
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Kamaraju Raghavendra
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India;
| | - Rocky Pebam
- NorthEast Space Application Centre (NESAC), Department of Space, Government of India, Umiam 793103, India; (R.P.); (D.D.)
| | - Vijay Mayakrishnan
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Phiroz Gogoi
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Susmita Senapati
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Pallabi Sarkar
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Saurav Biswas
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Daniel Debbarma
- NorthEast Space Application Centre (NESAC), Department of Space, Government of India, Umiam 793103, India; (R.P.); (D.D.)
| | | | - Sasmita Rani Jena
- Regional Office of Health and Family Welfare, Kolkata 700106, India; (S.R.J.); (T.K.B.)
| | - Bahniman Bayan
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Pinki Talukder
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Ashwarya Kumari Sihag
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Himadri Sankar Bharali
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Anisha Verma
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Kongkon Mahanta
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Gonsalo Sumer
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Ranjan Karmakar
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Saurav Jyoti Patgiri
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Supriya Chaudhuri
- District Health & Family Welfare Samiti, Alipurduar 736121, India; (A.K.M.); (S.C.); (S.G.)
| | - Sumit Ganguli
- District Health & Family Welfare Samiti, Alipurduar 736121, India; (A.K.M.); (S.C.); (S.G.)
| | - Harpreet Kaur
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, New Delhi 110029, India; (A.P.); (H.K.)
| | | | - Pyare Laal Joshi
- Directorate of National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi 110054, India; (P.L.J.); (K.B.)
| | | | - Kalpana Baruah
- Directorate of National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi 110054, India; (P.L.J.); (K.B.)
| | - Sanghamitra Pati
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Kanwar Narain
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
| | - Ipsita Pal Bhowmick
- Regional Medical Research Centre, Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (J.R.); (V.S.); (D.R.B.); (V.M.); (P.G.); (S.S.); (P.S.); (S.B.); (B.B.); (P.T.); (A.K.S.); (H.S.B.); (A.V.); (K.M.); (G.S.); (R.K.); (S.J.P.); (S.P.); (K.N.)
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4
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Koepfli C. Is qPCR always the most sensitive method for malaria diagnostic quality surveillance? Malar J 2023; 22:380. [PMID: 38102649 PMCID: PMC10722660 DOI: 10.1186/s12936-023-04822-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/13/2023] [Indexed: 12/17/2023] Open
Abstract
In many studies to evaluate the quality of malaria diagnosis, microscopy or rapid diagnostic tests (RDT) are compared to PCR. Depending on the method for sample collection and storage (whole blood or dried blood spot), volume of blood used for extraction, volume of DNA used as PCR template, and choice of PCR target (single vs. multi-copy gene), the limit of detection (LOD) of PCR might not exceed the LOD of expert microscopy or RDT. One should not assume that PCR always detects the highest number of infections.
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Affiliation(s)
- Cristian Koepfli
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA.
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5
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Abebe A, Bouyssou I, Mabilotte S, Dugassa S, Assefa A, Juliano JJ, Lo E, Menard D, Golassa L. Potential hidden Plasmodium vivax malaria reservoirs from low parasitemia Duffy-negative Ethiopians: Molecular evidence. PLoS Negl Trop Dis 2023; 17:e0011326. [PMID: 37399221 PMCID: PMC10348516 DOI: 10.1371/journal.pntd.0011326] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/14/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The interaction between the Plasmodium vivax Duffy-binding protein and the corresponding Duffy Antigen Receptor for Chemokines (DARC) is primarily responsible for the invasion of reticulocytes by P. vivax. The Duffy-negative host phenotype, highly prevalent in sub-Saharan Africa, is caused by a single point mutation in the GATA-1 transcription factor binding site of the DARC gene promoter. The aim of this study was to assess the Duffy status of patients with P. vivax infection from different study sites in Ethiopia. METHODS A cross-sectional study was conducted from February 2021 to September 2022 at five varying eco-epidemiological malaria endemic sites in Ethiopia. Outpatients who were diagnosed with P. vivax infection (pure and mixed P. vivax/P. falciparum) by microscopy and Rapid Diagnostic Test (RDT) were subjected to PCR genotyping at the DARC promoter. The associations between P. vivax infection, host genotypes and other factors were evaluated. RESULT In total, 361 patients with P. vivax infection were included in the study. Patients with pure P. vivax infections accounted for 89.8% (324/361), while the remaining 10.2% (37/361) had mixed P. vivax/P. falciparum infections. About 95.6% (345/361) of the participants were Duffy-positives (21.2% homozygous and 78.8%, heterozygous) and 4.4% (16/361) were Duffy-negatives. The mean asexual parasite density in homozygous and heterozygous Duffy-positives was 12,165 p/μl (IQR25-75: 1,640-24,234 p/μl) and11,655 p/μl (IQR25-75: 1,676-14,065 p/μl), respectively, significantly higher than that in Duffy-negatives (1,227p/μl; IQR25-75: 539-1,732p/μl). CONCLUSION This study confirms that Duffy-negativity does not provide complete protection against P. vivax infection. The development of P. vivax-specific elimination strategies, including alternative antimalarial vaccines should be facilitated by a better understanding of the epidemiological landscape of vivax malaria in Africa. More importantly, low parasitemia associated with P. vivax infections in Duffy-negative patients may represent hidden reservoirs of transmission in Ethiopia.
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Affiliation(s)
- Abnet Abebe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Isabelle Bouyssou
- Institut Pasteur, Université Paris Cité, Malaria Genetics and Resistance Unit, INSERM U1201, F-75015 Paris, France
- Sorbonne Université, Collège Doctoral ED 515 Complexité du Vivant, Paris, France
| | - Solenne Mabilotte
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Dynamics of Host-Pathogen Interactions, F-67000 Strasbourg, France
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jonathan J. Juliano
- Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eugenia Lo
- Department of Biological Sciences, Bioinformatics Research Center, University of North Carolina at Charlotte, United States of America
| | - Didier Menard
- Institut Pasteur, Université Paris Cité, Malaria Genetics and Resistance Unit, INSERM U1201, F-75015 Paris, France
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Dynamics of Host-Pathogen Interactions, F-67000 Strasbourg, France
- Institut Pasteur, Université Paris Cité, Malaria Parasite Biology and Vaccines Unit, Paris, France
- CHU Strasbourg, Laboratory of Parasitology and Medical Mycology, Strasbourg, France
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
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6
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Doum D, Mclver DJ, Hustedt J, Hii J, Sovannaroth S, Lek D, Richardson JH, Tatarsky A, Lobo NF. An active and targeted survey reveals asymptomatic malaria infections among high-risk populations in Mondulkiri, Cambodia. Malar J 2023; 22:193. [PMID: 37353790 DOI: 10.1186/s12936-023-04630-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/20/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Malaria is a mosquito-borne disease that is one of the most serious public health issues globally and a leading cause of mortality in many developing countries worldwide. Knowing the prevalence of both symptomatic and asymptomatic malaria on a subnational scale allows for the estimation of the burden of parasitaemia present in the transmission system, enabling targeting and tailoring of resources towards greater impact and better use of available capacity. This study aimed to determine the PCR-based point prevalence of malaria infection, by parasite species, among three high-risk populations in Mondulkiri province, Cambodia: forest rangers, forest dwellers, and forest goers. METHODS A cross-sectional survey was performed during the transmission season in November and December 2021. Blood samples collected on filter paper from participants (n = 1301) from all target groups were screened for Plasmodium spp using PCR. RESULTS Malaria prevalence among all study participants was 6.7% for any Plasmodium species. Malaria prevalence in the forest ranger group was 8.1%, was 6.8% in forest goers, and 6.4% in forest dwellers; all infections were asymptomatic. Plasmodium vivax was detected in all participant groups, while the few Plasmodium falciparum infections were found in goers and dwellers. 81% of all infections were due to P. vivax, 9% were due to P. falciparum, 3% due to Plasmodium cynomolgi, and the rest (7%) remained undefined. Gender was associated with malaria infection prevalence, with male participants having higher odds of malaria infection than female participants (OR = 1.69, 95% CI 1.08-2.64). Passively collected malaria incidence data from the Cambodian government were also investigated. Health facility-reported malaria cases, based on rapid diagnostic tests, for the period Jan-Dec 2021 were 521 Plasmodium vivax (0.89% prevalence), 34 P. falciparum (0.06%) and four P. falciparum + mixed (0.01%)-a total of 559 cases (0.95%) for all of Mondulkiri. CONCLUSION This reservoir of asymptomatic parasitaemia may be perpetuating low levels of transmission, and thus, new strategies are required to realize the goal of eliminating malaria in Cambodia by 2025.
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Affiliation(s)
- Dyna Doum
- Health Forefront Organization, Phnom Penh, Cambodia
| | - David J Mclver
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA.
| | - John Hustedt
- Health Forefront Organization, Phnom Penh, Cambodia
| | - Jeffrey Hii
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
| | - Siv Sovannaroth
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Dysoley Lek
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | - Allison Tatarsky
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
| | - Neil F Lobo
- Malaria Elimination Initiative, University of California, San Francisco, CA, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
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7
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Abate A, Hassen J, Dembele L, Menard D, Golassa L. Differential transmissibility to Anopheles arabiensis of Plasmodium vivax gametocytes in patients with diverse Duffy blood group genotypes. Malar J 2023; 22:136. [PMID: 37098534 PMCID: PMC10131423 DOI: 10.1186/s12936-023-04570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/21/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Measuring risk of malaria transmission is complex, especially in case of Plasmodium vivax. This may be overcome using membrane feeding assays in the field where P. vivax is endemic. However, mosquito-feeding assays are affected by a number of human, parasite and mosquito factors. Here, this study identified the contributions of Duffy blood group status of P. vivax-infected patients as a risk of parasite transmission to mosquitoes. METHODS A membrane feeding assay was conducted on a total of 44 conveniently recruited P. vivax infected patients in Adama city and its surroundings in East Shewa Zone, Oromia region, Ethiopia from October, 2019 to January, 2021. The assay was performed in Adama City administration. Mosquito infection rates were determined by midgut dissections at seven to 8 days post-infection. Duffy genotyping was defined for each of the 44 P. vivax infected patients. RESULTS The infection rate of Anopheles mosquitoes was 32.6% (296/907) with 77.3% proportion of infectious participants (34/44). Infectiousness of participants to Anopheles mosquitoes appeared to be higher among individuals with homozygous Duffy positive blood group (TCT/TCT) than heterozygous (TCT/CCT), but the difference was not statistically significant. The mean oocyst density was significantly higher among mosquitoes fed on blood of participants with FY*B/FY*BES than other genotypes (P = 0.001). CONCLUSION Duffy antigen polymorphisms appears to contribute to transmissibility difference of P. vivax gametocytes to Anopheles mosquitoes, but further studies are required.
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Affiliation(s)
- Andargie Abate
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Jifar Hassen
- School of Applied Natural Science, Adama Science and Technology University, Adama, Ethiopia
| | - Laurent Dembele
- Malaria Research and Training Centre (MRTC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Didier Menard
- Institut Pasteur, Malaria Genetics and Resistance Unit, Université Paris Cité, INSERM U1201, 75015, Paris, France
- Federation of Translational Medicine, Institute of Parasitology and Tropical Diseases, University of Strasbourg, UR7292 Dynamics of Host-Pathogen Interactions, 67000, Strasbourg, France
- Laboratory of Parasitology and Medical Mycology, Strasbourg University Hospital, Strasbourg, France
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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8
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Xu H, Sun Y, Zhang X, Chen R, Cai Z, Zhao B, Liu X, Liu J. Universal two-dimensional labelled probe-mediated melting curve analysis based on multiplex PCR for rapid typing of Plasmodium in a single closed tube. Microb Biotechnol 2023; 16:838-846. [PMID: 36745663 PMCID: PMC10034624 DOI: 10.1111/1751-7915.14232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023] Open
Abstract
Currently, malaria is still one of the major public health problems commonly caused by the four Plasmodium species. The similar symptoms of malaria and the COVID-19 epidemic of fever or fatigue lead to frequent misdiagnosis. The disadvantages of existing detection methods, such as time-consuming, costly, complicated operation, need for experienced technicians, and indistinguishable typing, lead to difficulties in meeting the clinical requirements of rapid, easy, and accurate typing of common Plasmodium species. In this study, we developed and optimized a universal two-dimensional labelled probe-mediated melting curve analysis (UP-MCA) assay based on multiplex and asymmetric PCR for rapid and accurate typing of five Plasmodium species, including novel human Plasmodium, Plasmodium knowlesi (Pk), in a single closed tube following genome extraction. The assay showed a limit of detection (LOD) of 10 copies per reaction and could accurately distinguish Plasmodium species from intra-plasmodium and other pathogens. Additionally, we proposed and validated different methods of fluorescence quenching and tag design for probes that are suitable for UP-MCA assays. Moreover, the clinical performance of the Plasmodium UP-MCA assay using a base-quenched universal probe was evaluated using 226 samples and showed a sensitivity of 100% (164/164) and specificity of 100% (62/62) at a 99% confidence interval, with the microscopy method as the gold standard. In summary, the UP-MCA assay showed excellent sensitivity, specificity, and accuracy for genotyping Plasmodium species spp. Additionally, it facilitates convenient and rapid Plasmodium detection in routine clinical practice and has great potential for clinical translation.
