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de Assis GMP, de Alvarenga DAM, Souza LBE, Sánchez-Arcila JC, Silva EFE, de Pina-Costa A, Gonçalves GHP, Souza JCDJ, Nunes AJD, Pissinatti A, Moreira SB, Torres LDM, Costa HL, Tinoco HDP, Pereira VDS, Soares IDS, de Sousa TN, Ntumngia FB, Adams JH, Kano FS, Hirano ZMB, Pratt-Riccio LR, Daniel-Ribeiro CT, Ferreira JO, Carvalho LH, Alves de Brito CF. IgM antibody responses against Plasmodium antigens in neotropical primates in the Brazilian Atlantic Forest. Front Cell Infect Microbiol 2023; 13:1169552. [PMID: 37829607 PMCID: PMC10565664 DOI: 10.3389/fcimb.2023.1169552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/11/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Zoonotic transmission is a challenge for the control and elimination of malaria. It has been recorded in the Atlantic Forest, outside the Amazon which is the endemic region in Brazil. However, only very few studies have assessed the antibody response, especially of IgM antibodies, in Neotropical primates (NP). Therefore, in order to contribute to a better understanding of the immune response in different hosts and facilitate the identification of potential reservoirs, in this study, naturally acquired IgM antibody responses against Plasmodium antigens were evaluated, for the first time, in NP from the Atlantic Forest. Methods The study was carried out using 154 NP samples from three different areas of the Atlantic Forest. IgM antibodies against peptides of the circumsporozoite protein (CSP) from different Plasmodium species and different erythrocytic stage antigens were detected by ELISA. Results Fifty-nine percent of NP had IgM antibodies against at least one CSP peptide and 87% against at least one Plasmodium vivax erythrocytic stage antigen. Levels of antibodies against PvAMA-1 were the highest compared to the other antigens. All families of NP showed IgM antibodies against CSP peptides, and, most strikingly, against erythrocytic stage antigens. Generalized linear models demonstrated that IgM positivity against PvCSP and PvAMA-1 was associated with PCR-detectable blood-stage malaria infection and the host being free-living. Interestingly, animals with IgM against both PvCSP and PvAMA-1 were 4.7 times more likely to be PCR positive than animals that did not have IgM for these two antigens simultaneously. Discussion IgM antibodies against different Plasmodium spp. antigens are present in NP from the Atlantic Forest. High seroprevalence and antibody levels against blood-stage antigens were observed, which had a significant association with molecular evidence of infection. IgM antibodies against CSP and AMA-1 may be used as a potential marker for the identification of NP infected with Plasmodium, which are reservoirs of malaria in the Brazilian Atlantic Forest.
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Affiliation(s)
- Gabriela Maíra Pereira de Assis
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | | | - Luisa Braga e Souza
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Juan Camilo Sánchez-Arcila
- School of Natural Sciences, Molecular and Cell Biology Department, University of California, Merced, Merced, CA, United States
| | | | - Anielle de Pina-Costa
- Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas (INI), Fiocruz, Rio de Janeiro, Brazil
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
- Escola de Enfermagem Aurora de Afonso Costa, Departamento de Doenças infecciosas e Parasitárias, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | - Ana Julia Dutra Nunes
- Fundação Universidade Regional de Blumenau (FURB), Blumenau, Brazil
- Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
- Programa de conservação do Bugio Ruivo, Perini Business Park, Joinville, Brazil
| | - Alcides Pissinatti
- Centro de Primatologia do Rio de Janeiro (CPRJ), Instituto Estadual do Ambiente (INEA), Guapimirim, Brazil
- Centro Universitário Serra dos Órgãos (Unifeso), Teresópolis, Brazil
| | - Silvia Bahadian Moreira
- Centro de Primatologia do Rio de Janeiro (CPRJ), Instituto Estadual do Ambiente (INEA), Guapimirim, Brazil
| | - Leticia de Menezes Torres
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Helena Lott Costa
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | | | | | - Irene da Silva Soares
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Taís Nóbrega de Sousa
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Francis Babila Ntumngia
- Center for Global Health and Infectious Diseases Research, College of Public Health, University of South Florida, Tampa, FL, United States
| | - John H. Adams
- Center for Global Health and Infectious Diseases Research, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Flora Satiko Kano
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Zelinda Maria Braga Hirano
- Fundação Universidade Regional de Blumenau (FURB), Blumenau, Brazil
- Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
- Programa de conservação do Bugio Ruivo, Perini Business Park, Joinville, Brazil
| | - Lilian Rose Pratt-Riccio
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
| | - Cláudio Tadeu Daniel-Ribeiro
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
| | - Joseli Oliveira Ferreira
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
| | - Luzia Helena Carvalho
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
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Prevalence of Asymptomatic Malaria Parasitemia among Blood Donors in Cape Coast, Ghana: A Cross-Sectional Study. J Trop Med 2023; 2023:8685482. [PMID: 36644573 PMCID: PMC9833917 DOI: 10.1155/2023/8685482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background Malaria is an important transfusion-associated infection in many parts of the world, particularly in sub-Saharan Africa, where it is endemic. We studied the prevalence of malaria parasites among blood donors in the Cape Coast Metropolitan Area. Methods A malaria parasite examination was added to the blood donor screening protocol for 240 voluntary and replacement blood donors (224 males and 16 females) between December 2020 and July 2021. Results Overall, 2.5% (6/240) had Plasmodium falciparum trophozoites detected in their blood sample. The remaining had no parasites detected. Four of the 148 who passed the blood donor screening tests were infected. The remaining two with malaria parasites failed one screening test. These included one donor with "hepatitis B + P. falciparum" and another with "syphilis + P. falciparum" parasite coinfection. All blood donors who had malaria parasites detected in their blood were males. Most donors, 45.8% (110/240), were in the 26-35 age group, with the highest prevalence of 1.3% (3/240). Blood group O was predominant (75.0%, 180/240), followed by B (12.9%, 31/240), A (11.3%, 27/240), and AB (0.8%, 2/240). All malaria parasites detected were among individuals with blood group O. Moreover, 96.3% (231/240) were rhesus-positive and had the highest prevalence of 2.1% (5/240). Conclusions Screening of blood donors in Ghana does not include malaria, although there is the potential for transmission through blood products. Malaria transmission via blood transfusion remains an issue of public health concern, as indicated in the results of this current study. We recommend studies on malaria prevention, pretransfusion and posttransfusion, and pathogen reduction technology.
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Transfusion-Transmitted Malaria of Plasmodium malariae in Palermo, Sicily. Healthcare (Basel) 2021; 9:healthcare9111558. [PMID: 34828604 PMCID: PMC8618732 DOI: 10.3390/healthcare9111558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
Transfusion-transmitted malaria (TTM) is a rare occurrence with serious consequences for the recipient. In non-endemic areas, the incidence of transmission of malaria by transfusion is very low. We report a clinical case of transfusion-transmitted malaria due to Plasmodium malariae, which happened in a patient with acute hemorrhagic gastropathy. Case presentation: In April 2019, a 70-year-old Italian man with recurrent spiking fever for four days was diagnosed with a P. malariae infection, as confirmed using microscopy and real-time PCR. The patient had never been abroad, but about two months before, he had received a red blood cell transfusion for anemia. Regarding the donor, we revealed that they were a missionary priest who often went to tropical regions. Plasmodium spp. PCR was also used on donor blood to confirm the causal link. Discussion and Conclusions: The donations of asymptomatic blood donors who are predominantly “semi-immune” with very low parasitic loads are an issue. The main problem is related to transfusion-transmitted malaria. Our case suggests that P. malariae infections in semi-immune asymptomatic donors are a threat to transfusion safety. Currently, microscopy is considered the gold standard for the diagnosis of malaria but has limited sensitivity to detect low levels of parasitemia. Screening using serological tests and molecular tests, combined with the donor’s questionnaire, should be used to reduce the cases of TTM.
