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Zhang L, Yi BY, Zhou SS, Xia ZG, Yin JH. Epidemiological characteristics of Plasmodium malariae malaria in China: a malaria that should not be neglected post elimination. Infect Dis Poverty 2023; 12:101. [PMID: 37986018 PMCID: PMC10658989 DOI: 10.1186/s40249-023-01156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Plasmodium malariae was always neglected compared with P. falciparum and P. vivax. In the present study, we aimed to describe the epidemiology of reported cases infected with P. malariae in the past decade to raise awareness of the potential threat of this malaria parasite in China. METHODS Individual data of malaria cases infected with P. malariae reported in China in the past decade were collected via the China Information System for Disease Control and Prevention and Parasitic Diseases Information Reporting Management System, to explore their epidemiological characteristics. Pearson Chi-square tests or Fisher's Exact Test was used in the statistical analysis. RESULTS From 2013 to 2022, a total of 581 P. malariae cases were reported in China, and mainly concentrated in 20-59 years old group (P < 0.001), and there was no significant trend in the number of cases reported per month. Moreover, four kinds of P. malariae cases were classified, including 567 imported cases from 41 countries in 8 regions and distributed in 27 provinces (autonomous regions, municipalities) in China, six indigenous cases in a small outbreak in Hainan, seven recurrent cases in Guangdong and Shanghai, and one induced case in Shanghai, respectively. In addition, only 379 cases (65.2%) were diagnosed as malaria on the first visit (P < 0.001), and 413 cases (71.1%) were further confirmed as P. malariae cases (P = 0.002). Meanwhile, most cases sought healthcare first in the health facilities at the county and prefectural levels, but only 76.7% (161/210) and 73.7% (146/198) cases were diagnosed as malaria, and the accuracy of confirmed diagnosis as malaria cases infected with P. malariae was only 77.2% (156/202) and 69.9% (167/239) in these health facilities respectively. CONCLUSIONS Even though malaria cases infected with P. malariae didn't account for a high proportion of reported malaria cases nationwide, the threat posed by widely distributed imported cases, a small number of indigenous cases, recurrent cases and induced case cannot be ignored in China. Therefore, it is necessary to raise awareness and improve the surveillance and response to the non-falciparum species such as P. malariae, and prevent the reestablishment of malaria transmission after elimination.
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Affiliation(s)
- Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Bo-Yu Yi
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Zhi-Gui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China
| | - Jian-Hai Yin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research On Tropical Diseases, Shanghai, 200025, China.
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2
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Sena-Dos-Santos C, Cavalcante GC, Marques D, Silva CS, de Moraes MR, Pinto P, Santana-da-Silva MN, Ferraz RS, Costa SPT, Ventura AMR, Póvoa MM, Cunha MG, Ribeiro-Dos-Santos Â. Association of apoptosis-related variants to malaria infection and parasite density in individuals from the Brazilian Amazon. Malar J 2023; 22:295. [PMID: 37794476 PMCID: PMC10552311 DOI: 10.1186/s12936-023-04729-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND In malaria infection, apoptosis acts as an important immunomodulatory mechanism that leads to the elimination of parasitized cells, thus reducing the parasite density and controlling immune cell populations. Here, it was investigated the association of INDEL variants in apoptotic genes-rs10562972 (FAS), rs4197 (FADD), rs3834129 and rs59308963 (CASP8), rs61079693 (CASP9), rs4647655 (CASP3), rs11269260 (BCL-2), and rs17880560 (TP53)-and the influence of genetic ancestry with susceptibility to malaria and parasite density in an admixed population from the Brazilian Amazon. METHODS Total DNA was extracted from 126 malaria patients and 101 uninfected individuals for investigation of genetic ancestries and genotypic distribution of apoptosis-related variants by Multiplex PCR. Association analyses consisted of multivariate logistic regressions, considering the following comparisons: (i) DEL/DEL genotype vs. INS/DEL + INS/INS; and (ii) INS/INS vs. INS/DEL + DEL/DEL. RESULTS Individuals infected by Plasmodium falciparum had significantly higher African ancestry proportions in comparison to uninfected controls, Plasmodium vivax, and mixed infections. The INS/INS genotype of rs3834129 (CASP8) seemed to increase the risk for P. falciparum infection (P = 0.038; OR = 1.867; 95% CI 0.736-3.725), while the DEL/DEL genotype presented a significant protective effect against infection by P. falciparum (P = 0.049; OR = 0.446; 95% CI 0.185-0.944) and mixed infection (P = 0.026; OR = 0.545; 95% CI 0.281-0.996), and was associated with lower parasite density in P. falciparum malaria (P = 0.009; OR = 0.383; 95% CI 0.113-1.295). Additionally, the INS/INS genotype of rs10562972 (FAS) was more frequent among individuals infected with P. vivax compared to P. falciparum (P = 0.036; OR = 2.493; 95% CI 1.104-4.551), and the DEL/DEL genotype of rs17880560 (TP53) was significantly more present in patients with mono-infection by P. vivax than in individuals with mixed infection (P = 0.029; OR = 0.667; 95% CI 0.211-1.669). CONCLUSIONS In conclusion, variants in apoptosis genes are associated with malaria susceptibility and parasite density, indicating the role of apoptosis-related genetic profiles in immune responses against malaria infection.