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Affiliation(s)
- Haipo Xu
- College of Chemical Engineering, Fuzhou University, Fuzhou, China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Yupeng Sun
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Xiaolong Zhang
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Ronghua Chen
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Zhixiong Cai
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Bixing Zhao
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Xiaolong Liu
- College of Chemical Engineering, Fuzhou University, Fuzhou, China
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- Mengchao Med-X Center, Fuzhou University, Fuzhou, China
| | - Jingfeng Liu
- College of Chemical Engineering, Fuzhou University, Fuzhou, China
- Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
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Lynch E, Jensen TO, Assao B, Chihana M, Turuho T, Nyehangane D, Manyok JB, Pasquale H, Khim N, Witkowski B, Coldiron ME. Evaluation of HRP2 and pLDH-based rapid diagnostic tests for malaria and prevalence of pfhrp2/3 deletions in Aweil, South Sudan. Malar J 2022; 21:261. [PMID: 36085071 PMCID: PMC9461093 DOI: 10.1186/s12936-022-04280-w] [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: 05/20/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid diagnostic tests (RDT) for malaria are the primary tool for malaria diagnosis in sub-Saharan Africa but the utility of the most commonly used histidine-rich protein 2 (HRP2) antigen-based tests is limited in high transmission settings due to the long duration of positivity after successful malaria treatment. HRP2 tests are also threatened by the emergence of Plasmodium that do not carry pfhrp2 or pfhrp 3 genes. Plasmodium lactate dehydrogenase (pLDH)-based tests are promising alternatives, but less available. This study assessed the performances of HRP2 and pLDH(pan) tests under field conditions. METHODS The study performed a prospective facility-based diagnostic evaluation of two malaria RDTs in Aweil, South Sudan, during the high transmission season. Capillary blood by fingerprick was collected from 800 children under 15 years of age with fever and no signs of severity. SD Bioline HRP2 and CareStart pLDH(pan) RDTs were performed in parallel, thick and thin smears for microscopy were examined, and dried blood was used for PCR testing. RESULTS Using microscopy as the gold standard, the sensitivity of both tests was estimated at > 99%, but the specificity of each was lower: 55.0% for the pLDH test and 61.7% for the HRP2 test. When using PCR as the gold standard, the sensitivity of both tests was lower than the values assessed using microscopy (97.0% for pLDH and 96.5% for HRP2), but the specificity increased (65.1% for pLDH and 72.9% for HRP2). Performance was similar across different production lots, sex, and age. Specificity of both the pLDH and HRP2 tests was significantly lower in children who reported taking a therapeutic course of anti-malarials in the 2 months prior to enrollment. The prevalence of pfhrp2/3 deletions in the study population was 0.6%. CONCLUSIONS The low specificity of the pLDH RDT in this setting confirms previous results and suggests a problem with this specific test. The prevalence of pfhrp2/3 deletions in the study area warrants continued monitoring and underscores the relevance of assessing deletion prevalence nationally. Improved malaria RDTs for high-transmission environments are needed.
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Affiliation(s)
- Emily Lynch
- Epicentre, 14-34 Avenue Jean Jaurès, Paris, France.
| | - Tomas O Jensen
- Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, Paris, France.,Center of Excellence for Health, Immunity, and Infections (CHIP) and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - John B Manyok
- Médecins Sans Frontières - France, Aweil, South Sudan
| | | | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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Abate A, Bouyssou I, Mabilotte S, Doderer-Lang C, Dembele L, Menard D, Golassa L. Vivax malaria in Duffy-negative patients shows invariably low asexual parasitaemia: implication towards malaria control in Ethiopia. Malar J 2022; 21:230. [PMID: 35915453 PMCID: PMC9341100 DOI: 10.1186/s12936-022-04250-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The increase in detections of Plasmodium vivax infection in Duffy-negative individuals in Africa has challenged the dogma establishing the unique P. vivax Duffy Binding Protein-Duffy antigen receptor for chemokines (PvDBP-DARC) pathway used by P. vivax merozoites to invade reticulocytes. Information on the impact of Duffy antigen polymorphisms on the epidemiology of P. vivax malaria remains elusive. The objective of this study was to determine the distribution of asexual parasitaemia of P. vivax according to the Duffy antigen polymorphisms in Ethiopia. METHODS DNA was extracted from dried blood spots (DBS) collected from prospectively recruited 138 P. vivax-infected patients from health centres. The identification and estimation of P. vivax asexual parasitaemia were performed by microscopic examination and quantitative real-time polymerase chain reaction (PCR). Duffy genotyping was conducted by DNA sequencing in a total of 138 P.vivax infected samples. RESULTS The proportion of Duffy-negatives (FY*BES/FY*BES) in P. vivax infected patients was 2.9% (4/138). Duffy genotype FY*B/FY*BES (48.6%) was the most common, followed by FY*A/FY*BES genotype (25.4%). In one patient, the FY*02 W.01/FY*02 N.01 genotype conferring a weak expression of the Fyb antigen was observed. All P.vivax infected Duffy-negative patients showed low asexual parasitaemia (≤ 110 parasites/µL). The median P. vivax parasitaemia in Duffy-negative patients (53 parasites/µL) was significantly lower than those found in homozygous and heterozygous individuals (P < 0.0001). CONCLUSION Plasmodium vivax in Duffy-negative patients shows invariably low asexual parasitaemia. This finding suggests that the pathway used by P. vivax to invade Duffy-negative reticulocytes is much less efficient than that used in Duffy-positives. Moreover, the low asexual parasitaemia observed in Duffy-negative individuals could constitute an 'undetected silent reservoir', thus likely delaying the elimination of vivax malaria in Ethiopia.
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Affiliation(s)
- Andargie Abate
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Isabelle Bouyssou
- Malaria Genetics and Resistance Unit, Institut Pasteur, INSERM U1201, Paris, France
- ED515 Complexité du Vivant, Sorbonne Université, Paris, France
| | - Solenne Mabilotte
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Cecile Doderer-Lang
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Laurent Dembele
- Malaria Research and Training Centre (MRTC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Didier Menard
- Malaria Genetics and Resistance Unit, Institut Pasteur, INSERM U1201, Paris, France
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
- Laboratory of Parasitology and Medical Mycology, Strasbourg University Hospital, Strasbourg, France
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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11
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Pepey A, Obadia T, Kim S, Sovannaroth S, Mueller I, Witkowski B, Vantaux A, Souris M. Mobility evaluation by GPS tracking in a rural, low-income population in Cambodia. PLoS One 2022; 17:e0266460. [PMID: 35559983 PMCID: PMC9106150 DOI: 10.1371/journal.pone.0266460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/21/2022] [Indexed: 01/31/2023] Open
Abstract
Global Positioning System (GPS) technology is an effective tool for quantifying individuals' mobility patterns and can be used to understand their influence on infectious disease transmission. In Cambodia, mobility measurements have been limited to questionnaires, which are of limited efficacy in rural environments. In this study, we used GPS tracking to measure the daily mobility of Cambodian forest goers, a population at high risk of malaria, and developed a workflow adapted to local constraints to produce an optimal dataset representative of the participants' mobility. We provide a detailed assessment of the GPS tracking and analysis of the data, and highlight the associated difficulties to facilitate the implementation of similar studies in the future.
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Affiliation(s)
- Anaïs Pepey
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- * E-mail:
| | - Thomas Obadia
- Department of Parasites and Insect Vectors, Infectious Diseases Epidemiology and Analytics, Institut Pasteur, Paris, France
- Département de Biologie Computationnelle, Hub de Bioinformatique et Biostatistique, Institut Pasteur, Paris, France
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Siv Sovannaroth
- National Centre for Parasitology Entomology and Malaria Control (CNM), Phnom Penh, Cambodia
| | - Ivo Mueller
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Marc Souris
- UMR Unité des Virus Emergents, UVE: Aix-Marseille Univ–IRD 190–Inserm 1207–IHU 5 Méditerranée Infection, Marseille, France
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12
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Van Bortel W, Van den Poel B, Hermans G, Vanden Driessche M, Molzahn H, Deblauwe I, De Wolf K, Schneider A, Van Hul N, Müller R, Wilmaerts L, Gombeer S, Smitz N, Kattenberg JH, Monsieurs P, Rosanas-Urgell A, Van Esbroeck M, Bottieau E, Maniewski-Kelner U, Rebolledo J. Two fatal autochthonous cases of airport malaria, Belgium, 2020. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35451360 PMCID: PMC9027149 DOI: 10.2807/1560-7917.es.2022.27.16.2100724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report an outbreak investigation of two fatal cases of autochthonous Plasmodium falciparum malaria that occurred in Belgium in September 2020. Various hypotheses of the potential source of infection were investigated. The most likely route of transmission was through an infectious exotic Anopheles mosquito that was imported via the international airport of Brussels or the military airport Melsbroek and infected the cases who lived at 5 km from the airports. Based on genomic analysis of the parasites collected from the two cases, the most likely origin of the Plasmodium was Gabon or Cameroon. Further, the parasites collected from the two Belgian patients were identical by descent, which supports the assumption that the two infections originated from the bite of the same mosquito, during interrupted feeding. Although airport malaria remains a rare event, it has significant implications, particularly for the patient, as delayed or missed diagnosis of the cause of illness often results in complications and mortality. Therefore, to prevent such severe or fatal outcomes, we suggest a number of public health actions including increased awareness among health practitioners, especially those working in the vicinity of airports, and increased surveillance of exotic mosquito species at airports.
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Affiliation(s)
- Wim Van Bortel
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium.,Outbreak Research Team, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bea Van den Poel
- Clinical Laboratory, Jan Portaels General Hospital, Vilvoorde, Belgium
| | - Greet Hermans
- Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | | | - Helmut Molzahn
- Intensive Care Unit, Jan Portaels General Hospital, Vilvoorde, Belgium
| | - Isra Deblauwe
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Katrien De Wolf
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Anna Schneider
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nick Van Hul
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ruth Müller
- Unit of Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Leen Wilmaerts
- Veterinary Service, Military Hospital Queen Astrid, Brussels, Belgium
| | - Sophie Gombeer
- Royal Belgian Institute of Natural Sciences, Barcoding Facility for Organisms and Tissues of Policy Concern (BopCo), Brussels, Belgium
| | - Nathalie Smitz
- Royal Museum for Central Africa, Barcoding Facility for Organisms and Tissues of Policy Concern (BopCo), Tervuren, Belgium
| | - Johanna Helena Kattenberg
- Unit of Malariology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Pieter Monsieurs
- Unit of Malariology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Anna Rosanas-Urgell
- Unit of Malariology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ula Maniewski-Kelner
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Javiera Rebolledo
- Department of epidemiology and infectious diseases, Sciensano, Brussels, Belgium
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13
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Mpina M, Stabler TC, Schindler T, Raso J, Deal A, Acuche Pupu L, Nyakarungu E, Del Carmen Ovono Davis M, Urbano V, Mtoro A, Hamad A, Lopez MSA, Pasialo B, Eyang MAO, Rivas MR, Falla CC, García GA, Momo JC, Chuquiyauri R, Saverino E, Preston Church LW, Kim Lee Sim B, Manguire B, Tanner M, Maas C, Abdulla S, Billingsley PF, Hoffman SL, Jongo S, Richie TL, Daubenberger CA. Diagnostic performance and comparison of ultrasensitive and conventional rapid diagnostic test, thick blood smear and quantitative PCR for detection of low-density Plasmodium falciparum infections during a controlled human malaria infection study in Equatorial Guinea. Malar J 2022; 21:99. [PMID: 35331251 PMCID: PMC8943516 DOI: 10.1186/s12936-022-04103-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Progress towards malaria elimination has stagnated, partly because infections persisting at low parasite densities comprise a large reservoir contributing to ongoing malaria transmission and are difficult to detect. This study compared the performance of an ultrasensitive rapid diagnostic test (uRDT) designed to detect low density infections to a conventional RDT (cRDT), expert microscopy using Giemsa-stained thick blood smears (TBS), and quantitative polymerase chain reaction (qPCR) during a controlled human malaria infection (CHMI) study conducted in malaria exposed adults (NCT03590340). Methods Blood samples were collected from healthy Equatoguineans aged 18–35 years beginning on day 8 after CHMI with 3.2 × 103 cryopreserved, infectious Plasmodium falciparum sporozoites (PfSPZ Challenge, strain NF54) administered by direct venous inoculation. qPCR (18s ribosomal DNA), uRDT (Alere™ Malaria Ag P.f.), cRDT [Carestart Malaria Pf/PAN (PfHRP2/pLDH)], and TBS were performed daily until the volunteer became TBS positive and treatment was administered. qPCR was the reference for the presence of Plasmodium falciparum parasites. Results 279 samples were collected from 24 participants; 123 were positive by qPCR. TBS detected 24/123 (19.5% sensitivity [95% CI 13.1–27.8%]), uRDT 21/123 (17.1% sensitivity [95% CI 11.1–25.1%]), cRDT 10/123 (8.1% sensitivity [95% CI 4.2–14.8%]); all were 100% specific and did not detect any positive samples not detected by qPCR. TBS and uRDT were more sensitive than cRDT (TBS vs. cRDT p = 0.015; uRDT vs. cRDT p = 0.053), detecting parasitaemias as low as 3.7 parasites/µL (p/µL) (TBS and uRDT) compared to 5.6 p/µL (cRDT) based on TBS density measurements. TBS, uRDT and cRDT did not detect any of the 70/123 samples positive by qPCR below 5.86 p/µL, the qPCR density corresponding to 3.7 p/µL by TBS. The median prepatent periods in days (ranges) were 14.5 (10–20), 18.0 (15–28), 18.0 (15–20) and 18.0 (16–24) for qPCR, TBS, uRDT and cRDT, respectively; qPCR detected parasitaemia significantly earlier (3.5 days) than the other tests. Conclusions TBS and uRDT had similar sensitivities, both were more sensitive than cRDT, and neither matched qPCR for detecting low density parasitaemia. uRDT could be considered an alternative to TBS in selected applications, such as CHMI or field diagnosis, where qualitative, dichotomous results for malaria infection might be sufficient. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04103-y.