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de Assis GMP, de Alvarenga DAM, Costa Pereira MDO, Sánchez-Arcila JC, de Pina Costa A, de Souza Junior JC, Nunes AJD, Pissinatti A, Moreira SB, de Menezes Torres L, Costa HL, da Penha Tinoco H, Pereira VDS, Soares IDS, de Sousa TN, Ntumngia FB, Adams JH, Kano FS, Hirano ZMB, Daniel-Ribeiro CT, Oliveira Ferreira J, Carvalho LH, Alves de Brito CF. Profiling Humoral Immune Response Against Pre-Erythrocytic and Erythrocytic Antigens of Malaria Parasites Among Neotropical Primates in the Brazilian Atlantic Forest. Front Cell Infect Microbiol 2021; 11:678996. [PMID: 34055672 PMCID: PMC8155606 DOI: 10.3389/fcimb.2021.678996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/22/2021] [Indexed: 12/22/2022] Open
Abstract
Human malaria due to zoonotic transmission has been recorded in the Atlantic Forest, an extra-Amazonian area in Brazil, which are a challenge for malaria control. Naturally acquired humoral immune response against pre-erythrocytic and erythrocytic antigens of Neotropical primates (NP) was evaluated here to improve the knowledge about the exposure of those animals to the malaria transmission and support the identification of the potential reservoirs of the disease in the Atlantic Forest. Blood samples of 154 monkeys from three areas of the Atlantic Forest were used to identify IgG antibodies against peptides of the repeat region of the major pre-erythrocytic antigen, the circumsporozoite protein (CSP), of Plasmodium vivax (PvCSP), Plasmodium brasilianum/Plasmodium malariae (Pb/PmCSP), and Plasmodium falciparum (PfCSP) by ELISA. Antibodies against erythrocytic recombinant antigens of P. vivax, Apical membrane antigen 1 (PvAMA-1), Erythrocyte binding protein 2 (PvEBP-2) and domain II of Duffy binding protein (PvDBPII) were also evaluated. Parameters, such as age, sex, PCR positivity, and captivity, potentially associated with humoral immune response were analyzed. Eighty-five percent of NP had antibodies against at least one CSP peptide, and 76% against at least one P. vivax erythrocytic antigen. A high percentage of adults compared to non-adults were seropositive and showed increased antibody levels. Neotropical primates with PCR positive for P. simium had a significantly higher frequency of positivity rate for immune response against PvEBP-2, PvDBPII and also higher antibody levels against PvDBPII, compared to PCR negative NPs for this species. Monkeys with PCR positive for P. brasilianum/P. malariae showed higher frequency of seropositivity and antibody levels against Pb/PmCSP. Levels of antibodies against Pb/PmCSP, PvEBP-2 and PvDBPII were higher in free-living than in captive monkeys from the same area. All Platyrrhine families showed antibodies against CSP peptides, however not all showed IgG against erythrocytic antigens. These findings showed a high prevalence of naturally acquired antibodies against CSP repeats in all studied areas, suggesting an intense exposure to infected-mosquitoes bites of NP from all families. However, mainly monkeys of Atelidae family showed antibodies against P. vivax erythrocytic antigens, suggesting blood infection, which might serve as potential reservoirs of malaria in the Atlantic Forest.
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Affiliation(s)
- Gabriela Maíra Pereira de Assis
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | | | | | | | - Anielle de Pina Costa
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz, Rio de Janeiro, Brazil
- Ambulatório de Doenças febris, Instituto Nacional de Infectologia (INI), Ambulatório de Doenças Febris Agudas Fiocruz, Rio de Janeiro, Brazil
- Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil
| | - Júlio César de Souza Junior
- Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
- Fundação Universidade Regional de Blumenau (FURB), Blumenau, Brazil
| | - Ana Julia Dutra Nunes
- Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
- Programa de conservação do Bugio Ruivo, Joinville, Brazil
| | - Alcides Pissinatti
- Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, Brazil
- Centro de Primatologia do Rio de Janeiro (CPRJ), Instituto Estadual do Ambiente (INEA), Guapimirim, Brazil
| | - Silvia Bahadian Moreira
- Centro de Primatologia do Rio de Janeiro (CPRJ), Instituto Estadual do Ambiente (INEA), Guapimirim, Brazil
| | - Leticia de Menezes Torres
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Helena Lott Costa
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | | | | | - Irene da Silva Soares
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Taís Nóbrega de Sousa
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Francis Babila Ntumngia
- Center for Global Health and Infectious Diseases Research, College of Public Health, University of South Florida, Tampa, FL, United States
| | - John H. Adams
- Center for Global Health and Infectious Diseases Research, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Flora Satiko Kano
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
| | - Zelinda Maria Braga Hirano
- Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
- Fundação Universidade Regional de Blumenau (FURB), Blumenau, Brazil
| | - Cláudio Tadeu Daniel-Ribeiro
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz, Rio de Janeiro, Brazil
- Laboratório de Pesquisa em Malária, IOC/Fiocruz, Rio de Janeiro, Brazil
| | - Joseli Oliveira Ferreira
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz (IOC), Fiocruz, Rio de Janeiro, Brazil
| | - Luzia Helena Carvalho
- Grupo de Pesquisa em Biologia Molecular e Imunologia da malária, Instituto René Rachou/Fiocruz Minas, Belo Horizonte, Brazil
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Buery JC, de Alencar FEC, Duarte AMRDC, Loss AC, Vicente CR, Ferreira LM, Fux B, Medeiros MM, Cravo P, Arez AP, Cerutti Junior C. Atlantic Forest Malaria: A Review of More than 20 Years of Epidemiological Investigation. Microorganisms 2021; 9:132. [PMID: 33430150 PMCID: PMC7826787 DOI: 10.3390/microorganisms9010132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/25/2020] [Accepted: 01/06/2021] [Indexed: 01/17/2023] Open
Abstract
In the south and southeast regions of Brazil, cases of malaria occur outside the endemic Amazon region near the Atlantic Forest in some coastal states, where Plasmodium vivax is the recognized parasite. Characteristics of cases and vectors, especially Anopheles (Kerteszia) cruzii, raise the hypothesis of a zoonosis with simians as reservoirs. The present review aims to report on investigations of the disease over a 23-year period. Two main sources have provided epidemiological data: the behavior of Anopheles vectors and the genetic and immunological aspects of Plasmodium spp. obtained from humans, Alouatta simians, and Anopheles spp. mosquitoes. Anopheles (K.) cruzii is the most captured species in the forest canopy and is the recognized vector. The similarity between P. vivax and Plasmodium simium and that between Plasmodium malariae and Plasmodium brasilianum shared between simian and human hosts and the involvement of the same vector in the transmission to both hosts suggest interspecies transfer of the parasites. Finally, recent evidence points to the presence of Plasmodium falciparum in a silent cycle, detected only by molecular methods in asymptomatic individuals and An. (K.) cruzii. In the context of malaria elimination, it is paramount to assemble data about transmission in such non-endemic low-incidence areas.
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Affiliation(s)
- Julyana Cerqueira Buery
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitória 29047-105, Brazil; (F.E.C.d.A.); (C.R.V.); (L.M.F.); (B.F.); (C.C.J.)
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal; (M.M.M.); (P.C.); (A.P.A.)
| | | | - Ana Maria Ribeiro de Castro Duarte
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo 05403-000, Brazil;
- Superintendência de Controle de Endemias do Estado de São Paulo, São Paulo 01027-000, Brazil
| | - Ana Carolina Loss
- Instituto Nacional da Mata Atlântica, Santa Teresa 29650-000, Brazil;
| | - Creuza Rachel Vicente
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitória 29047-105, Brazil; (F.E.C.d.A.); (C.R.V.); (L.M.F.); (B.F.); (C.C.J.)
| | - Lucas Mendes Ferreira
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitória 29047-105, Brazil; (F.E.C.d.A.); (C.R.V.); (L.M.F.); (B.F.); (C.C.J.)
| | - Blima Fux
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitória 29047-105, Brazil; (F.E.C.d.A.); (C.R.V.); (L.M.F.); (B.F.); (C.C.J.)
| | - Márcia Melo Medeiros
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal; (M.M.M.); (P.C.); (A.P.A.)
| | - Pedro Cravo
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal; (M.M.M.); (P.C.); (A.P.A.)
| | - Ana Paula Arez
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1349-008 Lisboa, Portugal; (M.M.M.); (P.C.); (A.P.A.)
| | - Crispim Cerutti Junior
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitória 29047-105, Brazil; (F.E.C.d.A.); (C.R.V.); (L.M.F.); (B.F.); (C.C.J.)