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Affiliation(s)
- Camille Sena-Dos-Santos
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Giovanna C Cavalcante
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Diego Marques
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Caio S Silva
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Milene Raiol de Moraes
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Pablo Pinto
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
- Laboratory of Dermatoimmunology, Federal University of Pará (UFPA), Marituba, Brazil
| | - Mayara Natália Santana-da-Silva
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | - Rafaella S Ferraz
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil
| | | | - Ana Maria R Ventura
- Division of Parasitology, Evandro Chagas Institute (IEC), Ananindeua, Brazil
| | - Marinete M Póvoa
- Division of Parasitology, Evandro Chagas Institute (IEC), Ananindeua, Brazil
| | - Maristela G Cunha
- Laboratory of Microbiology and Immunology, Federal University of Pará (UFPA), Belém, Brazil
| | - Ândrea Ribeiro-Dos-Santos
- Laboratory of Human and Medical Genetics, Program of Genetics and Molecular Biology, Federal University of Pará (UFPA), Belém, Brazil.
- Program of Oncology and Medical Sciences, Oncology Research Center, Belém, Brazil.
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3
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Ferreira JDJG, Costa SCB, Addas-Carvalho M, Pereira MB, França ADO, de Lima RG, Andrade PD, Wanderley JDS, Martins LC, de Almeida EA, Marcon GEB. Evaluation of Molecular Methods to Identify Chagas Disease and Leishmaniasis in Blood Donation Candidates in Two Brazilian Centers. Pathogens 2023; 12:pathogens12040508. [PMID: 37111394 PMCID: PMC10141534 DOI: 10.3390/pathogens12040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 04/29/2023] Open
Abstract
In Brazil, blood donation is regulated by the Brazilian Ministry of Health, and all States follow the same protocol for clinical and laboratory screening. Brazil is an endemic country for Chagas disease (CD), caused by Trypanosoma cruzi, and for leishmaniasis, caused by a species of Leishmania spp. Screening for leishmaniosis is not routinely performed by blood banks. Given the antigenic similarity between T. cruzi and Leishmania spp., cross-reactions in serological tests can occur, and inconclusive results for CD have been found. The objective of this study was to apply molecular techniques, e.g., nPCR, PCR, and qPCR, to clarify cases of blood donation candidates with non-negative serology for CD and to analyze the difference between the melting temperature during real-time PCR using SYBR Green. Thirty-seven cases that showed non-negative results for CD using chemiluminescent microparticle immunoassay (CMIA) tests from blood banks in Campo Grande, MS, and Campinas, SP, were analyzed. In the serum samples, 35 samples were evaluated by ELISA, and 24.3% (9/35) showed positive results for CD. nPCR was able to detect 12 positive results in 35 samples (34.28%). qPCR for T. cruzi was quantifiable in the samples that showed a value ≥0.002 par eq/mL (parasite equivalents per milliliter), and in 35 samples, 11 (31.42%) were positive. Of all evaluated samples using the described tests (CMIA, ELISA, nPCR, and qPCR), 18 (48.6%) were positive for CD. For MCA by qPCR, the melting temperature was 82.06 °C ± 0.46 for T. cruzi and 81.9 °C ± 0.24 for Leishmania infantum. The Mann-Whitney test showed a significant value of p < 0.0001. However, the differentiation between T. cruzi and L. infantum could not be considered due to temperature overlap. For leishmaniasis, of the 35 samples with non-negative serology for CD tested by the indirect fluorescent antibody test (IFAT), only one sample (2.85%) was positive (1:80). The PCR for Leishmania spp. was performed on 36 blood samples from donation candidates, and all were negative. qPCR for L. infantum showed 37 negative results for the 37 analyzed samples. The data presented here show the importance of performing two different tests in CD screening at blood banks. Molecular tests should be used for confirmation, thereby improving the blood donation system.