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Affiliation(s)
- Maxmillian Mpina
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Ifakara Health Institute, Ifakara, Tanzania.
| | - Thomas C Stabler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jose Raso
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Anna Deal
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Elizabeth Nyakarungu
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | | | - Vicente Urbano
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Ali Mtoro
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Ali Hamad
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Maria Silvia A Lopez
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Beltran Pasialo
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Marta Alene Owono Eyang
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Matilde Riloha Rivas
- Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | | | | | - Juan Carlos Momo
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Raul Chuquiyauri
- Medical Care Development International, Malabo, Equatorial Guinea.,Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | | | | | - B Kim Lee Sim
- Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | | | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Carl Maas
- Marathon EG production Ltd., Houston, USA
| | | | | | | | - Said Jongo
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Thomas L Richie
- Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | - Claudia A Daubenberger
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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14
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Tenfold difference in DNA recovery rate: systematic comparison of whole blood vs. dried blood spot sample collection for malaria molecular surveillance. Malar J 2022; 21:88. [PMID: 35292038 PMCID: PMC8922754 DOI: 10.1186/s12936-022-04122-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Molecular and genomic surveillance is becoming increasingly used to track malaria control and elimination efforts. Blood samples can be collected as whole blood and stored at - 20 °C until DNA extraction, or as dried blood spots (DBS), circumventing the need for a cold chain. Despite the wide use of either method, systematic comparisons of how the method of blood sample preservation affects the limit of detection (LOD) of molecular diagnosis and the proportion of DNA recovered for downstream applications are lacking. METHODS Extractions based on spin columns, magnetic beads, Tween-Chelex, and direct PCR without prior extraction were compared for whole blood and dried blood spots (DBS) using dilution series of Plasmodium falciparum culture samples. Extracted DNA was quantified by qPCR and droplet digital PCR (ddPCR). RESULTS DNA recovery was 5- to 10-fold higher for whole blood compared to DBS, resulting in a 2- to 3-fold lower LOD for both extraction methods compared to DBS. For whole blood, a magnetic bead-based method resulted in a DNA recovery rate of 88-98% when extracting from whole blood compared to 17-33% for a spin-column based method. For extractions from DBS, the magnetic bead-based method resulted in 8-20% DNA recovery, while the spin-column based method resulted in only 2% DNA recovery. The Tween-Chelex method was superior to other methods with 15-21% DNA recovery, and even more sensitive than extractions from whole blood samples. The direct PCR method was found to have the lowest LOD overall for both, whole blood and DBS. CONCLUSIONS Pronounced differences in LOD and DNA yield need to be considered when comparing prevalence estimates based on molecular methods and when selecting sampling protocols for other molecular surveillance applications.
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15
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Bhowmick IP, Nirmolia T, Pandey A, Subbarao SK, Nath A, Senapati S, Tripathy D, Pebam R, Nag S, Roy R, Dasgupta D, Debnath J, Gogoi K, Gogoi K, Borah L, Chanda R, Borgohain A, Mog C, Sarkar U, Gogoi P, Debnath B, Debbarma J, Ranjan Bhattacharya D, Joshi PL, Kaur H, Narain K. Dry Post Wintertime Mass Surveillance Unearths a Huge Burden of P. vivax, and Mixed Infection with P. vivax P. falciparum, a Threat to Malaria Elimination, in Dhalai, Tripura, India. Pathogens 2021; 10:pathogens10101259. [PMID: 34684207 PMCID: PMC8541100 DOI: 10.3390/pathogens10101259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
With India aiming to achieve malaria elimination by 2030, several strategies have been put in place. With that aim, mass surveillance is now being conducted in some malaria-endemic pockets. As dry season mass surveillance has been shown to have its importance in targeting the reservoir, a study was undertaken to assess the parasite load by a sensitive molecular method during one of the mass surveys conducted in the dry winter period. It was executed in two malaria-endemic villages of Dhalai District, Tripura, in northeast India, also reported as P. falciparum predominated area. The present study found an enormous burden of Rapid Diagnostic Test negative malaria cases with P. vivax along with P. vivax and P. falciparum mixed infections during the mass surveillance from febrile and afebrile cases in dry winter months (February 2021–March 2021). Of the total 150 samples tested, 72 (48%) were positive and 78 (52%) negative for malaria by PCR. Out of the 72 positives, 6 (8.33%) were P. falciparum, 40 (55.55%) P. vivax, and 26 (36.11%) mixed infections. Out of 78 malaria negative samples, 6 (7.7%) were with symptoms, while among the total malaria positive, 72 cases 7 (9.8%) were with symptoms, and 65 (90.2%) were asymptomatic. Out of 114 samples tested by both microscopy and PCR, 42 samples turned out to be submicroscopic with 4 P. falciparum, 23 P. vivax, and 15 mixed infections. Although all P. vivax submicroscopic infections were asymptomatic, three P. falciparum cases were found to be febrile. Evidence of malaria transmission was also found in the vectors in the winter month. The study ascertained the use of molecular diagnostic techniques in detecting the actual burden of malaria, especially of P. vivax, in mass surveys. As Jhum cultivators in Tripura are at high risk, screening for the malarial reservoirs in pre-Jhum months can help with malaria control and elimination.
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Affiliation(s)
- Ipsita Pal Bhowmick
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
- Correspondence:
| | - Tulika Nirmolia
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Apoorva Pandey
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, Delhi 110029, India; (A.P.); (H.K.)
| | - Sarala K. Subbarao
- Formerly National Institute of Malaria Research-ICMR, Delhi 110077, India;
| | - Aatreyee Nath
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Susmita Senapati
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Debabrata Tripathy
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Rocky Pebam
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Suman Nag
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Rajashree Roy
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Dipanjan Dasgupta
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Jayanta Debnath
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Kongkona Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Karuna Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Lakhyajit Borah
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | | | - Arup Borgohain
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Chelapro Mog
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Ujjwal Sarkar
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Phiroz Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Bishal Debnath
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Jyotish Debbarma
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Dibya Ranjan Bhattacharya
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Pyare Lal Joshi
- Formerly National Vector Borne Disease Control Program (NVBDCP), Delhi 110054, India;
| | - Harpreet Kaur
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, Delhi 110029, India; (A.P.); (H.K.)
| | - Kanwar Narain
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
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16
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Roesch C, Mairet-Khedim M, Kim S, Lek D, Popovici J, Witkowski B. Impact of the first-line treatment shift from dihydroartemisinin/piperaquine to artesunate/mefloquine on Plasmodium vivax drug susceptibility in Cambodia. J Antimicrob Chemother 2021; 75:1766-1771. [PMID: 32211790 PMCID: PMC7303819 DOI: 10.1093/jac/dkaa092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 02/06/2023] Open
Abstract
Background Cambodia is the epicentre of the emergence of Plasmodium falciparum drug resistance. Much less is known regarding the drug susceptibility of the co-endemic Plasmodium vivax. Only in vitro drug assays can determine the parasite’s intrinsic susceptibility, but these are challenging to implement for P. vivax and rarely performed. Objectives To evaluate the evolution of Cambodian P. vivax susceptibility to antimalarial drugs and determine their association with putative markers of drug resistance. Methods In vitro response to three drugs used in the past decade in Cambodia was measured for 52 clinical isolates from Eastern Cambodia collected between 2015 and 2018 and the sequence and copy number variation of their pvmdr1 and pvcrt genes were analysed. pvmdr1 polymorphism was also determined for an additional 250 isolates collected in Eastern Cambodia between 2014 and 2019. Results Among the 52 cryopreserved isolates tested, all were susceptible to the three drugs, with overall median IC50s of 16.1 nM (IQR 11.4–22.3) chloroquine, 3.4 nM (IQR 2.1–5.0) mefloquine and 4.6 nM (IQR 2.7–7.0) piperaquine. A significant increase in chloroquine and piperaquine susceptibility was observed between 2015 and 2018, unrelated to polymorphisms in pvcrt and pvmdr1. Susceptibility to mefloquine was significantly lower in parasites with a single mutation in pvmdr1 compared with isolates with multiple mutations. The proportion of parasites with this single mutation genotype increased between 2014 and 2019. Conclusions P. vivax with decreased susceptibility to mefloquine is associated with the introduction of mefloquine-based treatment during 2017–18.
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Affiliation(s)
- Camille Roesch
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Institut Pasteur, Paris & Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Mélissa Mairet-Khedim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Institut Pasteur, Paris & Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Institut Pasteur, Paris & Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Dysoley Lek
- National Center for Malariology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Jean Popovici
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Institut Pasteur, Paris & Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Institut Pasteur, Paris & Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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17
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Gimenez AM, Marques RF, Regiart M, Bargieri DY. Diagnostic Methods for Non-Falciparum Malaria. Front Cell Infect Microbiol 2021; 11:681063. [PMID: 34222049 PMCID: PMC8248680 DOI: 10.3389/fcimb.2021.681063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Malaria is a serious public health problem that affects mostly the poorest countries in the world, killing more than 400,000 people per year, mainly children under 5 years old. Among the control and prevention strategies, the differential diagnosis of the Plasmodium-infecting species is an important factor for selecting a treatment and, consequently, for preventing the spread of the disease. One of the main difficulties for the detection of a specific Plasmodium sp is that most of the existing methods for malaria diagnosis focus on detecting P. falciparum. Thus, in many cases, the diagnostic methods neglect the other non-falciparum species and underestimate their prevalence and severity. Traditional methods for diagnosing malaria may present low specificity or sensitivity to non-falciparum spp. Therefore, there is high demand for new alternative methods able to differentiate Plasmodium species in a faster, cheaper and easier manner to execute. This review details the classical procedures and new perspectives of diagnostic methods for malaria non-falciparum differential detection and the possibilities of their application in different circumstances.
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Affiliation(s)
- Alba Marina Gimenez
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rodolfo F. Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Matías Regiart
- Department of Fundamental Chemistry, Institute of Chemistry, University of São Paulo, São Paulo, Brazil
| | - Daniel Youssef Bargieri
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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18
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Vantaux A, Riehle MM, Piv E, Farley EJ, Chy S, Kim S, Corbett AG, Fehrman RL, Pepey A, Eiglmeier K, Lek D, Siv S, Mueller I, Vernick KD, Witkowski B. Anopheles ecology, genetics and malaria transmission in northern Cambodia. Sci Rep 2021; 11:6458. [PMID: 33742030 PMCID: PMC7979810 DOI: 10.1038/s41598-021-85628-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/04/2021] [Indexed: 12/20/2022] Open
Abstract
In the Greater Mekong Subregion, malaria cases have significantly decreased but little is known about the vectors or mechanisms responsible for residual malaria transmission. We analysed a total of 3920 Anopheles mosquitoes collected during the rainy and dry seasons from four ecological settings in Cambodia (villages, forested areas near villages, rubber tree plantations and forest sites). Using odor-baited traps, 81% of the total samples across all sites were collected in cow baited traps, although 67% of the samples attracted by human baited traps were collected in forest sites. Overall, 20% of collected Anopheles were active during the day, with increased day biting during the dry season. 3131 samples were identified morphologically as 14 different species, and a subset was also identified by DNA amplicon sequencing allowing determination of 29 Anopheles species. The investigation of well characterized insecticide mutations (ace-1, kdr, and rdl genes) indicated that individuals carried mutations associated with response to all the different classes of insecticides. There also appeared to be a non-random association between mosquito species and insecticide resistance with Anopheles peditaeniatus exhibiting nearly fixed mutations. Molecular screening for Plasmodium sp. presence indicated that 3.6% of collected Anopheles were positive, most for P. vivax followed by P. falciparum. These results highlight some of the key mechanisms driving residual human malaria transmission in Cambodia, and illustrate the importance of diverse collection methods, sites and seasons to avoid bias and better characterize Anopheles mosquito ecology in Southeast Asia.
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Affiliation(s)
- Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
| | - Michelle M Riehle
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Eakpor Piv
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Elise J Farley
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sophy Chy
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Anneli G Corbett
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rachel L Fehrman
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anais Pepey
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Karin Eiglmeier
- Unit of Insect Vector Genetics and Genomics, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.,CNRS Unit of Evolutionary Genomics, Modeling, and Health (UMR2000), Institut Pasteur, Paris, France
| | - Dysoley Lek
- National Center for Parasitology, Entomology and Malaria Control Program, Phnom Penh, Cambodia.,School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Sovannaroth Siv
- National Center for Parasitology, Entomology and Malaria Control Program, Phnom Penh, Cambodia
| | - Ivo Mueller
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France
| | - Kenneth D Vernick
- Unit of Insect Vector Genetics and Genomics, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.,CNRS Unit of Evolutionary Genomics, Modeling, and Health (UMR2000), Institut Pasteur, Paris, France
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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19
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Mahittikorn A, Masangkay FR, Kotepui KU, De Jesus Milanez G, Kotepui M. Comparative performance of PCR using DNA extracted from dried blood spots and whole blood samples for malaria diagnosis: a meta-analysis. Sci Rep 2021; 11:4845. [PMID: 33649410 PMCID: PMC7921648 DOI: 10.1038/s41598-021-83977-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/10/2021] [Indexed: 11/24/2022] Open
Abstract
Polymerase chain reaction (PCR) using deoxyribonucleic acid (DNA) extracted from dried blood spots (DBS) provides a fast, inexpensive, and convenient method for large-scale epidemiological studies. This study compared the performance of PCR between DNA extracted from DBS and DNA obtained from whole blood for detecting malarial parasites. Primary studies assessing the diagnostic performance of PCR using DNA extracted from DBS and whole blood for detecting malarial parasites were obtained from the ISI Web of Science, Scopus, and PubMed databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were plotted in forest plots using Review Manager version 5.3. Statistical analysis was performed via random-effects meta-analysis. Data heterogeneity was assessed using the I2 statistic. Of the 904 studies retrieved from the databases, seven were included in this study. The pooled meta-analysis demonstrated no significant difference in the comparative performance of PCR for detecting malaria parasites between DNA extracted from DBS and that extracted from whole blood (OR 0.85; 95% CI 0.62–1.16; I2 = 78%). However, subgroup analysis demonstrated that PCR using DNA extracted from DBS was less accurate in detecting Plasmodium vivax than that using DNA extracted from whole blood (OR = 0.85; 95% CI 0.77–0.94). In conclusion, a significant difference in detecting P. vivax was observed between PCR using DNA extracted from DBS and that using DNA extracted from whole blood. Therefore, P. vivax in endemic areas should be identified and detected with care with PCR using DNA obtained from DBS which potentially leads to a negative result. Further studies are required to investigate the performance of PCR using DBS for detecting P. vivax and other malarial parasites to provide data in research and routine surveillance of malaria, especially with renewed efforts towards the eradication of the disease.