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Allah HMA, Abdo E, Elamin EAE, Abdelghani S, Eltayeb LB. Molecular Screening for Transfusion Transmissible P. falciparum in Asymptomatic Blood Donors in the Non-endemic Region. JOURNAL OF BIOCHEMICAL TECHNOLOGY 2021; 12:6-10. [DOI: 10.51847/d8p0p9b063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ribeiro de Castro Duarte AM, Fernandes LN, Silva FS, Sicchi IL, Mucci LF, Curado I, Fernandes A, Medeiros-Sousa AR, Ceretti-Junior W, Marrelli MT, Evangelista E, Teixeira R, Summa JL, Nardi MS, Garnica MR, Loss AC, Buery JC, Cerutti Jr. C, Pacheco MA, Escalante AA, Mureb Sallum MA, Laporta GZ. Complexity of malaria transmission dynamics in the Brazilian Atlantic Forest. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2021; 1:100032. [PMID: 35284897 PMCID: PMC8906072 DOI: 10.1016/j.crpvbd.2021.100032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/07/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Abstract
Plasmodium malariae and Plasmodium vivax are protozoan parasites that can cause malaria in humans. They are genetically indistinguishable from, respectively, Plasmodium brasilianum and Plasmodium simium, i.e. parasites infecting New World non-human primates in South America. In the tropical rainforests of the Brazilian Atlantic coast, it has long been hypothesized that P. brasilianum and P. simium in platyrrhine primates originated from P. malariae and P. vivax in humans. A recent hypothesis proposed the inclusion of Plasmodium falciparum into the transmission dynamics between humans and non-human primates in the Brazilian Atlantic tropical rainforest. Herein, we assess the occurrence of human malaria in simians and sylvatic anophelines using field-collected samples in the Capivari-Monos Environmental Protection Area from 2015 to 2017. We first tested simian blood and anopheline samples. Two simian (Aloutta) blood samples (18%, n = 11) showed Plasmodium cytb DNA sequences, one for P. vivax and another for P. malariae. From a total of 9,416 anopheline females, we found 17 pools positive for Plasmodium species with a 18S qPCR assay. Only three showed P. cytb DNA sequence, one for P. vivax and the others for rodent malaria species (similar to Plasmodium chabaudi and Plasmodium berghei). Based on these results, we tested 25 rodent liver samples for the presence of Plasmodium and obtained P. falciparum cytb DNA sequence in a rodent (Oligoryzomys sp.) liver. The findings of this study indicate complex malaria transmission dynamics composed by parallel spillover-spillback of human malaria parasites, i.e. P. malariae, P. vivax, and P. falciparum, in the Brazilian Atlantic forest. Human malaria parasites circulate in sylvatic cycles in the Brazilian Atlantic forest. Plasmodium vivax and Plasmodium malariae identified in simian blood samples. Plasmodium falciparum detected in a rodent liver sample. Anopheline vectors found to carry human and rodent malaria parasites. Local vector ecology and biology are key to the spillover-spillback of human malaria parasites.
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Kerteszia cruzii and extra-Amazonian malaria in Brazil: Challenges due to climate change in the Atlantic Forest. INFECTION GENETICS AND EVOLUTION 2020; 85:104456. [PMID: 32668366 DOI: 10.1016/j.meegid.2020.104456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 01/09/2023]
Abstract
Kerteszia cruzii is a sylvatic mosquito and the primary vector of Plasmodium spp., which can cause malaria in humans in areas outside the Amazon River basin in Brazil. Anthropic changes in the natural environments are the major drivers of massive deforestation and local climate change, with serious impacts on the dynamics of mosquito communities and on the risk of acquiring malaria. Considering the lack of information on the dynamics of malaria transmission in areas across the Atlantic Forest biome, where Ke. cruzii is the dominant vector, and the impact of climate drivers of malaria, the present study aimed to: (i) investigate the occurrence and survival rate of Ke. cruzii based on the distinct vegetation profiles found in areas across the coastal region of the Brazilian Atlantic Forest biome; (ii) estimate the extrinsic incubation period (EIP) and survival rates of P. vivax and P. falciparum parasites in Ke. cruzii under current and future scenarios. The potential distribution of Plasmodium spp. was estimated using simulation analyses under distinct scenarios of average temperature increases from 1 °C to 3.7 °C. Our results showed that two conditions are necessary to explain the occurrence and survival of Ke. cruzii: warm temperature and presence of the Atlantic Forest biome. Moreover, both Plasmodium species showed a tendency to decrease their EIP and increase their estimated survival rates in a scenario of higher temperature. Our findings support that the high-risk malaria areas may include the southern region of the distribution range of the Atlantic Forest biome in the coming years. Despite its limitations and assumptions, the present study provides robust evidence of areas with potential to be impacted by malaria incidence in a future scenario. These areas should be monitored in the next decades regarding the occurrence of the mosquito vector and the potential for malaria persistence and increased occurrence.
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Neotropical Anopheles (Kerteszia) mosquitoes associated with bromeliad-malaria transmission in a changing world. Acta Trop 2020; 205:105413. [PMID: 32088278 DOI: 10.1016/j.actatropica.2020.105413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 01/17/2023]
Abstract
Kerteszia is a neotropical subgenus of Anopheles composed of 12 species. The species in this subgenus are strongly associated with humid forests rich in epiphytic bromeliads. Forest fragmentation and anthropogenic changes can therefore have a negative impact on the abundance and survival of these mosquito species. Within this subgenus, four species are considered primary vectors of malaria: An. cruzii, An. bellator, An. homunculus and An. neivai. Malaria cases associated with Kerteszia species are often referred to as bromeliad malaria, a type of malaria reported to be endemic in the coastal rainforest of the neotropical region since the end of the nineteenth century. Although the incidence of bromeliad-malaria cases has decreased since the middle of the last century, autochthonous malaria cases continue to be registered every year. The complexity of the epidemiology of bromeliad malaria appears to be increasing as asymptomatic plasmodial infections and transmission of simian Plasmodium to humans have recently been reported. Kerteszia vector species have a great affinity for human beings and can be found in human-modified areas close to forest fragments such as in the Extra-Amazonian region of Brazil, Colombian pacific coast, and the Caribbean coast. Deforestation and forest fragmentation have been occurring continuously in the biomes of the neotropical region, and findings of Kerteszia species in dwellings are frequent in this region. Controlling the species in the Kerteszia subgenus is particularly difficult because they move frequently from natural to rural and peri-urban areas in search of blood sources, posing a challenge for the development of control strategies based on integrated vector management. Furthermore, as it has been shown that some Kerteszia species share similar morphological and genetic characteristics, the existence of a species complex formed by cryptic, sibling species within the Kerteszia group in different areas in the South and Southeast of Brazil cannot be ruled out. The existence of such a complex could represent an obstacle to the control of Kerteszia species and consequently to the elimination of bromeliad-malaria transmission in these regions. Here, we review publications that focus on the biology and ecology of Kerteszia malaria vectors and their association with human-modified areas and bromeliad-malaria transmission.
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Bakker JW, Loy DE, Takken W, Hahn BH, Verhulst NO. Attraction of mosquitoes to primate odours and implications for zoonotic Plasmodium transmission. MEDICAL AND VETERINARY ENTOMOLOGY 2020; 34:17-26. [PMID: 31420992 PMCID: PMC7002228 DOI: 10.1111/mve.12402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/18/2019] [Accepted: 07/24/2019] [Indexed: 05/05/2023]
Abstract
Vector-borne diseases often originate from wildlife and can spill over into the human population. One of the most important determinants of vector-borne disease transmission is the host preference of mosquitoes. Mosquitoes with a specialised host preference are guided by body odours to find their hosts in addition to carbon dioxide. Little is known about the role of mosquito host preference in the spillover of pathogenic agents from humans towards animals and vice versa. In the Republic of Congo, the attraction of mosquitoes to primate host odours was determined, as well as their possible role as malaria vectors, using odour-baited traps mimicking the potential hosts of mosquitoes. Most of the mosquito species caught showed a generalistic host preference. Anopheles obscurus was the most abundant Anopheles mosquito, with a generalistic host preference observed from the olfactory response and the detection of various Plasmodium parasites. Interestingly, Culex decens showed a much higher attraction towards chimpanzee odours than to human or cow odours. Human Plasmodium parasites were observed in both human and chimpanzee blood, although not in the Anopheles mosquitoes that were collected. Understanding the role of mosquito host preference for cross-species parasite transmission provides information that will help to determine the risk of spillover of vector-borne diseases.