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Affiliation(s)
- Juliana de Jesus Guimarães Ferreira
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Sandra Cecília Botelho Costa
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Marcelo Addas-Carvalho
- Centro de Hematologia e Hemoterapia, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Mariane Barroso Pereira
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Adriana de Oliveira França
- Laboratório de Doenças Infecciosas e Parasitárias (LabDIP), Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Cidade Universitária s/n, Campo Grande 79090-900, MS, Brazil
| | - Rodrigo Gonçalves de Lima
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Paula Durante Andrade
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Jamiro da Silva Wanderley
- Grupo de Estudos em Doença de Chagas (GEDoCh), Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Luiz Cláudio Martins
- Grupo de Estudos em Doença de Chagas (GEDoCh), Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Eros Antonio de Almeida
- Grupo de Estudos em Doença de Chagas (GEDoCh), Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Gláucia Elisete Barbosa Marcon
- Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
- Fundação Oswaldo Cruz Mato Grosso do Sul (FIOCRUZ MS), Rua Gabriel Abrão, 92, Jardim das Nações, Campo Grande 79081-746, MS, Brazil
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Malaria. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:512-524. [PMID: 35119479 PMCID: PMC8814801 DOI: 10.1007/s00103-022-03490-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Gimenez AM, Marques RF, Regiart M, Bargieri DY. Diagnostic Methods for Non-Falciparum Malaria. Front Cell Infect Microbiol 2021; 11:681063. [PMID: 34222049 PMCID: PMC8248680 DOI: 10.3389/fcimb.2021.681063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Malaria is a serious public health problem that affects mostly the poorest countries in the world, killing more than 400,000 people per year, mainly children under 5 years old. Among the control and prevention strategies, the differential diagnosis of the Plasmodium-infecting species is an important factor for selecting a treatment and, consequently, for preventing the spread of the disease. One of the main difficulties for the detection of a specific Plasmodium sp is that most of the existing methods for malaria diagnosis focus on detecting P. falciparum. Thus, in many cases, the diagnostic methods neglect the other non-falciparum species and underestimate their prevalence and severity. Traditional methods for diagnosing malaria may present low specificity or sensitivity to non-falciparum spp. Therefore, there is high demand for new alternative methods able to differentiate Plasmodium species in a faster, cheaper and easier manner to execute. This review details the classical procedures and new perspectives of diagnostic methods for malaria non-falciparum differential detection and the possibilities of their application in different circumstances.
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Affiliation(s)
- Alba Marina Gimenez
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rodolfo F. Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Matías Regiart
- Department of Fundamental Chemistry, Institute of Chemistry, University of São Paulo, São Paulo, Brazil
| | - Daniel Youssef Bargieri
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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6
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Vernaza A, Pinilla-Monsalve G, Cañas F, Carrillo D, David López J, Flórez N, Gomez-Mesa JE. Malaria and encephalopathy in a heart transplant recipient: A case report in the context of multiorgan donation. Transpl Infect Dis 2021; 23:e13565. [PMID: 33432737 DOI: 10.1111/tid.13565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/10/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Malaria is an endemic infection in tropical circles. It can be transmitted from mosquitoes bite, but exceptional cases have been attributed to multiorgan transplantation. CASE REPORT This is a 34-year-old woman who received a heart transplant for final-stage dilated cardiomyopathy. Over the hospitalization, she developed fever, cephalalgia, and tonic-clonic seizures with MRI findings compatible with posterior reversible encephalopathy. A thick blood smear revealed hemoparasitic forms of Plasmodium vivax. Afterward, malaria was also diagnosed in recipients of one kidney and liver of the same organ donor. First-line treatment with artesunate was prescribed for 3 days and chloroquine with primaquine thereafter for 14 days. The patient was discharged and returned to the emergency department 5 days later, complaining of gastrointestinal symptoms and developed multiorgan failure that led to death. CONCLUSION We report a case of malaria transmission through heart transplantation. Despite adequate and supervised treatment, it can be related to a fatal outcome. Malaria screening in organ donors should be considered in regions where endemicity can lead to rare cases of transmission by transplantation.