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Affiliation(s)
- Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Frederick Ramirez Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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20
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Stratil AS, Vernaeve L, Lopes S, Bourny Y, Mannion K, Hamade P, Roca-Feltrer A, Tibenderana JK, Sovannaroth S, Debackere M. Eliminating Plasmodium falciparum malaria: results from tailoring active case detection approaches to remote populations in forested border areas in north-eastern Cambodia. Malar J 2021; 20:108. [PMID: 33618718 PMCID: PMC7898252 DOI: 10.1186/s12936-021-03622-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Remaining Plasmodium falciparum cases in Cambodia are concentrated in forested border areas and in remote populations who are hard to reach through passive case detection. A key approach to reach these populations is active case detection by mobile malaria workers (MMWs). However, this is operationally challenging because of changing movement patterns of the target population moving into less accessible areas. From January 2018 to December 2020, a tailored package of active case detection approaches was implemented in forested border areas of three provinces in north-eastern Cambodia to reach remote populations and support the elimination of falciparum malaria. METHODS Key elements of this project were to tailor approaches to local populations, use responsive monitoring systems, maintain operational flexibility, build strong relationships with local communities, and implement close supervision practices. MMWs were recruited from local communities. Proactive case detection approaches included mobile malaria posts positioned at frequented locations around and within forests, and locally informed outreach activities targeting more remote locations. Reactive case detection was conducted among co-travellers of confirmed cases. Testing for malaria was conducted independent of fever symptoms. Routine monitoring of programmatic data informed tactical adaptations, while supervision exercises ensured service quality. RESULTS Despite operational challenges, service delivery sites were able to maintain consistently high testing rates throughout the implementation period, with each of 45 sites testing a monthly average of 64 (SD 6) people in 2020. In 2020, project MMWs detected only 32 P. falciparum cases. Over the project period, the P. falciparum/P. vivax ratio steadily inversed. Including data from neighbouring health centres and village malaria workers, 45% (80,988/180,732) of all people tested and 39% (1280/3243) of P. falciparum cases detected in the area can be attributed to project MMWs. Remaining challenges of the last elimination phase include maintaining intensified elimination efforts, addressing the issue of detecting low parasitaemia cases and shifting focus to P. vivax malaria. CONCLUSIONS Reaching remote populations through active case detection should remain a key strategy to eliminate P. falciparum malaria. This case study presented a successful approach combining tailored proactive and reactive strategies that could be transferred to similar settings in other areas of the Greater Mekong Subregion.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Siv Sovannaroth
- National Center for Parasitology, Entomology and Malaria Control (CNM), Phnom Penh, Cambodia
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21
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Choosing interventions to eliminate forest malaria: preliminary results of two operational research studies inside Cambodian forests. Malar J 2021; 20:51. [PMID: 33472630 PMCID: PMC7818569 DOI: 10.1186/s12936-020-03572-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/24/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Rapid elimination of Plasmodium falciparum malaria in Cambodia is a goal with both national and international significance. Transmission of malaria in Cambodia is limited to forest environments, and the main population at risk consists of forest-goers who rely on forest products for income or sustenance. The ideal interventions to eliminate malaria from this population are unknown. METHODS In two forested regions of Cambodia, forest-goers were trained to become forest malaria workers (FMWs). In one region, FMWs performed mass screening and treatment, focal screening and treatment, and passive case detection inside the forest. In the other region, FMWs played an observational role for the first year, to inform the choice of intervention for the second year. In both forests, FMWs collected blood samples and questionnaire data from all forest-goers they encountered. Mosquito collections were performed in each forest. RESULTS Malaria prevalence by PCR was high in the forest, with 2.3-5.0% positive for P. falciparum and 14.6-25.0% positive for Plasmodium vivax among forest-goers in each study site. In vectors, malaria prevalence ranged from 2.1% to 9.6%, but no P. falciparum was observed. Results showed poor performance of mass screening and treatment, with sensitivity of rapid diagnostic tests equal to 9.1% (95% CI 1.1%, 29.2%) for P. falciparum and 4.4% (95% CI 1.6%, 9.2%) for P. vivax. Malaria infections were observed in all demographics and throughout the studied forests, with no clear risk factors emerging. CONCLUSIONS Malaria prevalence remains high among Cambodian forest-goers, but performance of rapid diagnostic tests is poor. More adapted strategies to this population, such as intermittent preventive treatment of forest goers, should be considered.
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22
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Gansané A, Moriarty LF, Ménard D, Yerbanga I, Ouedraogo E, Sondo P, Kinda R, Tarama C, Soulama E, Tapsoba M, Kangoye D, Compaore CS, Badolo O, Dao B, Tchwenko S, Tinto H, Valea I. Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017-2018. Malar J 2021; 20:48. [PMID: 33468147 PMCID: PMC7816451 DOI: 10.1186/s12936-021-03585-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background The World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplicated Plasmodium falciparum malaria in Burkina Faso in three sites: Niangoloko, Nanoro, and Gourcy. Methods This was a two-arm randomized control trial of the efficacy of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Children aged 6–59 months old were monitored for 42 days. The primary outcomes of the study were uncorrected and PCR-corrected efficacies to day 28 for AL and 42 for DP. Molecular markers of resistance to artemisinin derivatives and partner drugs were also analysed. Results Of 720 children enrolled, 672 reached study endpoints at day 28, 333 in the AL arm and 339 in the DP arm. PCR-corrected 28-day per protocol efficacy in the AL arm was 74% (64–83%) in Nanoro, 76% (66–83%) in Gourcy, and 92% (84–96%) in Niangoloko. The PCR-corrected 42-day per protocol efficacy in the DP arm was 84% (75–89%) in Gourcy, 89% (81–94%) in Nanoro, and 97% (92–99%) in Niangoloko. No Pfk13 mutation previously associated with artemisinin-resistance was observed. No statistically significant association was found between treatment outcome and presence of the 86Y mutation in the Pfmdr1 gene. There was also no association observed between treatment outcome and Pfpm2 or Pfmdr1 copy number variation. Conclusion The results of this study indicate evidence of inadequate efficacy of AL at day 28 and DP at day 42 in the same two sites. A change of first-line ACT may be warranted in Burkina Faso. Trial Registry Pan African Clinical Trial Registry Identifier: PACTR201708002499311. Date of registration: 8/3/2017 https://pactr.samrc.ac.za/Search.aspx
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Affiliation(s)
- Adama Gansané
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
| | - Leah F Moriarty
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President's Malaria Initiative, Atlanta, GA, USA
| | - Didier Ménard
- Malaria Genetics and Resistance Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Isidore Yerbanga
- IRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Esperance Ouedraogo
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | - Paul Sondo
- IRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Rene Kinda
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | - Casimir Tarama
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | - Edwige Soulama
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | - Madou Tapsoba
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | - David Kangoye
- Centre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso
| | | | - Ousmane Badolo
- JHPIEGO/ Improving Malaria Care, Ouagadougou, Burkina Faso
| | - Blami Dao
- JHPIEGO/ Improving Malaria Care, Ouagadougou, Burkina Faso
| | - Samuel Tchwenko
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President's Malaria Initiative, Atlanta, GA, USA
| | - Halidou Tinto
- IRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Innocent Valea
- IRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
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23
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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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24
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Sandfort M, Vantaux A, Kim S, Obadia T, Pepey A, Gardais S, Khim N, Lek D, White M, Robinson LJ, Witkowski B, Mueller I. Forest malaria in Cambodia: the occupational and spatial clustering of Plasmodium vivax and Plasmodium falciparum infection risk in a cross-sectional survey in Mondulkiri province, Cambodia. Malar J 2020; 19:413. [PMID: 33213471 PMCID: PMC7678315 DOI: 10.1186/s12936-020-03482-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/04/2020] [Indexed: 02/24/2023] Open
Abstract
Background After a marked reduction in malaria burden in Cambodia over the last decades, case numbers increased again in 2017–2018. In light of the national goal of malaria elimination by 2025, remaining pockets of high risk need to be well defined and strategies well-tailored to identify and target the persisting burden cost-effectively. This study presents species-specific prevalence estimates and risk stratification for a remote area in Cambodia. Methods A cross-sectional survey was conducted in 17 villages in the high-incidence province Mondulkiri in the dry season (December 2017 to April 2018). 4200 randomly selected participants (2–80 years old) were tested for Plasmodium infection by PCR. Risk of infection was associated with questionnaire-derived covariates and spatially stratified based on household GPS coordinates. Results The prevalence of PCR-detectable Plasmodium infection was 8.3% (349/4200) and was more than twice as high for Plasmodium vivax (6.4%, 268) than for Plasmodium falciparum (3.0%, 125, p < 0.001). 97.8% (262/268) of P. vivax and 92.8% (116/125, p < 0.05) of P. falciparum infections were neither accompanied by symptoms at the time of the interview nor detected by microscopy or RDT. Recent travels to forest sites (aOR 2.17, p < 0.01) and forest work (aOR 2.88, p < 0.001) were particularly strong risk factors and risk profiles for both species were similar. Large village-level differences in prevalence of Plasmodium infection were observed, ranging from 0.6% outside the forest to 40.4% inside. Residing in villages at the forest fringe or inside the forest compared to outside was associated with risk of infection (aOR 2.14 and 12.47, p < 0.001). Villages inside the forest formed spatial hotspots of infection despite adjustment for the other risk factors. Conclusions Persisting pockets of high malaria risk were detected in forested areas and in sub-populations engaging in forest-related activities. High levels of asymptomatic infections suggest the need of better case detection plans and the predominance of P. vivax the implementation of radical cure. In villages inside the forest, within-village exposure was indicated in addition to risk due to forest activities. Village-level stratification of targeted interventions based on forest proximity could render the elimination efforts more cost-effective and successful.
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Affiliation(s)
- Mirco Sandfort
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France. .,Sorbonne Université, Collège doctoral, Paris, France.
| | - Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Thomas Obadia
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France.,Hub de Bioinformatique et Biostatistique, Département Biologie Computationnelle, Institut Pasteur, USR 3756 CNRS, Paris, France
| | - Anaïs Pepey
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Soazic Gardais
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France
| | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Dysoley Lek
- National Centre for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.,School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Michael White
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France.,Population Health & Immunity, Walter and Eliza Hall Institute, Melbourne, Australia
| | - Leanne J Robinson
- Population Health & Immunity, Walter and Eliza Hall Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,Burnet Institute, Melbourne, Australia
| | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Ivo Mueller
- Malaria: Parasites and Hosts Unit, Institut Pasteur, Paris, France.,Population Health & Immunity, Walter and Eliza Hall Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
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25
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Marcombe S, Maithaviphet S, Bobichon J, Phommavan N, Nambanya S, Corbel V, Brey PT. New insights into malaria vector bionomics in Lao PDR: a nationwide entomology survey. Malar J 2020; 19:396. [PMID: 33168012 PMCID: PMC7654023 DOI: 10.1186/s12936-020-03453-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Laos, the malaria burden remains high despite a significant reduction of cases during the last decade. In the context of the disease elimination by 2030, a nationwide entomological survey was conducted to better understand the distribution, abundance and behaviour of major malaria vectors (Anopheles spp.) in the country. METHODS Mosquito collections were implemented in ten villages from ten provinces during the rainy and dry seasons of 2014 and 2015 by using human landing catch (HLC) and cow bait collection (CBC) methods. After morphological identification in the field, molecular identification of the sibling species of Anopheles mosquitoes from the Funestus, Leucosphyrus, and Maculatus groups were determined using PCR specific alleles. A screening of Plasmodium falciparum and Plasmodium vivax infections in the vectors was carried out by quantitative PCR assays. RESULTS A total of 14,146 adult mosquitoes representing 25 different Anopheles species were collected and morphologically identified. Molecular identification revealed the presence of 12 sibling species within the main primary vector groups, including Anopheles maculatus, Anopheles rampae, Anopheles sawadwongporni, Anopheles pseudowillmori, Anopheles dravidicus, Anopheles minimus, Anopheles aconitus, Anopheles pampanai, Anopheles harrisoni, Anopheles dirus, Anopheles baimaii, Anopheles nemophilous. Anopheles maculatus and An. minimus were predominant during both the dry and rainy seasons, but showed highly zoophilic preferences (Zoophilic index of 98% and 95%, respectively). Overall, 22% of the total malaria vectors were collected between 10:00 PM and 5:00 AM indoors when people are sleeping. Twenty-seven percent of primary and secondary vectors were collected outdoors before 10:00 PM or after 5:00 AM, times when people are usually awake and outdoors. Only two specimens were positive for P. falciparum, one An. aconitus from Phongsaly and one An. minimus from Vientiane Province CONCLUSIONS: The results indicate that people living in rural areas in Laos are constantly exposed to malaria vectors throughout the year and specifically outdoors. The use of LLINs/IRS remains important but innovative tools and new strategies are needed to address locally, the early and outdoor malaria transmission. Lack of expertise in general entomological methods may further exacerbate the situation.