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Affiliation(s)
- J. W. Bakker
- Laboratory of EntomologyWageningen University & ResearchWageningenThe Netherlands
| | - D. E. Loy
- Departments of Medicine and Microbiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAU.S.A.
| | - W. Takken
- Laboratory of EntomologyWageningen University & ResearchWageningenThe Netherlands
| | - B. H. Hahn
- Departments of Medicine and Microbiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAU.S.A.
| | - N. O. Verhulst
- Laboratory of EntomologyWageningen University & ResearchWageningenThe Netherlands
- National Centre for Vector Entomology, Institute of Parasitology, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Fong IW. Blood Transfusion-Associated Infections in the Twenty-First Century: New Challenges. CURRENT TRENDS AND CONCERNS IN INFECTIOUS DISEASES 2020. [PMCID: PMC7120358 DOI: 10.1007/978-3-030-36966-8_8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Blood transfusions are vital components of modern medical treatment to which there is no viable alternative despite efforts to create artificial blood. Each year thousands of lives are saved by blood transfusions in every country of the world. However, blood and blood products can result in significant adverse events including immunologic reactions, infections, inefficacy, and others which can sometimes result in death and severe disability. Thus, the sustainability of safe blood systems and costs are considered to be at crisis level. In industrialized countries, the risk of transfusion-transmitted infections such as HIV, syphilis, hepatitis viruses B and C are very low [generally [<1 in a million units], but in developing countries [especially in Africa] blood safety is still not assured. Compounding the problem of blood/product safety with respect to infectious agents are new emerging infectious microbes that are not being routinely tested for in blood that are donated. This chapter reviews the infectious risk of blood transfusions, types, mode and geographic variation, and the methods being used by blood services to attenuate and prevent these risks.
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Increasing Complexity Threatens the Elimination of Extra-Amazonian Malaria in Brazil. Trends Parasitol 2019; 35:383-387. [DOI: 10.1016/j.pt.2019.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/24/2019] [Accepted: 03/27/2019] [Indexed: 01/15/2023]
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13
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Medeiros-Sousa AR, de Oliveira Christe R, de Castro Duarte AMR, Mucci LF, Ceretti-Junior W, Marrelli MT. Effects of anthropogenic landscape changes on the abundance and acrodendrophily of Anopheles (Kerteszia) cruzii, the main vector of malaria parasites in the Atlantic Forest in Brazil. Malar J 2019; 18:110. [PMID: 30940142 PMCID: PMC6444577 DOI: 10.1186/s12936-019-2744-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background The mosquito Anopheles (Kerteszia) cruzii is the main vector of human and simian malaria in the Atlantic Forest. This species is usually abundant in the forests where it occurs, preferring to live and feed on canopies, behaviour known as acrodendrophily. However, in several studies and locations this species has been observed in high density near the ground in the forest. In this study, it was hypothesized that factors associated with anthropogenic landscape changes may be responsible for the variation in abundance and acrodendrophily observed in An. cruzii. Methods The study was conducted in a conservation unit in the city of São Paulo, Brazil. Monthly entomological collections were performed from March 2015 to April 2017, and the resulting data were used with data from another study conducted in the same area between May 2009 and June 2010. Mosquitoes were collected from five sites using CDC and Shannon traps. Landscape composition and configuration metrics were measured, and generalized linear mixed-effect models were used to investigate the relationship between these metrics and variations in the abundance and acrodendrophily of An. cruzii. Results The model that showed the best fit for the relationship between landscape metrics and An. cruzii abundance suggests that an increase in the proportion of forest cover leads to an increase in the abundance of this mosquito, while the model that best explained variations in An. cruzii acrodendrophily suggests that an increase in total forest-edge length leads to greater activity by this species at ground level. Conclusion While the data indicate that changes in landscape due to human activities lead to a reduction in An. cruzii abundance, such changes may increase the contact rate between this species and humans living on the edges of forest fragments where An. cruzii is found. Future studies should, therefore, seek to elucidate the effect of these landscape changes on the dynamics of Plasmodium transmission in the Atlantic Forest, which according to some studies includes the participation of simian hosts. Electronic supplementary material The online version of this article (10.1186/s12936-019-2744-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Luis Filipe Mucci
- Superintendency for the Control of Endemic Diseases (SUCEN), State Department of Health, São Paulo, Brazil
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Miguel RB, Albuquerque HG, Sanchez MCA, Coura JR, Santos SDS, Silva SD, Moreira CJDC, Suárez-Mutis MC. Asymptomatic Plasmodium infection in a residual malaria transmission area in the Atlantic Forest region: Implications for elimination. Rev Soc Bras Med Trop 2019; 52:e20180537. [PMID: 30942262 DOI: 10.1590/0037-8682-0537-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/19/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Elimination of malaria in areas of interrupted transmission warrants careful case assessment to avoid the reintroduction of this disease. Occasional malaria cases are reported among visitors of the Atlantic Forest area of Brazil, while data on residents of this area are scarce. METHODS A sectional study was carried out to examine 324 individuals living in a municipality where autochthonous cases were detected. RESULTS Asymptomatic Plasmodium infections were detected in 2.8% of the individuals by polymerase chain reaction (PCR), with one case of P. falciparum (0.3%), two cases of P. vivax (0.6%), and six cases of P. malariae (1.9%). The thick blood smears were negative in all individuals. Serological tests performed in 314 subjects were reactive in 11.1%, with 3.5% for P. falciparum and 7.7% for P. vivax. A subsample of 42 reactive individuals for any Plasmodium species showed P. malariae in 30.9% of specimens. Individuals who entered the Atlantic Forest region were 2.7 times more likely to exhibit reactive serology for P. vivax compared with individuals who did not enter this region (p<0.05). Children <15 years had a higher chance of reactive serology for P. falciparum and P. vivax than individuals ≥15 years of age (p<0.05). Individuals living in the Paraiso district had a higher chance of reactive serology for P. vivax compared to other districts (p<0.05). No associations were found between sex, past exposure to malaria, or serological response to antibodies of any Plasmodium species. CONCLUSIONS The implications of these results for the elimination of malaria were discussed.
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Affiliation(s)
- Renata Bortolasse Miguel
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil.,Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Hermano Gomes Albuquerque
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil.,Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Maria Carmen Arroyo Sanchez
- Laboratório de Soroepidemiologia e Imunobiologia, Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brasil
| | - José Rodrigues Coura
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil.,Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Simone da Silva Santos
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Sidnei da Silva
- Laboratório de Parasitologia, Instituto Nacional de Infectologia, Rio de Janeiro, RJ, Brasil
| | | | - Martha Cecilia Suárez-Mutis
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil.,Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, RJ, Brasil
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Carlos BC, Rona LDP, Christophides GK, Souza-Neto JA. A comprehensive analysis of malaria transmission in Brazil. Pathog Glob Health 2019; 113:1-13. [PMID: 30829565 PMCID: PMC6425916 DOI: 10.1080/20477724.2019.1581463] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Malaria remains a serious public health problem in Brazil despite a significant drop in the number of cases in the past decade. We conduct a comprehensive analysis of malaria transmission in Brazil to highlight the epidemiologically most relevant components that could help tackle the disease. We consider factors impacting on the malaria burden and transmission dynamics including the geographical occurrence of both autochthonous and imported infections, the distribution and abundance of malaria vectors and records of natural mosquito infections with Plasmodium. Our analysis identifies three discrete malaria transmission systems related to the Amazon rainforest, Atlantic rainforest and Brazilian coast, respectively. The Amazonian system accounts for 99% of all malaria cases in the country. It is largely due to autochthonous P. vivax and P. falciparum transmission by mosquitoes of the Nyssorhynchus subgenus, primarily Anopheles darlingi. Whilst P. vivax transmission is widespread, P. falciparum transmission is restricted to hotspot areas mostly in the States of Amazonas and Acre. This system is the major source of P. vivax exportation to the extra-Amazonian regions that are also affected by importation of P. falciparum from Africa. The Atlantic system comprises autochthonous P. vivax transmission typically by the bromeliad-associated mosquitoes An. cruzii and An. bellator of the Kerteszia subgenus. An. cruzii also transmits simian malaria parasites to humans. The third, widespread but geographically fragmented, system is found along the Brazilian coast and comprises P. vivax transmission mainly by An. aquasalis. We conclude that these geographically and biologically distinct malaria transmission systems require specific strategies for effective disease control.