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Affiliation(s)
- Armando Vernaza
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
| | - Gabriel Pinilla-Monsalve
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Neurology, Fundación Valle del Lili, Cali, Colombia
| | - Felipe Cañas
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
| | - Diana Carrillo
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
| | - Juan David López
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
| | - Noel Flórez
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
| | - Juan Esteban Gomez-Mesa
- Faculty of Health Sciences, Icesi University, Cali, Colombia.,Department of Cardiology, Fundación Valle del Lili, Cali, Colombia
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Aschar M, Levi JE, Farinas MLRN, Montebello SC, Mendrone-Junior A, Di Santi SM. The hidden Plasmodium malariae in blood donors: a risk coming from areas of low transmission of malaria. Rev Inst Med Trop Sao Paulo 2020; 62:e100. [PMID: 33331519 PMCID: PMC7748032 DOI: 10.1590/s1678-9946202062100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/30/2020] [Indexed: 11/23/2022] Open
Abstract
Malaria is an infectious vector-borne disease with other important routes of
transmission, such as blood transfusion and organ/tissue transplantation, due to
asymptomatic reservoirs of Plasmodium presenting with low
parasitemia. Reports of transfusion-transmitted malaria have shown that in
immunosuppressed recipients, infections can be fatal if they are not diagnosed
and timely treated. All Plasmodium species can survive on blood
components at temperatures from 2 to 6 °C for some days or even weeks. This
report describes two candidates for blood donation harboring
Plasmodium, infected in an area considered non-endemic.
Blood samples were collected from donors who attended a blood bank in Sao Paulo
and tested by microscopy, qPCR for Plasmodium genus-specific
amplification, targeting the parasite 18S ribosomal subunit gene and a multiplex
qPCR based on mtDNA of the five species. Under microscopy, only structures
resembling Plasmodium were observed. The qPCR whose standard
curve tested parasites varying from 2 to 0.1 parasites/ µL, showed the presence
of Plasmodium DNA in the two blood donors, as did the multiplex
qPCR that revealed the presence of P. malariae. The prevalence
of positive donors varies according to the level of transmission, ranging from
0.7 to 55% in endemic areas. In non-endemic regions, prevalences are lower,
however, transfusion malaria can evolve to severe cases, due to the lack of
suspicion of this transmission route. Asymptomatic donors from low transmission
regions pose a risk to blood banks, with particular emphasis on those located in
areas with malaria elimination goals.