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Affiliation(s)
| | - Santi Maithaviphet
- Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR
| | - Julie Bobichon
- Institut Pasteur du Laos, Ministry of Health, Vientiane, Lao PDR
| | | | - Simone Nambanya
- Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR
| | - Vincent Corbel
- Institut de Recherche Pour Le Développement (IRD), Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC, UM1-CNRS 5290-IRD 224), Montpellier, France
| | - Paul T Brey
- Institut Pasteur du Laos, Ministry of Health, Vientiane, Lao PDR
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26
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Goupeyou-Youmsi J, Rakotondranaivo T, Puchot N, Peterson I, Girod R, Vigan-Womas I, Paul R, Ndiath MO, Bourgouin C. Differential contribution of Anopheles coustani and Anopheles arabiensis to the transmission of Plasmodium falciparum and Plasmodium vivax in two neighbouring villages of Madagascar. Parasit Vectors 2020; 13:430. [PMID: 32843082 PMCID: PMC7447585 DOI: 10.1186/s13071-020-04282-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/03/2020] [Indexed: 02/01/2023] Open
Abstract
Background Malaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been conducted despite the need for accurate information to design effective vector control measures. In a Malagasy region of moderate to intense transmission of both Plasmodium falciparum and P. vivax, parasitology and entomology have been combined to survey malaria transmission in two nearby villages. Methods Community-based surveys were conducted in the villages of Ambohitromby and Miarinarivo at three time points (T1, T2 and T3) during a single malaria transmission season. Human malaria prevalence was determined by rapid diagnostic tests (RDTs), microscopy and real-time PCR. Mosquitoes were collected by human landing catches and pyrethrum spray catches and the presence of Plasmodium sporozoites was assessed by TaqMan assay. Results Malaria prevalence was not significantly different between villages, with an average of 8.0% by RDT, 4.8% by microscopy and 11.9% by PCR. This was mainly due to P. falciparum and to a lesser extent to P. vivax. However, there was a significantly higher prevalence rate as determined by PCR at T2 (\documentclass[12pt]{minimal}
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\begin{document}$$\chi_{2}^{2}$$\end{document}χ22 = 7.46, P = 0.025). Likewise, mosquitoes were significantly more abundant at T2 (\documentclass[12pt]{minimal}
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\begin{document}$$\chi_{2}^{2}$$\end{document}χ22 = 64.8, P < 0.001), especially in Ambohitromby. At T1 and T3 mosquito abundance was higher in Miarinarivo than in Ambohitromby (\documentclass[12pt]{minimal}
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\begin{document}$$\chi_{2}^{2}$$\end{document}χ22 = 14.92, P < 0.001). Of 1550 Anopheles mosquitoes tested, 28 (1.8%) were found carrying Plasmodium sporozoites. The entomological inoculation rate revealed that Anopheles coustani played a major contribution in malaria transmission in Miarinarivo, being responsible of 61.2 infective bites per human (ib/h) during the whole six months of the survey, whereas, it was An. arabiensis, with 36 ib/h, that played that role in Ambohitromby. Conclusions Despite a similar malaria prevalence in two nearby villages, the entomological survey showed a different contribution of An. coustani and An. arabiensis to malaria transmission in each village. Importantly, the suspected secondary malaria vector An. coustani, was found playing the major role in malaria transmission in one village. This highlights the importance of combining parasitology and entomology surveys for better targeting local malaria vectors. Such study should contribute to the malaria pre-elimination goal established under the 2018–2022 National Malaria Strategic Plan. ![]()
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Affiliation(s)
- Jessy Goupeyou-Youmsi
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar. .,Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France. .,Doctoral School "Complexité du Vivant", Sorbonne University, Paris, France.
| | - Tsiriniaina Rakotondranaivo
- G4 Malaria Group, Institut Pasteur de Madagascar, Antananarivo, Madagascar.,Doctoral School "Génie du vivant et modélisation" Mahajanga University, Mahajanga, Madagascar
| | - Nicolas Puchot
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France
| | - Ingrid Peterson
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Romain Girod
- Medical Entomology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Inès Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Richard Paul
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France
| | | | - Catherine Bourgouin
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France. .,Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France.
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27
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Goupeyou-Youmsi J, Rakotondranaivo T, Puchot N, Peterson I, Girod R, Vigan-Womas I, Paul R, Ndiath MO, Bourgouin C. Differential contribution of Anopheles coustani and Anopheles arabiensis to the transmission of Plasmodium falciparum and Plasmodium vivax in two neighbouring villages of Madagascar. Parasit Vectors 2020; 13:430. [PMID: 32843082 DOI: 10.1101/787432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/03/2020] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Malaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been conducted despite the need for accurate information to design effective vector control measures. In a Malagasy region of moderate to intense transmission of both Plasmodium falciparum and P. vivax, parasitology and entomology have been combined to survey malaria transmission in two nearby villages. METHODS Community-based surveys were conducted in the villages of Ambohitromby and Miarinarivo at three time points (T1, T2 and T3) during a single malaria transmission season. Human malaria prevalence was determined by rapid diagnostic tests (RDTs), microscopy and real-time PCR. Mosquitoes were collected by human landing catches and pyrethrum spray catches and the presence of Plasmodium sporozoites was assessed by TaqMan assay. RESULTS Malaria prevalence was not significantly different between villages, with an average of 8.0% by RDT, 4.8% by microscopy and 11.9% by PCR. This was mainly due to P. falciparum and to a lesser extent to P. vivax. However, there was a significantly higher prevalence rate as determined by PCR at T2 ([Formula: see text] = 7.46, P = 0.025). Likewise, mosquitoes were significantly more abundant at T2 ([Formula: see text] = 64.8, P < 0.001), especially in Ambohitromby. At T1 and T3 mosquito abundance was higher in Miarinarivo than in Ambohitromby ([Formula: see text] = 14.92, P < 0.001). Of 1550 Anopheles mosquitoes tested, 28 (1.8%) were found carrying Plasmodium sporozoites. The entomological inoculation rate revealed that Anopheles coustani played a major contribution in malaria transmission in Miarinarivo, being responsible of 61.2 infective bites per human (ib/h) during the whole six months of the survey, whereas, it was An. arabiensis, with 36 ib/h, that played that role in Ambohitromby. CONCLUSIONS Despite a similar malaria prevalence in two nearby villages, the entomological survey showed a different contribution of An. coustani and An. arabiensis to malaria transmission in each village. Importantly, the suspected secondary malaria vector An. coustani, was found playing the major role in malaria transmission in one village. This highlights the importance of combining parasitology and entomology surveys for better targeting local malaria vectors. Such study should contribute to the malaria pre-elimination goal established under the 2018-2022 National Malaria Strategic Plan.
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Affiliation(s)
- Jessy Goupeyou-Youmsi
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France.
- Doctoral School "Complexité du Vivant", Sorbonne University, Paris, France.
| | - Tsiriniaina Rakotondranaivo
- G4 Malaria Group, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Doctoral School "Génie du vivant et modélisation" Mahajanga University, Mahajanga, Madagascar
| | - Nicolas Puchot
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France
| | - Ingrid Peterson
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Romain Girod
- Medical Entomology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Inès Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Richard Paul
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France
| | | | - Catherine Bourgouin
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France.
- Centre National de la Recherche Scientifique UMR2000, Institut Pasteur, Paris, France.
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28
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Golassa L, Amenga-Etego L, Lo E, Amambua-Ngwa A. The biology of unconventional invasion of Duffy-negative reticulocytes by Plasmodium vivax and its implication in malaria epidemiology and public health. Malar J 2020; 19:299. [PMID: 32831093 PMCID: PMC7443611 DOI: 10.1186/s12936-020-03372-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/10/2020] [Indexed: 12/30/2022] Open
Abstract
Plasmodium vivax has been largely neglected over the past century, despite a widespread recognition of its burden across region where it is endemic. The parasite invades reticulocytes, employing the interaction between Plasmodium vivax Duffy binding protein (PvDBP) and human Duffy antigen receptor for chemokines (DARC). However, P. vivax has now been observed in Duffy-negative individuals, presenting a potentially serious public health problem as the majority of African populations are Duffy-negative. Invasion of Duffy-negative reticulocytes is suggested to be through duplication of the PvDBP and a novel protein encoded by P. vivax erythrocyte binding protein (EBP) genes. The emergence and spread of specific P. vivax strains with ability to invade Duffy-negative reticulocytes has, therefore, drawn substantial attention and further complicated the epidemiology and public health implication of vivax malaria. Given the right environment and vectorial capacity for transmission coupled with the parasite’s ability to invade Duffy-negative individuals, P. vivax could increase its epidemiological significance in Africa. In this review, authors present accruing knowledge on the paradigm shift in P. vivax invasion of Duffy-negative reticulocytes against the established mechanism of invading only Duffy-positive individuals and offer a perspective on the epidemiological diagnostic and public health implication in Africa.
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Affiliation(s)
- Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Lucas Amenga-Etego
- West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Eugenia Lo
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
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29
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Rei Yan SL, Wakasuqui F, Wrenger C. Point-of-care tests for malaria: speeding up the diagnostics at the bedside and challenges in malaria cases detection. Diagn Microbiol Infect Dis 2020; 98:115122. [PMID: 32711185 DOI: 10.1016/j.diagmicrobio.2020.115122] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 12/18/2022]
Abstract
Malaria remains as one of the major public health problems worldwide. About 228 million cases occurred in 2018 only, with Africa bearing about 93% of the cases. Asymptomatic population carrying the various forms of the parasite Plasmodium in endemic areas plays an important role in the spread of the disease. To tackle this battle, more sensitive and precise detection kits for malaria are crucial to better control the number of new malaria cases. In this review, we not only discuss some of the available approaches to rapidly detect new malaria cases in endemic areas but also shed light on parallel problems that may affect the detection of individuals infected with the parasite, covering kelch 13 mutation, glucose 6-phosphate dehydrogenase deficiency, and hemoglobin disorders. Available approaches for malaria detection covered in this review are focused on point-of-care tests, including portable polymerase chain reaction and aptamers.
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Affiliation(s)
- Sun L Rei Yan
- Department of Parasitology, Institute of Biomedical Sciences at the University of São Paulo, São Paulo, Brazil
| | - Felipe Wakasuqui
- Department of Parasitology, Institute of Biomedical Sciences at the University of São Paulo, São Paulo, Brazil
| | - Carsten Wrenger
- Department of Parasitology, Institute of Biomedical Sciences at the University of São Paulo, São Paulo, Brazil.
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30
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Bannister-Tyrrell M, Krit M, Sluydts V, Tho S, Sokny M, Mean V, Kim S, Menard D, Grietens KP, Abrams S, Hens N, Coosemans M, Bassat Q, van Hensbroek MB, Durnez L, Van Bortel W. Households or Hotspots? Defining Intervention Targets for Malaria Elimination in Ratanakiri Province, Eastern Cambodia. J Infect Dis 2020; 220:1034-1043. [PMID: 31028393 PMCID: PMC6688056 DOI: 10.1093/infdis/jiz211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/25/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Malaria "hotspots" have been proposed as potential intervention units for targeted malaria elimination. Little is known about hotspot formation and stability in settings outside sub-Saharan Africa. METHODS Clustering of Plasmodium infections at the household and hotspot level was assessed over 2 years in 3 villages in eastern Cambodia. Social and spatial autocorrelation statistics were calculated to assess clustering of malaria risk, and logistic regression was used to assess the effect of living in a malaria hotspot compared to living in a malaria-positive household in the first year of the study on risk of malaria infection in the second year. RESULTS The crude prevalence of Plasmodium infection was 8.4% in 2016 and 3.6% in 2017. Living in a hotspot in 2016 did not predict Plasmodium risk at the individual or household level in 2017 overall, but living in a Plasmodium-positive household in 2016 strongly predicted living in a Plasmodium-positive household in 2017 (Risk Ratio, 5.00 [95% confidence interval, 2.09-11.96], P < .0001). There was no consistent evidence that malaria risk clustered in groups of socially connected individuals from different households. CONCLUSIONS Malaria risk clustered more clearly in households than in hotspots over 2 years. Household-based strategies should be prioritized in malaria elimination programs in this region.
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Affiliation(s)
| | | | - Vincent Sluydts
- Institute of Tropical Medicine, Antwerp.,University of Antwerp, Belgium
| | - Sochantha Tho
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh
| | - Mao Sokny
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh
| | - Vanna Mean
- Ratanakiri Provincial Health Department, Banlung
| | | | | | | | - Steven Abrams
- University of Antwerp, Belgium.,University of Hasselt, Belgium
| | - Niel Hens
- University of Antwerp, Belgium.,University of Hasselt, Belgium
| | | | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Lies Durnez
- Institute of Tropical Medicine, Antwerp.,University of Antwerp, Belgium
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31
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Significant Efficacy of a Single Low Dose of Primaquine Compared to Stand-Alone Artemisinin Combination Therapy in Reducing Gametocyte Carriage in Cambodian Patients with Uncomplicated Multidrug-Resistant Plasmodium falciparum Malaria. Antimicrob Agents Chemother 2020; 64:AAC.02108-19. [PMID: 32179526 PMCID: PMC7269483 DOI: 10.1128/aac.02108-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/06/2020] [Indexed: 11/22/2022] Open
Abstract
Since 2012, a single low dose of primaquine (SLDPQ; 0.25 mg/kg of body weight) with artemisinin-based combination therapies has been recommended as the first-line treatment of acute uncomplicated Plasmodium falciparum malaria to interrupt its transmission, especially in low-transmission settings of multidrug resistance, including artemisinin resistance. Policy makers in Cambodia have been reluctant to implement this recommendation due to primaquine safety concerns and a lack of data on its efficacy. Since 2012, a single low dose of primaquine (SLDPQ; 0.25 mg/kg of body weight) with artemisinin-based combination therapies has been recommended as the first-line treatment of acute uncomplicated Plasmodium falciparum malaria to interrupt its transmission, especially in low-transmission settings of multidrug resistance, including artemisinin resistance. Policy makers in Cambodia have been reluctant to implement this recommendation due to primaquine safety concerns and a lack of data on its efficacy. In this randomized controlled trial, 109 Cambodians with acute uncomplicated P. falciparum malaria received dihydroartemisinin-piperaquine (DP) alone or combined with SLDPQ on the first treatment day. The transmission-blocking efficacy of SLDPQ was evaluated on days 0, 1, 2, 3, 7, 14, 21, and 28, and recrudescence by reverse transcriptase PCR (RT-PCR) (gametocyte prevalence) and membrane feeding assays with Anopheles minimus mosquitoes (gametocyte infectivity). Without the influence of recrudescent infections, DP-SLDPQ reduced gametocyte carriage 3-fold compared to that achieved with DP. Of 48 patients tested on day 0, only 3 patients were infectious to mosquitoes (∼6%). Posttreatment, three patients were infectious on day 14 (3.5%, 1/29) and on the 1st and 7th days of recrudescence (8.3%, 1/12 for each); this overall low infectivity precluded our ability to assess its transmission-blocking efficacy. Our study confirms the effective gametocyte clearance of SLDPQ when combined with DP in multidrug-resistant P. falciparum infections and the negative impact of recrudescent infections due to poor DP efficacy. Artesunate-mefloquine (ASMQ) has replaced DP, and ASMQ-SLDPQ has been deployed to treat all patients with symptomatic P. falciparum infections to further support the elimination of multidrug-resistant P. falciparum in Cambodia. (This study has been registered at ClinicalTrials.gov under identifier NCT02434952.)