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Affiliation(s)
- Bianca C Carlos
- a School of Agricultural Sciences, Department of Bioprocesses and Biotechnology, Central Multiuser Laboratory , São Paulo State University (UNESP) , Botucatu , Brazil.,b Institute of Biotechnology , São Paulo State University (UNESP) , Botucatu , Brazil
| | - Luisa D P Rona
- c Department of Life Sciences , Imperial College London , London , UK.,d Department of Cell Biology, Embryology and Genetics , Federal University of Santa Catarina (UFSC) , Florianópolis , Brazil.,e National Council for Scientific and Technological Development (INCT-EM, CNPq) , National Institute of Science and Technology in Molecular Entomology , Rio de Janeiro , Brazil
| | | | - Jayme A Souza-Neto
- a School of Agricultural Sciences, Department of Bioprocesses and Biotechnology, Central Multiuser Laboratory , São Paulo State University (UNESP) , Botucatu , Brazil.,b Institute of Biotechnology , São Paulo State University (UNESP) , Botucatu , Brazil
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Batista-Dos-Santos SA, Freitas DRC, Raiol M, Cabral GF, Feio AC, Póvoa MM, Cunha MG, Ribeiro-Dos-Santos Â. Strategy to improve malaria surveillance system preventing transfusion-transmitted malaria in blood banks using molecular diagnostic. Malar J 2018; 17:344. [PMID: 30285750 PMCID: PMC6167815 DOI: 10.1186/s12936-018-2486-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Malaria can be transmitted by blood transfusion through donations collected from asymptomatic or parasitic donors. The parasites are released into the bloodstream during its life cycle and will therefore be present in donated blood by infected individuals. All cases of transfusion-transmitted malaria (TTM) notified since 2005 in Brazil were fatal. A good screening tool for Plasmodium spp. detection in blood units must have a high detection threshold, and the prevention of TTM relies entirely on the exclusion of potentially infected donors. However, in Brazilian blood banks, the screening test relies on blood thick smears examination. Methods The molecular diagnostic based on mitochondrial DNA (mtDNA) using real time PCR (mt-qPCR) was improved to detect Plasmodium falciparum, Plasmodium vivax, and standardized for use in Plasmodium malariae. The analytic sensitivity of this mt-qPCR methodology was performed using a sample of P. vivax. Results The mt-qPCR was highly efficient, and the analytic sensitivity for P. vivax was determined (0.000006 parasites/µL). This method was tested to detect P. vivax and P. falciparum in individuals from two malaria-endemic areas in Brazil, Amazon region (Pará and Rondônia states), the samples were collected in 10 reference units of two blood banks (Pará/nine cities and Rondônia/Porto Velho), and parasites mtDNA were detected in 10 of 2224 potential blood donors (0.45%). In all 10 positive samples, only P. vivax was detected. Conclusion Molecular diagnostic using mt-qPCR was effective in revealing infected potential donors with good perspectives to be applied as screening routine of asymptomatic carriers for preventing transfusion-transmitted malaria in blood banks.
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Affiliation(s)
- Sérgio Antônio Batista-Dos-Santos
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil.,Fundação Centro de Hemoterapia e Hematologia do Pará, Belém, Pará, CEP: 660033-000, Brazil
| | | | - Milene Raiol
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
| | - Gleyce F Cabral
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
| | - Ana Cecília Feio
- Instituto Evandro Chagas, Ananindeua, Pará, CEP: 66087-082, Brazil
| | - Marinete M Póvoa
- Instituto Evandro Chagas, Ananindeua, Pará, CEP: 66087-082, Brazil
| | - Maristela G Cunha
- Laboratório de Microbiologia e Imunologia, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil.
| | - Ândrea Ribeiro-Dos-Santos
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
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de Alencar FEC, Malafronte RDS, Cerutti Junior C, Natal Fernandes L, Buery JC, Fux B, Rezende HR, Duarte AMRDC, Medeiros-Sousa AR, Miranda AE. Assessment of asymptomatic Plasmodium spp. infection by detection of parasite DNA in residents of an extra-Amazonian region of Brazil. Malar J 2018. [PMID: 29540186 PMCID: PMC5853114 DOI: 10.1186/s12936-018-2263-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The hypotheses put forward to explain the malaria transmission cycle in extra-Amazonian Brazil, an area of very low malaria incidence, are based on either a zoonotic scenario involving simian malaria, or a scenario in which asymptomatic carriers play an important role. Objectives To determine the incidence of asymptomatic infection by detecting Plasmodium spp. DNA and its role in residual malaria transmission in a non-Amazonian region of Brazil. Methods Upon the report of the first malaria case in 2010 in the Atlantic Forest region of the state of Espírito Santo, inhabitants within a 2 km radius were invited to participate in a follow-up study. After providing signed informed consent forms, inhabitants filled out a questionnaire and gave blood samples for PCR, and thick and thin smears. Follow-up visits were performed every 3 months over a 21 month period, when new samples were collected and information was updated. Results Ninety-two individuals were initially included for follow-up. At the first collection, all of them were clearly asymptomatic. One individual was positive for Plasmodium vivax, one for Plasmodium malariae and one for both P. vivax and P. malariae, corresponding to a prevalence of 3.4% (2.3% for each species). During follow-up, four new PCR-positive cases (two for each species) were recorded, corresponding to an incidence of 2.5 infections per 100 person-years or 1.25 infections per 100 person-years for each species. A mathematical transmission model was applied, using a low frequency of human carriers and the vector density in the region, and calculated based on previous studies in the same locality whose results were subjected to a linear regression. This analysis suggests that the transmission chain is unlikely to be based solely on human carriers, regardless of whether they are symptomatic or not. Conclusion The low incidence of cases and the low frequency of asymptomatic malaria carriers investigated make it unlikely that the transmission chain in the region is based solely on human hosts, as cases are isolated one from another by hundreds of kilometers and frequently by long periods of time, reinforcing instead the hypothesis of zoonotic transmission. Electronic supplementary material The online version of this article (10.1186/s12936-018-2263-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Filomena E C de Alencar
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil.
| | | | - Crispim Cerutti Junior
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Lícia Natal Fernandes
- Protozoology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Julyana Cerqueira Buery
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Blima Fux
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Helder Ricas Rezende
- Entomology and Malacology Unit, Espírito Santo State Department of Health (SESA), Vitória, Brazil
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Xu M, Yang Y, Zhou Y, Liu Z, Liu Y, He M. Metagenomics in pooled plasma, with identification of potential emerging infectious pathogens. Transfusion 2017; 58:633-637. [PMID: 29250787 DOI: 10.1111/trf.14455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Many emerging infectious pathogens are well known for existing in healthy blood donors and could be transmitted via blood transfusion or plasma derivatives usage. Therefore, there is an urgent need to discover the pathogens in qualified blood donation to avoid potential threats to blood safety. STUDY DESIGN AND METHODS The objective of this study was to investigate the microbiome that existed in pooled plasma from different manufacturers in Chengdu and Guiyang. Random polymerase chain reaction, large-scale clone sequencing, and bioinformatics were used to investigate the metagenomics and microbiome structure of pooled plasma. Among detected microbiomes, potential pathogens were subsequently identified. RESULT After host DNA cleaning, 551 clones were classified as bacteria; 88 clones were classified as viruses, and four clones were considered to be parasites, respectively. Thirteen kinds of bacteria and two kinds of parasites that might potentially threaten blood safety were identified along with six kinds of nonpathogenic viruses. The infection status of one identified pathogen Coxiella burnetii was evaluated in 1638 plasma samples. The reactive rate of immunoglobulin (Ig)G1 was 1.10% (18/1638), the reactive rate of IgG2 was 0.85% (14/1638), and the reactive rate of IgM was 0.98% (16/1638). CONCLUSION Some pathogens that were already considered as threats to blood safety were discovered in those pooled plasma such as C. burnetii, Orientia tsutsugamushi, and Plasmodium sp. As a result, we should initiate some specific tests in the endemic area on plasma donors to enhance the blood safety in China.