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Affiliation(s)
- Mariana Aschar
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - José Eduardo Levi
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia, São Paulo, São Paulo, Brazil
| | - Maria L R N Farinas
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - Sandra C Montebello
- Secretaria da Saúde de São Paulo, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - Alfredo Mendrone-Junior
- Secretaria da Saúde de São Paulo, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, São Paulo, Brazil
| | - Silvia Maria Di Santi
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.,Secretaria da Saúde de São Paulo, Superintendência de Controle de Endemias, Núcleo de Estudos em Malária, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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Costa EMF, Amador ECC, Silva ES, Alvarenga CO, Pereira PE, Póvoa MM, Cunha MG. Malaria transmission and individual variability of the naturally acquired IgG antibody against the Plasmodium vivax blood-stage antigen in an endemic area in Brazil. Acta Trop 2020; 209:105537. [PMID: 32454033 DOI: 10.1016/j.actatropica.2020.105537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/20/2022]
Abstract
Plasmodium vivax remains an important cause of malaria in South America and Asia, and analyses of the antibody immune response are being used to identify biomarker of parasite exposure. The IgG antibody naturally acquired predominantly occurs against targets on blood-stage parasites, including C-terminal of the merozoite surface protein 1 (MSP1-19). Epidemiological and immunological evidence has been showed that antibodies to malaria parasite antigens are lost in the absence of ongoing exposure. We describe the IgG antibody response in individuals living in an unstable malaria transmission area in Pará state, Amazon region, Brazil, where an epidemic of P. vivax malaria was recorded and monitored over time. As indicated by epidemiological data, the number of P. vivax-caused malaria cases decreased by approximately 90% after three years and the prevalence of IgG positive to PvMSP1-19 decreased significantly over time, in 2010 (93.4%), 2012 (78.3%), and 2013 (85.1%). Acquisition and decay of the IgG antibody against P. vivax MSP1-19 showed variability among individuals living in areas with recent circulating parasites, where the malaria epidemic was being monitored until transmission had been completely controlled. We also found that previous malaria episodes were associated with an increased in the IgG positivity . Our results showed epidemiological, spatial, temporal and individual variability. The understanding on dynamics of antibodies may have implications for the design of serosurveillance tools for monitoring parasite circulation, especially in a context with spatial and temporal changes in P. vivax malaria transmission.
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Affiliation(s)
- Edna Maria F Costa
- Universidade Federal do Pará, Instituto de Ciências Biológicas, CEP: 66075-110, Belém, Pará, Brazil
| | | | - Eliane S Silva
- Fundação Centro de Hemoterapia e Hematologia do Pará, CEP: 660033-000, Belém, Pará, Brazil
| | - Cassiana O Alvarenga
- Universidade Federal do Pará, Instituto de Ciências Biológicas, CEP: 66075-110, Belém, Pará, Brazil
| | - Pedro Elias Pereira
- Fundação Centro de Hemoterapia e Hematologia do Pará, CEP: 660033-000, Belém, Pará, Brazil
| | - Marinete M Póvoa
- Instituto Evandro Chagas, CEP: 66087-082, Ananindeua, Pará, Brazil
| | - Maristela G Cunha
- Universidade Federal do Pará, Instituto de Ciências Biológicas, CEP: 66075-110, Belém, Pará, Brazil.
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9
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Rocha D, de Melo GC, Carneiro JMH, Ribeiro M, Ribeiro S, de Godoy DT, Costa E, de Almeida ACG, de Andrade EF, Abrahim CMDM, Fraiji NA, Ferreira AGP, Monteiro WM, Brindeiro R, Tanuri A, de Lacerda MVG, Alvarez P. Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks. Malar J 2020; 19:275. [PMID: 32736625 PMCID: PMC7395345 DOI: 10.1186/s12936-020-03345-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/23/2020] [Indexed: 02/04/2023] Open
Abstract
Background Malaria can be transmitted by blood transfusion through donations collected from asymptomatic donors. Transfusion-transmitted malaria (TTM) poses a great risk to blood services worldwide. A good screening tool for Plasmodium spp. detection in blood banks must have a high sensitivity for prevention of TTM. However, in Brazilian blood banks, screening for malaria still relies on microscopy. Methods In Brazil, screening for human immunodeficiency virus type 1 (HIV), RNA/DNA for hepatitis C (HCV) and hepatitis B (HBV) viruses is mandatory for every blood donation and uses nucleic acid amplification testing (NAT). The aim of this study was to evaluate the inclusion of an assay for malaria to identify Plasmodium sp. from total nucleic acid (TNA; DNA/RNA) by targeting the 18S rRNA gene of the parasite. Results Considering the limitations of microscopy and the wide availability of the Brazilian NAT platform in the screening of blood units for HIV, HCV, and HBV, a molecular diagnostic tool was validated for detection of Plasmodium sp. in blood banks; a pilot study showed that using this novel NAT assay could reduce the risk of TTM. Conclusion The prototype HIV/HCV/HBV/malaria NAT assay was effective in detecting infected candidate donors and has good prospects to be applied in routine screening for preventing TTM.