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Posfai D, Maher SP, Roesch C, Vantaux A, Sylvester K, Péneau J, Popovici J, Kyle DE, Witkowski B, Derbyshire ER. Plasmodium vivax Liver and Blood Stages Recruit the Druggable Host Membrane Channel Aquaporin-3. Cell Chem Biol 2020; 27:719-727.e5. [PMID: 32330444 PMCID: PMC7303948 DOI: 10.1016/j.chembiol.2020.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/07/2020] [Accepted: 03/09/2020] [Indexed: 12/17/2022]
Abstract
Plasmodium vivax infects hepatocytes to form schizonts that cause blood infection, or dormant hypnozoites that can persist for months in the liver before leading to relapsing blood infections. The molecular processes that drive P. vivax schizont and hypnozoite survival remain largely unknown, but they likely involve a rich network of host-pathogen interactions, including those occurring at the host-parasite interface, the parasitophorous vacuole membrane (PVM). Using a recently developed P. vivax liver-stage model system we demonstrate that host aquaporin-3 (AQP3) localizes to the PVM of schizonts and hypnozoites within 5 days after invasion. This recruitment is also observed in P. vivax-infected reticulocytes. Chemical treatment with the AQP3 inhibitor auphen reduces P. vivax liver hypnozoite and schizont burden, and inhibits P. vivax asexual blood-stage growth. These findings reveal a role for AQP3 in P. vivax liver and blood stages and suggest that the protein may be targeted for therapeutic treatment. Host aquaporin-3 (AQP3) is recruited to P. vivax hypnozoites and schizonts The AQP3 inhibitor auphen inhibits P. vivax hypnozoites and schizonts Host AQP3 is recruited to P. vivax-infected erythrocytes derived from patient samples Auphen inhibits blood stages of clinical P. vivax isolates
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Affiliation(s)
- Dora Posfai
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, 213 Research Drive, Durham, NC 27710, USA
| | - Steven P Maher
- Center for Tropical and Emerging Global Diseases, University of Georgia, 500 D.W. Brooks Dr, ste 370, Athens, GE 30602, USA
| | - Camille Roesch
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia
| | - Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia
| | - Kayla Sylvester
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, 213 Research Drive, Durham, NC 27710, USA
| | - Julie Péneau
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia
| | - Jean Popovici
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia
| | - Dennis E Kyle
- Center for Tropical and Emerging Global Diseases, University of Georgia, 500 D.W. Brooks Dr, ste 370, Athens, GE 30602, USA
| | - Benoît Witkowski
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia.
| | - Emily R Derbyshire
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, 213 Research Drive, Durham, NC 27710, USA; Chemistry Department, Duke University, 124 Science Drive, Durham, NC 27708, USA.
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33
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Wahab A, Shaukat A, Ali Q, Hussain M, Khan TA, Khan MAU, Rashid I, Saleem MA, Evans M, Sargison ND, Chaudhry U. A novel metabarcoded 18S ribosomal DNA sequencing tool for the detection of Plasmodium species in malaria positive patients. INFECTION GENETICS AND EVOLUTION 2020; 82:104305. [PMID: 32247865 DOI: 10.1016/j.meegid.2020.104305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 02/07/2023]
Abstract
Various PCR based methods have been described for the diagnosis of malaria, but most depend on the use of Plasmodium species-specific probes and primers; hence only the tested species are identified and there is limited available data on the true circulating species diversity. Sensitive diagnostic tools and platforms for their use are needed to detect Plasmodium species in both clinical cases and asymptomatic infections that contribute to disease transmission. We have recently developed for the first time a novel high throughput 'haemoprotobiome' metabarcoded DNA sequencing method and applied it for the quantification of haemoprotozoan parasites (Theleria and Babesia) of livestock. Here, we describe a novel, high throughput method using an Illumina MiSeq platform to demonstrate the proportions of Plasmodium species in metabarcoded DNA samples derived from human malaria patients. Plasmodium falciparum and Plasmodium vivax positive control gDNA was used to prepare mock DNA pools of parasites to evaluate the detection threshold of the assay for each of the two species. The different mock pools demonstrate the accurate detection ability and to show the proportions of each of the species being present. We then applied the assay to malaria-positive human samples to show the species composition of Plasmodium communities in the Punjab province of Pakistan and in the Afghanistan-Pakistan tribal areas. The diagnostic performance of the deep amplicon sequencing method was compared to an immunochromatographic assay that is widely used in the region. The deep amplicon sequencing showed that P. vivax was present in 69.8%, P. falciparum in 29.5% and mixed infection in 0.7% patients examined. The immunochromatographic assay showed that P. vivax was present in 65.6%, P. falciparum in 27.4%, mixed infection 0.7% patients and 6.32% malaria-positive cases were negative in immunochromatographic assay, but positive in the deep amplicon sequencing. Overall, metabarcoded DNA sequencing demonstrates better diagnostic performance, greatly increasing the estimated prevalence of Plasmodium infection. The next-generation sequencing method using metabarcoded DNA has potential applications in the diagnosis, surveillance, treatment, and control of Plasmodium infections, as well as to study the parasite biology.
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Affiliation(s)
- Abdul Wahab
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Ayaz Shaukat
- University of Central Punjab, Lahore, Punjab, Pakistan
| | - Qasim Ali
- Gomal University, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan
| | - Mubashir Hussain
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Taj Ali Khan
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | | | - Imran Rashid
- University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan
| | | | - Mike Evans
- Royal Dick School of Veterinary Studies, University of Edinburgh, UK
| | - Neil D Sargison
- Royal Dick School of Veterinary Studies, University of Edinburgh, UK.
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34
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Cunningham JA, Thomson RM, Murphy SC, de la Paz Ade M, Ding XC, Incardona S, Legrand E, Lucchi NW, Menard D, Nsobya SL, Saez AC, Chiodini PL, Shrivastava J. WHO malaria nucleic acid amplification test external quality assessment scheme: results of distribution programmes one to three. Malar J 2020; 19:129. [PMID: 32228615 PMCID: PMC7106789 DOI: 10.1186/s12936-020-03200-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends parasite-based diagnosis of malaria. In recent years, there has been surge in the use of various kinds of nucleic-acid amplification based tests (NAATs) for detection and identification of Plasmodium spp. to support clinical care in high-resource settings and clinical and epidemiological research worldwide. However, these tests are not without challenges, including lack (or limited use) of standards and lack of reproducibility, due in part to variation in protocols amongst laboratories. Therefore, there is a need for rigorous quality control, including a robust external quality assessment (EQA) scheme targeted towards malaria NAATs. To this effect, the WHO Global Malaria Programme worked with the UK National External Quality Assessment Scheme (UK NEQAS) Parasitology and with technical experts to launch a global NAAT EQA scheme in January 2017. METHODS Panels of NAAT EQA specimens containing five major species of human-infecting Plasmodium at various parasite concentrations and negative samples were created in lyophilized blood (LB) and dried blood spot (DBS) formats. Two distributions per year were sent, containing five LB and five DBS specimens. Samples were tested and validated by six expert referee laboratories prior to distribution. Between 37 and 45 laboratories participated in each distribution and submitted results using the online submission portal of UK NEQAS. Participants were scored based on their laboratory's stated capacity to identify Plasmodium species, and individual laboratory reports were sent which included performance comparison with anonymized peers. RESULTS Analysis of the first three distributions revealed that the factors that most significantly affected performance were sample format (DBS vs LB), species and parasite density, while laboratory location and the reported methodology used (type of nucleic acid extraction, amplification, or DNA vs RNA target) did not significantly affect performance. Referee laboratories performed better than non-referee laboratories. CONCLUSIONS Globally, malaria NAAT assays now inform a range of clinical, epidemiological and research investigations. EQA schemes offer a way for laboratories to assess and improve their performance, which is critical to safeguarding the reliability of data and diagnoses especially in situations where various NAAT methodologies and protocols are in use.
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Affiliation(s)
| | | | - Sean C Murphy
- Seattle Malaria Clinical Trials Center, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Maria de la Paz Ade
- Department of Communicable Diseases and Health Analysis, Pan American Health Organization/World Health Organization, Washington, DC, USA
| | - Xavier C Ding
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | - Eric Legrand
- Biology of Host-Parasite Interactions Unit, Institut Pasteur, INSERM U1201/CNRS ERL9195, Paris, France
| | - Naomi W Lucchi
- Malaria Branch, Division of Parasitic Diseases and MalariaCenter for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Didier Menard
- Biology of Host-Parasite Interactions Unit, Institut Pasteur, INSERM U1201/CNRS ERL9195, Paris, France
| | - Samuel L Nsobya
- Department of Pathology, School of Biomedical Science, Makerere University, Kampala, Uganda
| | - Agatha C Saez
- UK NEQAS Parasitology, Public Health England, London, UK
| | - Peter L Chiodini
- UK NEQAS Parasitology, Public Health England, London, UK
- The Hospital for Tropical Diseases, London, UK
| | - Jaya Shrivastava
- UK NEQAS Parasitology, Public Health England, London, UK
- The Hospital for Tropical Diseases, London, UK
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35
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Amplification of Duffy binding protein-encoding gene allows Plasmodium vivax to evade host anti-DBP humoral immunity. Nat Commun 2020; 11:953. [PMID: 32075983 PMCID: PMC7031336 DOI: 10.1038/s41467-020-14574-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/18/2020] [Indexed: 01/02/2023] Open
Abstract
Antigenic variation, the capacity to produce a range of variable antigens, is a well-described strategy of Plasmodium and other parasites to evade host immunity. Here, we show that gene amplification is an additional evasion mechanism used by Plasmodium vivax to escape humoral immunity targeting PvDBP, the key ligand involved in reticulocyte invasion. PvDBP gene amplification leads to increased mRNA levels and protects P. vivax in vitro against invasion inhibitory human monoclonal antibodies targeting a conserved binding domain of DBP. Patient samples suggest that parasites with increased pvdbp copy number are able to infect individuals with naturally acquired antibodies highly blocking the binding of PvDBP to the Duffy receptor. These results show that gene copy number variation affect the parasite’s ability to evade anti-PvDBP humoral immunity. Duffy binding protein (DBP) of Plasmodium vivax is important for invasion and is a potential vaccine candidate. Here, the authors show that PvDBP gene amplification protects P vivax in vitro against invasion inhibitory human monoclonal antibodies and is associated to infection of patients with PvDBP binding inhibitory antibodies.