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Affiliation(s)
- Min Xu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Yashan Yang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Ya Zhou
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Zhiyang Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Yu Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, and the Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
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de Alencar FEC, Malafronte RDS, Cerutti C, Natal Fernandes L, Buery JC, Fux B, Rezende HR, Miranda AE. Reassessment of asymptomatic carriers of Plasmodium spp. in an endemic area with a very low incidence of malaria in extra-Amazonian Brazil. Malar J 2017; 16:452. [PMID: 29121963 PMCID: PMC5679383 DOI: 10.1186/s12936-017-2103-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/02/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Regions with residual transmission are potential obstacles to the elimination of malaria. It is, therefore, essential to understand the factors associated with the maintenance of endemic malaria in these areas. The objective was to investigate whether the status of asymptomatic carriers of Plasmodium spp. DNA is maintained in the long term in an extra-Amazonian region of Brazil with low incidence, residual malaria transmission. METHODS Asymptomatic carriers of Plasmodium DNA detected in a survey carried out between 2001 and 2004 were reassessed between 2010 and 2011 using questionnaires, PCR and thick and thin blood smear tests three times at 3-month intervals. RESULTS Of the 48 carriers detected between 2001 and 2004, 37 were located. Of these, only two had positive PCR results and, as in the first survey, Plasmodium malariae DNA was detected. CONCLUSION The findings suggest that untreated dwellers from this extra-Amazonian region, who initially harbour malaria parasites, may become negative without ever developing apparent symptoms of the disease. Although the possibility of re-infection cannot be ruled out, the finding of two individuals harbouring P. malariae, both in the first and in the second survey, may be compatible with a long-term carrier state for this parasite. Since most clinical cases of malaria in the region are a consequence of infection by Plasmodium vivax, the epidemiological impact of such long-term carriage would be limited.
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Affiliation(s)
- Filomena E C de Alencar
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil.
| | | | - Crispim Cerutti
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Lícia Natal Fernandes
- Protozoology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Julyana Cerqueira Buery
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Blima Fux
- Graduate Programme in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | - Helder Ricas Rezende
- Entomology and Malacology Unit, Espírito Santo State Department of Health (SESA), Vitória, Brazil
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Bakr S, Edris S, Abdel Fattah NS, Ibrahim NM, El-Khadragy MF. Molecular Screening for Malaria among Blood Donors in a WHO Claimed Region of Egypt, Fayoum Governorate. Mediterr J Hematol Infect Dis 2017; 9:e2017065. [PMID: 29181142 PMCID: PMC5667524 DOI: 10.4084/mjhid.2017.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/25/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Transfusion-transmitted malaria is undoubtedly a potential health hazard for blood recipients. Egypt is still on the prevention of reintroduction phase of malaria control program. Fayoum Governorate is considered one of the high-risk foci in Egypt due to its geology. However, no studies have been reported to evaluate the current status of subclinical Plasmodium infection based on sensitive molecular techniques. Moreover, screening of malaria is not listed within screening protocols of blood-borne pathogens in Fayoum blood banks. OBJECTIVE To assess the current prevalence of subclinical Plasmodium infection among blood donors of Fayoum inhabitants for transfusion biosafety. To predict any possibility of the reemergence of malaria in the governorate and the effectiveness of malaria control measures. METHODS A cross-sectional survey was conducted on 400 apparently healthy blood-donors in blood transfusion center of Fayoum University hospital from Jun 2012 to Jan 2013. Conventional PCR was used to detect the 18 S ssrRNA Plasmodium gene. RESULTS All Fayoum inhabitants' blood donors' samples were negative for Plasmodium infection. CONCLUSIONS Current applied control, and preventive measures are valid in the context of blood transfusion biosafety in Fayoum blood banks and, therefore, the implementation of a routine malaria screening test in Fayoum blood banks is not merited at this time.
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Affiliation(s)
- Salwa Bakr
- Department of Clinical Pathology, College of Medicine, Fayoum University, Fayoum, Egypt
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudia Arabia
| | - Sherif Edris
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University (KAU), Jeddah, Saudi Arabia
- Department of Genetics, Faculty of Agriculture, Ain Shams University, Cairo, Egypt
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), Faculty of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia
| | | | | | - Manal F. El-Khadragy
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
- Chair Vaccines Research of Infectious Diseases, Faculty of Science, King Saud University, Riyadh, Saudi Arabia
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo, Egypt
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Laporta GZ. Spotlight on Plasmodium falciparum evolutionary system in the southeastern Atlantic forest. BIOTA NEOTROPICA 2017. [DOI: 10.1590/1676-0611-bn-2016-0314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract Malaria elimination is now set to occur in Brazil until 2030. While this achievement is feasible, as it is for other endemic regions worldwide, it is important to recognize resistance of parasites and vectors against anti-malarial interventions. Resistance against drugs and insecticides can lead to discontinuities of malaria transmission, known as residual malaria transmission. Herein, we described a novel phenomenon that is occurring in a residual malaria transmission scenario in the southeastern Atlantic forest. This novel phenomenon does not belong to what is known and therefore we decided to explain it based on an evolutionary perspective. Although it shall not be viewed as a threat to public health, the phenomenon has important aspects that should be highlighted. Specifically, it represents an adaptation of P. falciparum among vectors and hosts in the southeastern Atlantic forest. Knowledge about this phenomenon could be of importance, including to the on-going malaria elimination programs.
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22
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Alho RM, Machado KVA, Val FFA, Fraiji NA, Alexandre MAA, Melo GC, Recht J, Siqueira AM, Monteiro WM, Lacerda MVG. Alternative transmission routes in the malaria elimination era: an overview of transfusion-transmitted malaria in the Americas. Malar J 2017; 16:78. [PMID: 28202065 PMCID: PMC5312538 DOI: 10.1186/s12936-017-1726-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/06/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Transfusion-transmitted (TT) malaria is an alternative infection route that has gained little attention from authorities, despite representing a life-threatening condition. There has been no systematic review of this health problem in American countries. The aim of this study was to describe the clinical and epidemiological characteristics of TT malaria in the Americas and identify factors associated with lethality based on the studies published in the literature. METHODS Potentially relevant papers in all languages were retrieved from MEDLINE and LILACS. Additional articles were obtained from reviews and original papers. Publications on screening of candidate blood donors and on surveillance of TT malaria cases were included. Odds ratios with respective 95% confidence intervals (95% CI) were calculated. Epidemiological characteristics of blood donors of TT malaria cases, including a pooled positivity of different tests for malaria diagnosis, were retrieved. RESULTS A total of 63 publications regarding TT malaria from seven countries were included, from 1971 to 2016. A total of 422 cases of TT malaria were recorded. Most TT malaria cases were in females (62.0%) and 39.5% were in the ≥61 years-old age group. About half of all cases were from Mexico (50.7%), 40.3% from the United States of America (USA) and 6.6% from Brazil. Gyneco-obstetrical conditions (67.3%), surgical procedures (20.6%) and complications from neoplasias (6.1%) were the most common indications of transfusion. Packed red blood cells (RBCs) (50.7%) and whole blood (43.3%) were the blood products mostly associated with TT malaria. Cases were mostly caused by Plasmodium malariae (58.4%), followed by Plasmodium vivax (20.7%) and Plasmodium falciparum (17.9%). A total of 66.6% of cases were diagnosed by microscopy. Incubation period of 2-3 weeks was the most commonly observed (28.6%). Lethality was seen in 5.3% of cases and was associated with living in non-endemic countries, P. falciparum infection and concomitant neoplastic diseases. CONCLUSION There is an important research and knowledge gap regarding the TT malaria burden in Latin American countries where malaria remains endemic. No screening method that is practical, affordable and suitably sensitive is available at blood banks in Latin American countries, where infections with low parasitaemia contribute greatly to transmission. Lethality from TT malaria was not negligible. TT malaria needs to be acknowledged and addressed in areas moving toward elimination.
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Affiliation(s)
- Regina M Alho
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.,Fundação de Hematologia e Hemoterapia do Amazonas, Av. Constantino Nery, 4397, Chapada, Manaus, AM, 69050-002, Brazil
| | - Kim Vinícius Amaral Machado
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil
| | - Fernando F A Val
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil
| | - Nelson A Fraiji
- Fundação de Hematologia e Hemoterapia do Amazonas, Av. Constantino Nery, 4397, Chapada, Manaus, AM, 69050-002, Brazil
| | - Marcia A A Alexandre
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil
| | - Gisely C Melo
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil
| | | | - André M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Wuelton M Monteiro
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil. .,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.
| | - Marcus V G Lacerda
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.,Instituto de Pesquisas Leônidas & Maria Deane, Fundação Oswaldo Cruz, Rua Terezina, 476, Adrianópolis, Manaus, AM, 69057-070, Brazil
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Nascimento JAAD, Guimarães LM, Carvalho-Costa FA. Malaria epidemiology in the State of Piauí, Northeastern Brazil: a retrospective study with secondary data. Rev Soc Bras Med Trop 2017; 49:99-103. [PMID: 27163571 DOI: 10.1590/0037-8682-0153-2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/22/2015] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED INTRODUCTION Malaria is not considered endemic in State of Piauí. METHODS Malaria epidemiology was examined using surveillance data. RESULTS During 2002-2013, of the 484 cases of malaria, 217 were classified as probably acquired in Piauí, most frequently in the Campo Largo, Buriti dos Lopes, and Luzilândia municipalities, and 267 were considered probably imported, from the States of Pará, Maranhão, Amazonas, Roraima, and Rondônia. Probably-imported cases occurred throughout the year, while 80.2% of the probably-acquired cases occurred in April-August, peaking at the end of the rainy season. CONCLUSIONS Malaria surveillance should be intensified. Further ecoepidemiological and entomological studies are needed.