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Affiliation(s)
- Daniele Rocha
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil.,Departamento de Genética, Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Gisely Cardoso de Melo
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | - Marisa Ribeiro
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil.,Departamento de Genética, Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Sthefanie Ribeiro
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil
| | - Daniela Tupy de Godoy
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil
| | - Elaine Costa
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil
| | - Anne Cristine Gomes de Almeida
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Elisabete Ferreira de Andrade
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil.,Departamento de Genética, Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | | | - Nelson Abrahim Fraiji
- HEMOAM-Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas, Brazil
| | - Antonio Gomes Pinto Ferreira
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil
| | - Wuelton Marcelo Monteiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Rodrigo Brindeiro
- Departamento de Genética, Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Amilcar Tanuri
- Departamento de Genética, Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Marcus Vinicius Guimarães de Lacerda
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.,Instituto de Pesquisas Leônidas e Maria Deane, Fiocruz, Manaus, Amazonas, Brazil
| | - Patrícia Alvarez
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Avenida Brasil 4365, Rio de Janeiro, Brazil.
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10
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Dos Santos EH, Yamamoto L, Domingues W, di Santi SM, Kanunfre KA, Okay TS. A new Real Time PCR with species-specific primers from Plasmodium malariae/P. brasilianum mitochondrial cytochrome b gene. Parasitol Int 2020; 76:102069. [PMID: 32032726 DOI: 10.1016/j.parint.2020.102069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
Abstract
Plasmodium malariae mainly causes asymptomatic submicroscopic parasitemia in the endemic Amazon and non-endemic Atlantic Forest, where the number of cases and transmission of malaria through blood transfusion has increased. This study developed a P. malariae/P. brasilianum Real Time PCR (rtPCR) targeting the cytochrome b oxidase (cytb), a highly repetitive gene (20-150 copies/parasite) that should detect more cases than the 18S rRNA (4-8 copies/parasite) gene-based amplification systems. Cytb from human and non-human Plasmodium species (including P. brasilianum) aligned to the only 20 African P. malariae cytb sequences identified polymorphic regions within which we designed P. malariae species-specific primers. Non-human Plasmodium species, related parasites, anemia-causing microorganisms, normal human DNA and 47 blood bank donors samples that were truly negative to malaria accessed rtPCR specificity. Truly positive samples (n = 101) with species identification by semi-nested, nested or TaqMan PCR, and four samples from the Atlantic Forest that were suspected of malaria but three of them had negative genus TaqMan and 18S rRNA nested PCR. The cloned amplification product used in standard curves determined qPCR detection limit (0.5-1 parasite equivalent/μL). The 10 positive P. malariae samples among truly positives yielded positive rtPCR results and more importantly, rtPCR detected the four samples suspected of malaria from the Atlantic Forest. The rtPCR specificity was 100%, reproducibility 11.1% and repeatability 6.7%. In conclusion, the proposed rtPCR is fast, apparently more sensitive than all 18S rRNA amplification systems for detecting extremely low parasitemia. The rtPCR is also specific to P. malariae/P. brasilianum species. This new molecular tool could be applied to the detection of P. malariae/brasilianum infections with submicroscopic parasitemias in the context of epidemiological studies and blood bank safety programs.
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Affiliation(s)
| | - Lidia Yamamoto
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wilson Domingues
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvia Maria di Santi
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil; Núcleo de Estudos em Malária, Superintendência de Controle de Endemias (SUCEN), São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Kelly Aparecida Kanunfre
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil; LIM 48, Laboratório de Investigação Médica, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Thelma Suely Okay
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil; Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
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11
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Houzé S. [Malaria: immuno-permissive management in the prevention of transfusional malaria]. Transfus Clin Biol 2019; 26:192-194. [PMID: 31331829 DOI: 10.1016/j.tracli.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
Abstract
Malaria is a potentially life-threatening tropical infectious disease caused by a parasite that infects erythrocytes. Its transmission is vectorial, but the transfusion of infected red blood cells can cause a delicate diagnosis of transmitted malaria. Prevention is based on the selection of donors at risk by the search for antibodies reflecting past infection, in the absence of a sufficiently sensitive parasite detection technique to prevent all risks. Recent cases of transfusion malaria have reiterated that this preventive measure does not allow screening of all asymptomatic carriers.
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Affiliation(s)
- S Houzé
- CNR du Paludisme, hôpital Bichat, AP-HP, 46, rue Henri Huchard, 75018 Paris, France.
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