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36
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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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37
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Lover AA, Dantzer E, Hocini S, Estera R, Rerolle F, Smith JL, Hwang J, Gosling R, Yukich J, Greenhouse B, Jacobson J, Phetsouvanh R, Hongvanthong B, Bennett A. Study protocol for a cluster-randomized split-plot design trial to assess the effectiveness of targeted active malaria case detection among high-risk populations in Southern Lao PDR (the AcME-Lao study). Gates Open Res 2019; 3:1730. [PMID: 32118199 PMCID: PMC7019195 DOI: 10.12688/gatesopenres.13088.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2019] [Indexed: 01/19/2023] Open
Abstract
Introduction: Novel interventions are needed to accelerate malaria elimination, especially in areas where asymptomatic parasitemia is common, and where transmission generally occurs outside of village-based settings. Testing of community members linked to a person with clinical illness (reactive case detection, RACD) has not shown effectiveness in prior studies due to the limited sensitivity of current point-of-care tests. This study aims to assess the effectiveness of active case finding in village-based and forested-based settings using novel high-sensitivity rapid diagnostic tests in Lao People’s Democratic Republic (Lao PDR). Methods and analysis: This study is a cluster-randomized split-plot design trial. The interventions include village-based mass test and treat (MTAT), focal test and treat in high-risk populations (FTAT), and the combination of these approaches, using high-sensitivity rapid diagnostic tests (HS-RDTs) to asses
P. falciparum infection status. Within four districts in Champasak province, Lao PDR fourteen health center-catchment areas will be randomized to either FTAT or control; and within these HCCAs, 56 villages will be randomized to either MTAT or control. In intervention areas, FTAT will be conducted by community-based peer navigators on a routine basis, and three separate rounds of MTAT are planned. The primary study outcome will be PCR-based
Plasmodium falciparum prevalence after one year of implementation. Secondary outcomes include malaria incidence; interventional coverage; operational feasibility and acceptability; and cost and cost- effectiveness. Ethics and dissemination: Findings will be reported on clinicaltrials.gov, in peer-reviewed publications and through stakeholder meetings with Ministry of Health and community leaders in Lao PDR and throughout the Greater Mekong Subregion. Trial registration: clinicaltrials.gov
NCT03783299 (21/12/2018)
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Affiliation(s)
- Andrew A Lover
- Department of Biostatistics and Epidemiology; School of Public Health and Health Sciences, University of Massachusetts- Amherst, Amherst, Massachusetts, 01003-9304, USA
| | - Emily Dantzer
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Sophia Hocini
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ronaldo Estera
- Health Poverty Action, Vientiane, Lao People's Democratic Republic
| | - Francois Rerolle
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Jennifer L Smith
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Jimee Hwang
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA.,Center for Global Health/ DPDM Malaria Branch/ US President's Malaria Initiative, US Center for Disease Control & Prevention, Atlanta, GA, 30333, USA
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Joshua Yukich
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70118, USA
| | - Bryan Greenhouse
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, 94158, USA
| | | | - Rattanaxay Phetsouvanh
- Department of Communicable Disease Control, Ministry of Health, Lao PDR, Vientiane, Lao People's Democratic Republic
| | - Bouasy Hongvanthong
- Center for Malariology, Parasitology and Entomology, Ministry of Health, Lao PDR, Vientiane, Lao People's Democratic Republic
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA, 94158, USA
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Thomson R, Sochea P, Sarath M, MacDonald A, Pratt A, Poyer S, Allen H, Kunthy S, Chamroeun S, Daro K, Samean S, Panharith N, Ra S, Sovottha C, Mundy G, Yeung S. Rubber plantations and drug resistant malaria: a cross-sectional survey in Cambodia. Malar J 2019; 18:379. [PMID: 31775755 PMCID: PMC6882203 DOI: 10.1186/s12936-019-3000-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/11/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The ongoing spread of artemisinin resistant Plasmodium falciparum malaria is a major threat to global health. In response, countries in the Greater Mekong Sub-region, including Cambodia, have declared ambitious goals to eliminate malaria. Major challenges include the lack of information on the at-risk population-individuals who live or work in or near the forest where the malaria vectors are found, including plantation workers. This study aimed to address this knowledge gap through a cross-sectional survey conducted in rubber plantations in Cambodia in 2014. METHODS The survey was conducted in two rounds in four provinces and included a malaria prevalence survey, analysis for the K13 genetic mutation, and a comprehensive behavioural questionnaire. Forty plantations were included in each round, and 4201 interviews were conducted. An additional 701 blood samples were collected from family members of plantation workers. RESULTS Overall malaria prevalence was relatively low with adjusted PCR prevalence rate of 0.6% for P. falciparum and 0.3% for Plasmodium vivax, and was very heterogenous between plantations. There was little difference in risk between permanent residents and temporary workers, and between the two rounds. The main risk factors for P. falciparum infection were smaller plantations, age under 30 years, lack of self-reported use of a treated net and recent travel, especially to the Northeastern provinces. Proximity of plantations to the forest was also a risk factor for malaria in round one, while male gender was also a risk factor for malaria by either species. CONCLUSIONS With Cambodia's P. falciparum elimination target on the horizon, identifying every single malaria case will become increasingly important. Plantations workers are relatively accessible compared to some other at-risk groups and will likely remain a high priority. Ongoing surveillance and adaptive strategies will be critical if malaria elimination is to be achieved in this setting.
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Affiliation(s)
- Rebecca Thomson
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Phok Sochea
- Population Services Khmer, Phnom Penh, Cambodia
| | - Mak Sarath
- Population Services Khmer, Phnom Penh, Cambodia
| | | | - Abigail Pratt
- Population Services International, Washington, DC, USA
| | - Steve Poyer
- Population Services International, Washington, DC, USA
| | | | - Sok Kunthy
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Sok Chamroeun
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Kim Daro
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Sourn Samean
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Nou Panharith
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Sok Ra
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Chan Sovottha
- Partners for Development-LSHTM Partnership, Phnom Penh, Cambodia
| | - Gary Mundy
- Helen Keller International, New York, USA
| | - Shunmay Yeung
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
- Clinical Research Department, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK.
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Popovici J, Pierce-Friedrich L, Kim S, Bin S, Run V, Lek D, Hee KHD, Lee Soon-U L, Cannon MV, Serre D, Menard D. Recrudescence, Reinfection, or Relapse? A More Rigorous Framework to Assess Chloroquine Efficacy for Plasmodium vivax Malaria. J Infect Dis 2019; 219:315-322. [PMID: 30102351 DOI: 10.1093/infdis/jiy484] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/07/2018] [Indexed: 11/14/2022] Open
Abstract
Background Plasmodium vivax resistance to chloroquine (CQ) has been reported worldwide, although the World Health Organization clinical drug efficacy studies protocol does not permit classification of patient outcomes. Methods We enrolled 40 patients with P. vivax malaria in northeastern Cambodia, where >17% treatment failures were previously reported. Patients were treated with CQ (30 mg/kg) and followed for 2 months, with frequent clinical examination and capillary blood sample collection for microscopy, molecular parasite detection and genotyping, and drug concentration measurements. Reinfections were prevented by relocating patients to a transmission-free area. Results P. vivax parasites were eliminated in all patients by day 3. Genomic analyses revealed that all clones in polyclonal infections were cleared at the same rate, indicating their equal susceptibility to CQ. CQ blood concentrations were below the therapeutic level in all recurrent infections (24 of 40 patients), which were efficiently cleared by a second course of CQ treatment. Genotyping (128 SNPs barcode) and sequences of entire parasite genome (Whole-Genome Sequencing, Illumina) indicated that two thirds (6 of 8) of the recurrent parasites resulted from heterologous relapses whose 50% are from by sibling/recombinant clones. Conclusions No evidence of CQ resistance was observed. Our data suggest that P. vivax antimalarial drug resistance is likely overestimated and that the current guidelines for clinical drug studies of P. vivax malaria need to be revised.
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Affiliation(s)
- Jean Popovici
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh
| | | | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh
| | - Sophalai Bin
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh
| | - Vorleak Run
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh
| | - Dysoley Lek
- National Center for Malaria Control, Phnom Penh, Cambodia
| | | | | | - Matthew V Cannon
- Genomic Medicine Institute, Cleveland Clinic, Ohio.,Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore
| | - David Serre
- Genomic Medicine Institute, Cleveland Clinic, Ohio.,Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore
| | - Didier Menard
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh.,Malaria Genetics and Resistance Group, Biology of Host-Parasite Interactions Unit, Institut Pasteur, France
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40
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Rossi G, Vernaeve L, Van den Bergh R, Nguon C, Debackere M, Abello Peiri C, Van V, Khim N, Kim S, Eam R, Ken M, Khean C, De Smet M, Menard D, Kindermans JM. Closing in on the Reservoir: Proactive Case Detection in High-Risk Groups as a Strategy to Detect Plasmodium falciparum Asymptomatic Carriers in Cambodia. Clin Infect Dis 2019; 66:1610-1617. [PMID: 29361021 DOI: 10.1093/cid/cix1064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022] Open
Abstract
Background In the frame of elimination strategies of Plasmodium falciparum (Pf), active case detection has been recommended as complementary approach to the existing passive case detection programs. We trialed a polymerase chain reaction (PCR)-based active detection strategy targeting asymptomatic individuals, named proactive case detection (PACD), with the aim of assessing its feasibility, the extra yield of Pf infections, and the at-risk population for Pf carriage status. Methods A pilot of PACD was conducted in 3 villages in Chey Saen district (Preah Vihear province, Cambodia), from December 2015 to March 2016. Voluntary screening and treatment, following health promotion sensitization, was used as mobilization strategy. Results A total of 2802 persons were tested, representing 54% of the population. PACD (n = 30) and the respective reactive case detection (RACD) (n = 3) identified 33 Pf carriers, approximately twice as many as the Pf infections (n = 17) diagnosed in passive case detection and respective RACD, by health centers and village malaria workers using PCR, in the same villages/period. Final positivity rate was 1.07% (30/2802). People spending nighttime in forests and plantations were found to be at increased risk for Pf infection (odds ratio [OR], 3.4 [95% CI, 1.6-7.2], P = .002 and OR, 2.3 [95% CI, 1.1-4.9], P = .03, respectively). Conclusions We demonstrated the usefulness of the PACD component in identifying Pf asymptomatic carriers. Social mobilization and promotion led to good attendance of specific risk groups, identified to be, in the Cambodian context, individuals spending nighttime in forest and plantations.
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Affiliation(s)
| | | | | | - Chea Nguon
- Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | | | - Vuthea Van
- Médecins Sans Frontières, Phnom Penh, Cambodia
| | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia
| | - Rotha Eam
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia
| | - Malen Ken
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia
| | - Chanra Khean
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia
| | - Martin De Smet
- Médecins Sans Frontières Operational Center, Brussels, Belgium
| | - Didier Menard
- Malaria Molecular Epidemiology Unit, Institut Pasteur, Phnom Penh, Cambodia.,Unité Biologie des Interactions Hôte-Parasite, Institut Pasteur, Paris, France
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41
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Rossi G, Van den Bergh R, Nguon C, Debackere M, Vernaeve L, Khim N, Kim S, Menard D, De Smet M, Kindermans JM. Adapting Reactive Case Detection Strategies for falciparum Malaria in a Low-Transmission Area in Cambodia. Clin Infect Dis 2019; 66:296-298. [PMID: 29020325 DOI: 10.1093/cid/cix781] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/26/2017] [Indexed: 12/26/2022] Open
Abstract
Reactive case detection around falciparum malaria cases in Cambodia presents a low output. We improved it by including individuals occupationally coexposed with index case patients and using polymerase chain reaction-based diagnosis. The positivity rate increased from 0.16% to 3.9%.
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Affiliation(s)
| | | | - Chea Nguon
- Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | | | | | | | | | - Martin De Smet
- Médecins Sans Frontières Operational Center Brussels, Belgium
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Vantaux A, Samreth R, Piv E, Khim N, Kim S, Berne L, Chy S, Lek D, Siv S, Taylor WR, Ménard D. Contribution to Malaria Transmission of Symptomatic and Asymptomatic Parasite Carriers in Cambodia. J Infect Dis 2019; 217:1561-1568. [PMID: 29394367 DOI: 10.1093/infdis/jiy060] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background Eliminating falciparum malaria in Cambodia is a top priority, requiring the implementation of novel tools and strategies to interrupt its transmission. To date, few data are available regarding the contributions to malaria transmission of symptomatic and asymptomatic carriers. Methods Direct-membrane and skin feeding assays (DMFAs, SFAs) were performed, using Anopheles minimus and Anopheles dirus, to determine infectivity of symptomatic falciparum-infected patients and malaria asymptomatic carriers; a subset of the latter were followed up for 2 months to assess their transmission potential. Results By microscopy and real-time polymerase chain reaction, Plasmodium falciparum gametocyte prevalence rates were, respectively, 19.3% (n = 21/109) and 44% (n = 47/109) on day (D) 0 and 17.9% (n = 5/28) and 89.3% (n = 25/28) in recrudescent patients (Drec) (RT-PCR Drec vs D0 P = .002). Falciparum malaria patient infectivity was low on D0 (6.2%; n = 3/48) and in Drec (8.3%; n = 1/12). Direct-membrane feeding assays and SFAs gave similar results. None of the falciparum (n = 0/19) and 3 of 28 Plasmodium vivax asymptomatic carriers were infectious to mosquitoes, including those that were followed up for 2 months. Overall, P. falciparum gametocytemias were low except in a few symptomatic carriers. Conclusions Only symptomatic falciparum malaria patients were infectious to mosquito vectors at baseline and recrudescence, highlighting the need to detect promptly and treat effectively P. falciparum patients.
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Affiliation(s)
- Amélie Vantaux
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Reingsey Samreth
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Eakpor Piv
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Laura Berne
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia.,Xeno Cell Innovations, Plzen, Czech Republic
| | - Sophy Chy
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Dysoley Lek
- National Center for Parasitology, Entomology and Malaria Control Program, Phnom Penh, Cambodia.,School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Sovannaroth Siv
- National Center for Parasitology, Entomology and Malaria Control Program, Phnom Penh, Cambodia
| | - Walter R Taylor
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Didier Ménard
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia.,Unité Biologie des Interactions Hôte-Parasite, Institut Pasteur, Paris, France
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Deida J, Tahar R, Khalef YO, Lekweiry KM, Hmeyade A, Khairy MLO, Simard F, Bogreau H, Basco L, Boukhary AOMS. Oasis Malaria, Northern Mauritania 1. Emerg Infect Dis 2019; 25:273-280. [PMID: 30666926 PMCID: PMC6346462 DOI: 10.3201/eid2502.180732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
A malaria survey was conducted in Atar, the northernmost oasis city in Mauritania, during 2015–2016. All febrile patients in whom malaria was suspected were screened for malaria by using rapid diagnostic testing and microscopic examination of blood smears and later confirmed by PCR. Of 453 suspected malaria cases, 108 (23.8%) were positive by rapid diagnostic testing, 154 (34.0%) by microscopic examination, and 162 (35.7%) by PCR. Malaria cases were observed throughout the year and among all age groups. Plasmodium vivax was present in 120/162 (74.1%) cases, P. falciparum in 4/162 (2.4%), and mixed P. falciparum–P. vivax in 38/162 (23.4%). Malaria is endemic in northern Mauritania and could be spreading farther north in the Sahara, possibly because of human-driven environmental changes. Further entomologic and parasitologic studies and monitoring are needed to relate these findings to major Anopheles mosquito vectors and to design and implement strategies for malaria prevention and control.