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Affiliation(s)
- Joyce Anny Alves do Nascimento
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucas Melo Guimarães
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Filipe Anibal Carvalho-Costa
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
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PIRAHMADI S, ZAKERI S, RAEISI A. Absence of Asymptomatic Malaria Infection in a Cross-sectional Study in Iranshahr District, Iran under Elimination Programmes. IRANIAN JOURNAL OF PARASITOLOGY 2017; 12:90-100. [PMID: 28761465 PMCID: PMC5522703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Asymptomatic malaria infection provides a reservoir of parasites, causing the persistence of malaria transmission. It accounts an important challenge for successful management of the control, elimination, and eradication programmes in any malaria-endemic region. This investigation was designed to assess the presence and the prevalence of asymptomatic carriers in Iranshahr district of Sistan and Baluchistan Province (2013-2014), with a considerable population movement, during the malaria elimination phase in Iran. METHODS Finger-prick blood samples were collected from symptomless (n=250) and febrile (n=50) individuals residing in Iranshahr district, easthern Iran (Hoodian, Mand, Chah-e Giji, Jolgehashem, Esfand, Dalgan and Chahshour) during Jan 2013 to Dec 2014, and Plasmodium infections were detected using light microscopic and highly sensitive nested-PCR techniques. RESULTS Thick and thin Giemsa-stained blood smears were negative for Plasmodium parasites. In addition, based on nested-PCR analysis, no P. vivax, P. falciparum, and P. malariae parasites were detected among the studied individuals. CONCLUSION Investigation the absence of asymptomatic carriers in Iranshahr district was illustrated and achieving malaria elimination in this area is feasible in a near future.
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Affiliation(s)
- Sakineh PIRAHMADI
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Tehran, Iran
| | - Sedigheh ZAKERI
- Malaria and Vector Research Group (MVRG), Biotechnology Research Center (BRC), Pasteur Institute of Iran, Tehran, Iran,Correspondence
| | - Ahmad RAEISI
- National Programme Manager for Malaria Control, Ministry of Health and Medical Education, Tehran, Iran
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Jamrozik E, de la Fuente-Núñez V, Reis A, Ringwald P, Selgelid MJ. Ethical aspects of malaria control and research. Malar J 2015; 14:518. [PMID: 26693920 PMCID: PMC4688922 DOI: 10.1186/s12936-015-1042-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/09/2015] [Indexed: 01/09/2023] Open
Abstract
Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria--and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy.
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Affiliation(s)
- Euzebiusz Jamrozik
- Centre for Human Bioethics, Monash University, Clayton, VIC, Australia. .,Department of Knowledge, Ethics and Research, World Health Organization, Geneva, Switzerland.
| | | | - Andreas Reis
- Department of Knowledge, Ethics and Research, World Health Organization, Geneva, Switzerland.
| | - Pascal Ringwald
- Global Malaria Programme, World Health Organization, Geneva, Switzerland.
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Lorenz C, Virginio F, Aguiar BS, Suesdek L, Chiaravalloti-Neto F. Spatial and temporal epidemiology of malaria in extra-Amazonian regions of Brazil. Malar J 2015; 14:408. [PMID: 26466889 PMCID: PMC4607178 DOI: 10.1186/s12936-015-0934-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
Abstract
Background Mosquitoes, Plasmodium parasites, and humans live in sympatry in some extra-Amazonian regions of Brazil. Recent migrations of people from Amazonia and other countries to extra-Amazonian regions have led to many malaria outbreaks. Lack of relevant expertise among health professionals in non-endemic areas can lead to a neglect of the disease, which can be dangerous given its high fatality rate. Therefore, understanding the spatial and temporal epidemiology of malaria is essential for developing strategies for disease control and elimination. This study aimed to characterize imported (IMP) and autochthonous/introduced (AU/IN) cases in the extra-Amazonian regions and identify risk areas and groups. Methods Epidemiological data collected between 2007 and 2014 were obtained from the Notifiable Diseases Information System of the Ministry of Health (SINAN) and from the Department of the Unified Health System (DATASUS). High malaria risk areas were determined using the Local Indicator of Spatial Association. IMP and AU/IN malaria incidence rates were corrected by Local Empirical Bayesian rates. Results A total of 6092 malaria cases (IMP: 5416, 88.9 %; AU/IN: 676, 11.1 %) was recorded in the extra-Amazonian regions in 2007–2014. The highest numbers of IMP and AU/IN cases were registered in 2007 (n = 862) and 2010 (n = 149), respectively. IMP cases were more frequent than AU/IN cases in all states except for Espírito Santo. Piauí, Espírito Santo, and Paraná states had high incidences of AU/IN malaria. The majority of infections were by Plasmodium falciparum in northeast and southeast regions, while Plasmodium vivax was the predominant species in the south and mid-west showed cases of dual infection. AU/IN malaria cases were concentrated in the coastal region of Brazil, which contains the Atlantic Forest and hosts the Anopheles transmitters. Several malaria clusters were also associated with the Brazilian Pantanal biome and regions bordering the Amazonian biome. Conclusion Malaria is widespread outside the Amazonian region of Brazil, including in more urbanized and industrialized states. This fact is concerning because these highly populated areas retain favourable conditions for spreading of the parasites and vectors. Control measures for both IMP and AU/IN malaria are essential in these high-risk areas. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0934-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camila Lorenz
- Instituto Butantan, Avenida Vital Brasil, 1500, São Paulo, CEP 05509-300, Brazil. .,Biologia da Relação Patógeno-Hospedeiro-Instituto de Ciências Biomédicas-USP, São Paulo, Brazil.
| | - Flávia Virginio
- Instituto Butantan, Avenida Vital Brasil, 1500, São Paulo, CEP 05509-300, Brazil. .,Biologia da Relação Patógeno-Hospedeiro-Instituto de Ciências Biomédicas-USP, São Paulo, Brazil.
| | - Breno S Aguiar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Av Dr Arnaldo, 715, São Paulo, CEP 05509-300, Brazil.
| | - Lincoln Suesdek
- Instituto Butantan, Avenida Vital Brasil, 1500, São Paulo, CEP 05509-300, Brazil. .,Biologia da Relação Patógeno-Hospedeiro-Instituto de Ciências Biomédicas-USP, São Paulo, Brazil. .,Instituto de Medicina Tropical, Avenida Dr Enéas Carvalho de Aguiar, 470, São Paulo, CEP 05403-000, Brazil.
| | - Francisco Chiaravalloti-Neto
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Av Dr Arnaldo, 715, São Paulo, CEP 05509-300, Brazil.