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44
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Warsame M, Hassan AM, Hassan AH, Jibril AM, Khim N, Arale AM, Gomey AH, Nur ZS, Osman SM, Mohamed MS, Abdulrahman A, Yusuf FE, Amran JGH, Witkowski B, Ringwald P. High therapeutic efficacy of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Somalia. Malar J 2019; 18:231. [PMID: 31296223 PMCID: PMC6624891 DOI: 10.1186/s12936-019-2864-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/03/2019] [Indexed: 11/26/2022] Open
Abstract
Background Artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DHA/PPQ) are the recommended first- and second-line treatments, respectively, for uncomplicated falciparum malaria in Somalia. The studies reported here were conducted to assess the efficacy of these artemisinin-based combinations and the mutations in Plasmodium falciparum K13-propeller (Pfk13) domain and amplification in Pfplasmepsin 2 (Pfpm2) gene in Somalia. Methods One-arm prospective studies were conducted to assess the clinical and parasitological responses to DHA/PPQ and AL at two sites in 2016 and 2017, respectively, using the standard WHO protocol. The patterns of molecular markers associated with artemisinin and PPQ resistance were investigated for the first time in Somalia. Results A total of 339 patients were enrolled with 139 for AL and 200 for DHA/PPQ. With AL, no parasite recurrence was observed among patients treated at either site, corresponding to 100% clinical and parasitological responses. For DHA–PPQ, an adequate clinical and parasitological response rate > 97% was observed. All study patients on both treatments at both sites were parasite-free on day 3. Of the 138 samples with interpretable results for the polymorphism in Pfk13, only one (0.7%), from Bosaso, contained a non-synonymous mutation (R622I), which is not one of the known markers of artemisinin resistance. No Pfpm2 amplification was observed among the 135 samples with interpretable results. Conclusions AL and DHA/PPQ were highly effective in the treatment of uncomplicated falciparum malaria, and there was no evidence of resistance to artemisinin or PPQ. These two combinations are thus relevant in the chemotherapeutic strategy for malaria control in Somalia. Trial registration ACTRN12616001005448 (Jowhar DP study), ACTRN12616000553471 (Bosaso DP study), ACTRN12617001055392 (AL study in Bosaso and Jowhar)
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Affiliation(s)
- Marian Warsame
- Global Malaria Programme, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland. .,University of Gothenburg, Gothenburg, Sweden.
| | | | | | | | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh, Cambodia
| | | | | | | | | | | | | | | | | | - Benoit Witkowski
- Malaria Molecular Epidemiology Unit, Pasteur Institute in Cambodia, Phnom Penh, Cambodia.,Malaria Translational Research Unit, Pasteur Institute, Paris, France
| | - Pascal Ringwald
- Global Malaria Programme, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
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45
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SHAHANDEH K, BASSERI HR. Challenges and the Path Forward on Malaria Elimination Intervention: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1004-1013. [PMID: 31341841 PMCID: PMC6635336] [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 This systematic review was conducted to highlights key challenges, and outlines important next steps to maximize the potential to contribute to the broader malaria elimination interventions. METHODS This systematic review on malaria elimination intervention and challenges was undertaken searching six databases, between 1995 and 2018. Inclusion and exclusion criteria were set. The references were collated and categorized according to type of study, intervention, population, and health outcome. Articles selection based on title and abstract, retrieval of full text and additions of articles from reference lists and recommendations from experts. Disagreement in data extraction was solved by consultation of third reviewer. RESULTS Overall, 4039 records were examined related to malaria elimination that initially identified by our designated electronic databases search. Overall, 35 studies contained 14 experimental studies (40%) and 21 analytic observational studies (60%) met the inclusion criteria for this review. Studies used a wide variety of malaria elimination interventions. Types of interventions either elimination-focused interventions or general interventions on educational, prevention and treatment of malaria are included. This review pointed out the variety of challenges for eliminate malaria among low and high endemic countries. CONCLUSION Malaria elimination is facilitated by strong health systems, determined leadership, appropriate incentivization, an effective surveillance system, and regional collaborations. We have identified areas for elimination-specific interventions deserve more attention in the conduct and reporting.
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Affiliation(s)
- Khandan SHAHANDEH
- Deputy of Research and Technology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza BASSERI
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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46
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Rossi G, De Smet M, Khim N, Kindermans JM, Menard D. Performance of Rapid Diagnostic Testing in Patients with Suspected Malaria in Cambodia, a Low-Endemicity Country Aiming for Malaria Elimination. Clin Infect Dis 2019; 65:1769-1770. [PMID: 29020315 DOI: 10.1093/cid/cix625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Martin De Smet
- Médecins Sans Frontières, Phnom Penh, Cambodia.,Médecins Sans Frontières Operational Center, Brussels, Belgium
| | | | - Jean-Marie Kindermans
- Médecins Sans Frontières, Phnom Penh, Cambodia.,Médecins Sans Frontières Operational Center, Brussels, Belgium
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47
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Low genetic diversity and complexity of submicroscopic Plasmodium falciparum infections among febrile patients in low transmission areas in Senegal. PLoS One 2019; 14:e0215755. [PMID: 31022221 PMCID: PMC6483351 DOI: 10.1371/journal.pone.0215755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/08/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Submicroscopic Plasmodium infections are common in malaria endemic countries, but very little studies have been done in Senegal. This study investigates the genetic diversity and complexity of submicroscopic P. falciparum infections among febrile patients in low transmission areas in Senegal. MATERIALS AND METHODS Hundred and fifty blood samples were collected from febrile individuals living in Dielmo and Ndiop (Senegal) between August 2014 and January 2015, tested for microscopic and sub-microscopic P. falciparum infections and characterized for their genetic diversity and complexity of infections using msp-1 and msp-2 genotyping. RESULTS Submicroscopic P. falciparum infections were 19.6% and 25% in Dielmo and Ndiop, respectively. K1 and 3D7 were the predominant msp-1 and msp-2 allelic types with respective frequencies of 67.36% and 67.10% in microscopic isolates and 58.24% and 78% in submicroscopic ones. Frequencies of msp-1 allelic types were statistically comparable between the studied groups (p>0.05), and were respectively 93.54% vs 87.5% for K1, 60% vs 54.83% for MAD20 and 41.93% vs 22.5% for RO33 while frequencies of msp-2 allelic types were significantly highest in the microscopy group for FC27 (41.93% vs 10%, Fisher's Exact Test, p = 0.001) and 3D7 (61.29% vs 32.5%, Fisher's Exact Test, p = 0.02). Multiplicities of infection were lowest in submicroscopic P. falciparum isolates. CONCLUSIONS The study revealed a high submicroscopic P. falciparum carriage among patients in the study areas, and that submicroscopic P. falciparum isolates had a lower genetic diversity and complexity of malaria infections.
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Bei AK, Niang M, Deme AB, Daniels RF, Sarr FD, Sokhna C, Talla C, Faye J, Diagne N, Doucoure S, Mboup S, Wirth DF, Tall A, Ndiaye D, Hartl DL, Volkman SK, Toure-Balde A. Dramatic Changes in Malaria Population Genetic Complexity in Dielmo and Ndiop, Senegal, Revealed Using Genomic Surveillance. J Infect Dis 2019; 217:622-627. [PMID: 29325146 DOI: 10.1093/infdis/jix580] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/26/2017] [Indexed: 11/12/2022] Open
Abstract
Dramatic changes in transmission intensity can impact Plasmodium population diversity. Using samples from 2 distant time-points in the Dielmo/Ndiop longitudinal cohorts from Senegal, we applied a molecular barcode tool to detect changes in parasite genotypes and complexity of infection that corresponded to changes in transmission intensity. We observed a striking statistically significant difference in genetic diversity between the 2 parasite populations. Furthermore, we identified a genotype in Dielmo and Ndiop previously observed in Thiès, potentially implicating imported malaria. This genetic surveillance study validates the molecular barcode as a tool to assess parasite population diversity changes and track parasite genotypes.
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Affiliation(s)
- Amy K Bei
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Laboratory of Bacteriology and Virology, Le Dantec Hospital, Senegal.,Laboratory of Parasitology and Mycology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Senegal
| | | | - Awa B Deme
- Laboratory of Bacteriology and Virology, Le Dantec Hospital, Senegal.,Laboratory of Parasitology and Mycology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Senegal
| | - Rachel F Daniels
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge
| | | | - Cheikh Sokhna
- French National Research Institute for Sustainable Development, URMITE, Senegal
| | - Cheikh Talla
- Epidemiology Unit, Institut Pasteur de Dakar, Senegal
| | - Joseph Faye
- Epidemiology Unit, Institut Pasteur de Dakar, Senegal
| | - Nafissatou Diagne
- French National Research Institute for Sustainable Development, URMITE, Senegal
| | - Souleymane Doucoure
- French National Research Institute for Sustainable Development, URMITE, Senegal
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Le Dantec Hospital, Senegal.,Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Senegal
| | - Dyann F Wirth
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge
| | - Adama Tall
- Epidemiology Unit, Institut Pasteur de Dakar, Senegal
| | - Daouda Ndiaye
- Laboratory of Parasitology and Mycology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Senegal
| | - Daniel L Hartl
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge.,Department of Organismic and Evolutionary Biology, Harvard University, Cambridge
| | - Sarah K Volkman
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge.,School of Nursing and Health Sciences, Simmons College, Boston, Massachusetts
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Leroy D, Macintyre F, Adoke Y, Ouoba S, Barry A, Mombo-Ngoma G, Ndong Ngomo JM, Varo R, Dossou Y, Tshefu AK, Duong TT, Phuc BQ, Laurijssens B, Klopper R, Khim N, Legrand E, Ménard D. African isolates show a high proportion of multiple copies of the Plasmodium falciparum plasmepsin-2 gene, a piperaquine resistance marker. Malar J 2019; 18:126. [PMID: 30967148 PMCID: PMC6457011 DOI: 10.1186/s12936-019-2756-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Today, the development of new and well-tolerated anti-malarial drugs is strongly justified by the emergence of Plasmodium falciparum resistance. In 2014-2015, a phase 2b clinical study was conducted to evaluate the efficacy of a single oral dose of Artefenomel (OZ439)-piperaquine (PPQ) in Asian and African patients presenting with uncomplicated falciparum malaria. METHODS Blood samples collected before treatment offered the opportunity to investigate the proportion of multidrug resistant parasite genotypes, including P. falciparum kelch13 mutations and copy number variation of both P. falciparum plasmepsin 2 (Pfpm2) and P. falciparum multidrug resistance 1 (Pfmdr1) genes. RESULTS Validated kelch13 resistance mutations including C580Y, I543T, P553L and V568G were only detected in parasites from Vietnamese patients. In Africa, isolates with multiple copies of the Pfmdr1 gene were shown to be more frequent than previously reported (21.1%, range from 12.4% in Burkina Faso to 27.4% in Uganda). More strikingly, high proportions of isolates with multiple copies of the Pfpm2 gene, associated with piperaquine (PPQ) resistance, were frequently observed in the African sites, especially in Burkina Faso and Uganda (> 30%). CONCLUSIONS These findings were considered to sharply contrast with the recent description of increased sensitivity to PPQ of Ugandan parasite isolates. This emphasizes the necessity to investigate in vitro susceptibility profiles to PPQ of African isolates with multiple copies of the Pfpm2 gene and estimate the risk of development of PPQ resistance in Africa. Trial registration Clinicaltrials.gov reference: NCT02083380. Study title: Phase II efficacy study of artefenomel and piperaquine in adults and children with P. falciparum malaria. https://clinicaltrials.gov/ct2/results?cond=&term=NCT02083380&cntry=&state=&city=&dist= . FSFV: 23-Jul-2014; LSLV: 09-Oct-2015.
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Affiliation(s)
- Didier Leroy
- Medicines for Malaria Venture, Geneva, Switzerland.
| | | | - Yeka Adoke
- Infectious Diseases Research Collaboration, Tororo Hospital, Tororo, Uganda
| | - Serge Ouoba
- Institut de Recherche en Sciences de la Santé - Unité de Recherche Clinique de Nanoro, Ouagadougou, Burkina Faso
| | - Aissata Barry
- Institut de Recherche en Sciences de la Santé - Unité de Recherche Clinique de Nanoro, Ouagadougou, Burkina Faso
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | | | - Rosauro Varo
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Yannelle Dossou
- Centre de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance, Faculté Des Sciences De La Santé, Cotonou, Benin
| | - Antoinette Kitoto Tshefu
- Centre de Recherche du Centre Hospitalier de Mont Amba, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Tran Thanh Duong
- National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam
| | - Bui Quang Phuc
- Clinical Pharmaceutical Research Department, National Institute of Malariology, Parasitology and Entomology, 35 Trung Van Street, Nam Tu Liem District, Hanoi, Vietnam
| | | | | | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Eric Legrand
- Malaria Genetics and Resistance Group, INSERM U1201-CNRS ERL919, Institut Pasteur, Paris, France
| | - Didier Ménard
- Malaria Genetics and Resistance Group, INSERM U1201-CNRS ERL919, Institut Pasteur, Paris, France.
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50
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Uwimana A, Penkunas MJ, Nisingizwe MP, Warsame M, Umulisa N, Uyizeye D, Musanabaganwa C, Munyaneza T, Ntagwabira E, Hakizimana D, Muvunyi CM, Kayobotsi C, Kabera M, Murindahabi M, Mbituyumuremyi A. Efficacy of artemether–lumefantrine versus dihydroartemisinin–piperaquine for the treatment of uncomplicated malaria among children in Rwanda: an open-label, randomized controlled trial. Trans R Soc Trop Med Hyg 2019; 113:312-319. [DOI: 10.1093/trstmh/trz009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/09/2019] [Accepted: 03/06/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aline Uwimana
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda
| | - Michael J Penkunas
- Demand-Driven Evaluations for Decisions, Clinton Health Access Initiative, Kigali, Rwanda
| | - Marie Paul Nisingizwe
- Demand-Driven Evaluations for Decisions, Clinton Health Access Initiative, Kigali, Rwanda
| | - Marian Warsame
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Noella Umulisa
- Maternal and Child Survival Program, United States Agency for International Development, Kigali, Rwanda
| | - Didier Uyizeye
- Maternal and Child Survival Program, United States Agency for International Development, Kigali, Rwanda
| | | | | | | | - Dieudonne Hakizimana
- Demand-Driven Evaluations for Decisions, Clinton Health Access Initiative, Kigali, Rwanda
| | | | - Claver Kayobotsi
- Single Project Implementation Unit, Rwanda Biomedical Center, Kigali, Rwanda
| | - Michee Kabera
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda
| | - Monique Murindahabi
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda
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