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Laporta GZ, Burattini MN, Levy D, Fukuya LA, de Oliveira TMP, Maselli LMF, Conn JE, Massad E, Bydlowski SP, Sallum MAM. Plasmodium falciparum in the southeastern Atlantic forest: a challenge to the bromeliad-malaria paradigm? Malar J 2015; 14:181. [PMID: 25909655 PMCID: PMC4417526 DOI: 10.1186/s12936-015-0680-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 04/04/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Recently an unexpectedly high prevalence of Plasmodium falciparum was found in asymptomatic blood donors living in the southeastern Brazilian Atlantic forest. The bromeliad-malaria paradigm assumes that transmission of Plasmodium vivax and Plasmodium malariae involves species of the subgenus Kerteszia of Anopheles and only a few cases of P. vivax malaria are reported annually in this region. The expectations of this paradigm are a low prevalence of P. vivax and a null prevalence of P. falciparum. Therefore, the aim of this study was to verify if P. falciparum is actively circulating in the southeastern Brazilian Atlantic forest remains. METHODS In this study, anophelines were collected with Shannon and CDC-light traps in seven distinct Atlantic forest landscapes over a 4-month period. Field-collected Anopheles mosquitoes were tested by real-time PCR assay in pools of ten, and then each mosquito from every positive pool, separately for P. falciparum and P. vivax. Genomic DNA of P. falciparum or P. vivax from positive anophelines was then amplified by traditional PCR for sequencing of the 18S ribosomal DNA to confirm Plasmodium species. Binomial probabilities were calculated to identify non-random results of the P. falciparum-infected anopheline findings. RESULTS The overall proportion of anophelines naturally infected with P. falciparum was 4.4% (21/480) and only 0.8% (4/480) with P. vivax. All of the infected mosquitoes were found in intermixed natural and human-modified environments and most were Anopheles cruzii (22/25 = 88%, 18 P. falciparum plus 4 P. vivax). Plasmodium falciparum was confirmed by sequencing in 76% (16/21) of positive mosquitoes, whereas P. vivax was confirmed in only 25% (1/4). Binomial probabilities suggest that P. falciparum actively circulates throughout the region and that there may be a threshold of the forested over human-modified environment ratio upon which the proportion of P. falciparum-infected anophelines increases significantly. CONCLUSIONS These results show that P. falciparum actively circulates, in higher proportion than P. vivax, among Anopheles mosquitoes of fragments of the southeastern Brazilian Atlantic forest. This finding challenges the classical bromeliad-malaria paradigm, which considers P. vivax circulation as the driver for the dynamics of residual malaria transmission in this region.
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Affiliation(s)
- Gabriel Zorello Laporta
- Departamento de Epidemiologia, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, 01246-904, Brazil. .,Laboratório de Informática Médica (LIM 01), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05405-000, Brazil.
| | - Marcelo Nascimento Burattini
- Laboratório de Informática Médica (LIM 01), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05405-000, Brazil. .,Divisão de Doenças Infecciosas, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, 04024-002, Brazil.
| | - Debora Levy
- Laboratório de Genética e Hematologia Molecular (LIM 31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil.
| | - Linah Akemi Fukuya
- Divisão de Pesquisa, Fundação Pró-Sangue Hemocentro de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil.
| | | | - Luciana Morganti Ferreira Maselli
- Laboratório de Genética e Hematologia Molecular (LIM 31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil. .,Divisão de Pesquisa, Fundação Pró-Sangue Hemocentro de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil.
| | - Jan Evelyn Conn
- Department of Health, Wadsworth Center, Slingerlands, NY, 12159, USA. .,Department of Biomedical Sciences, School of Public Health, State University of New York-Albany, Albany, NY, 12222, USA.
| | - Eduardo Massad
- Laboratório de Informática Médica (LIM 01), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05405-000, Brazil.
| | - Sergio Paulo Bydlowski
- Laboratório de Genética e Hematologia Molecular (LIM 31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil.
| | - Maria Anice Mureb Sallum
- Departamento de Epidemiologia, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, SP, 01246-904, Brazil.
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We need to talk more about transfusion-transmitted malaria in Plasmodium vivax endemic areas. Rev Bras Hematol Hemoter 2014; 36:385-7. [PMID: 25453644 PMCID: PMC4318471 DOI: 10.1016/j.bjhh.2014.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mendrone A, Cerutti C, Levi JE, Boulos M, Sanchez MCA, Malafronte RDS, Di Santi SM, Odone V. Unexpected detection of Plasmodium vivax and Plasmodium falciparum DNA in asymptomatic blood donors: fact or artifact? Malar J 2014; 13:336. [PMID: 25168246 PMCID: PMC4158092 DOI: 10.1186/1475-2875-13-336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 08/08/2014] [Indexed: 11/23/2022] Open
Abstract
A study searching for Plasmodium vivax and Plasmodium falciparum DNA among blood donors from the non-endemic area in Brazil reported a rate of 7.41%. This number is at least three times higher than what has been observed in blood donors from the Amazon, an endemic area concentrating >99% of all malaria cases in Brazil. Moreover, the majority of the donors were supposedly infected by P. falciparum, a rare finding both in men and anophelines from the Atlantic forest. These findings shall be taken with caution since they disagree with several publications in the literature and possibly overestimate the actual risk of malaria transmission by blood transfusion in São Paulo city.
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Affiliation(s)
- Alfredo Mendrone
- />Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
| | - Crispim Cerutti
- />Unidade de Medicina Tropical, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | - José Eduardo Levi
- />Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
- />Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Marcos Boulos
- />Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Silvia Maria Di Santi
- />Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
- />Superintendência de Controle de Endemias, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | - Vicente Odone
- />Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
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Sallum MAM, Daniel-Ribeiro CT, Laporta GZ, Ferreira-da-Cruz MDF, Maselli LMF, Levy D, Bydlowski SP. Finding connections in the unexpected detection of Plasmodium vivax and Plasmodium falciparum DNA in asymptomatic blood donors: a fact in the Atlantic Forest. Malar J 2014; 13:337. [PMID: 25168319 PMCID: PMC4155108 DOI: 10.1186/1475-2875-13-337] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 08/19/2014] [Indexed: 12/30/2022] Open
Abstract
A recent paper in Malaria Journal reported the observation of unexpected prevalence rates of healthy individuals carrying Plasmodium falciparum (5.14%) or Plasmodium vivax (2.26%) DNA among blood donors from the main transfusion centre in the metropolitan São Paulo, a non-endemic area for malaria. The article has been challenged by a group of authors who argued that the percentages reported were higher than those found in blood banks of the endemic Amazon Region and also that that paper had not considered the literature on the classical dynamics of malaria transmission in the Atlantic Forest, which involves Anopheles (Kerteszia) cruzii and bromeliad malaria, due to P. vivax and Plasmodium malariae parasites, but not P. falciparum. The present commentary paper responds to this challenge and brings evidence and literature data supporting that the observed prevalence ratios may indicate a proportion of individuals that are exposed to Plasmodium transmission in permissive environments; that blood carrying parasite DNA may not be necessarily infective if used in transfusion; and that in the literature, there are examples supporting the circulation of P. falciparum in the area.
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Affiliation(s)
- Maria Anice Mureb Sallum
- />Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP 01246-904 Brazil
| | | | - Gabriel Zorello Laporta
- />Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP 01246-904 Brazil
| | | | - Luciana Morganti Ferreira Maselli
- />Fundação Pró-Sangue Hemocentro de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000 Brazil
- />Laboratório de Genética e Hematologia Molecular (LIM31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000 Brazil
| | - Débora Levy
- />Laboratório de Genética e Hematologia Molecular (LIM31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000 Brazil
| | - Sérgio Paulo Bydlowski
- />Laboratório de Genética e Hematologia Molecular (LIM31), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000 Brazil
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de Pina-Costa A, Brasil P, Santi SMD, de Araujo MP, Suárez-Mutis MC, Santelli ACFES, Oliveira-Ferreira J, Lourenço-de-Oliveira R, Daniel-Ribeiro CT. Malaria in Brazil: what happens outside the Amazonian endemic region. Mem Inst Oswaldo Cruz 2014; 109:618-33. [PMID: 25185003 PMCID: PMC4156455 DOI: 10.1590/0074-0276140228] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/30/2014] [Indexed: 12/16/2022] Open
Abstract
Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation's territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation's malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon.
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Affiliation(s)
- Anielle de Pina-Costa
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Reference
Laboratory for Malaria in the Extra-Amazonian Region for the Brazilian Ministry of
Health
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto
Nacional de Infectologia Evandro Chagas
| | - Patrícia Brasil
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Reference
Laboratory for Malaria in the Extra-Amazonian Region for the Brazilian Ministry of
Health
- Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto
Nacional de Infectologia Evandro Chagas
| | - Sílvia Maria Di Santi
- Núcleo de Estudos em Malária, Superintendência de Controle de Endemias,
Secretaria de Saúde do Estado de São Paulo, São Paulo, SP, Brasil
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP,
Brasil
| | - Mariana Pereira de Araujo
- Programa Nacional de Controle da Malária, Secretaria de Vigilância em
Saúde, Ministério da Saúde, Brasilia, DF, Brasil
| | | | | | | | - Ricardo Lourenço-de-Oliveira
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Reference
Laboratory for Malaria in the Extra-Amazonian Region for the Brazilian Ministry of
Health
- Laboratório de Transmissores de Hematozoários
| | - Cláudio Tadeu Daniel-Ribeiro
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Reference
Laboratory for Malaria in the Extra-Amazonian Region for the Brazilian Ministry of
Health
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz-Fiocruz, Rio
de Janeiro, RJ, Brasil
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