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Taheri S, González MA, Ruiz-López MJ, Magallanes S, Delacour-Estrella S, Lucientes J, Bueno-Marí R, Martínez-de la Puente J, Bravo-Barriga D, Frontera E, Polina A, Martinez-Barciela Y, Pereira JM, Garrido J, Aranda C, Marzal A, Ruiz-Arrondo I, Oteo JA, Ferraguti M, Gutíerrez-López R, Estrada R, Miranda MÁ, Barceló C, Morchón R, Montalvo T, Gangoso L, Goiri F, García-Pérez AL, Ruiz S, Fernandez-Martinez B, Gómez-Barroso D, Figuerola J. Modelling the spatial risk of malaria through probability distribution of Anopheles maculipennis s.l. and imported cases. Emerg Microbes Infect 2024; 13:2343911. [PMID: 38618930 PMCID: PMC11073426 DOI: 10.1080/22221751.2024.2343911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
Malaria remains one of the most important infectious diseases globally due to its high incidence and mortality rates. The influx of infected cases from endemic to non-endemic malaria regions like Europe has resulted in a public health concern over sporadic local outbreaks. This is facilitated by the continued presence of competent Anopheles vectors in non-endemic countries.We modelled the potential distribution of the main malaria vector across Spain using the ensemble of eight modelling techniques based on environmental parameters and the Anopheles maculipennis s.l. presence/absence data collected from 2000 to 2020. We then combined this map with the number of imported malaria cases in each municipality to detect the geographic hot spots with a higher risk of local malaria transmission.The malaria vector occurred preferentially in irrigated lands characterized by warm climate conditions and moderate annual precipitation. Some areas surrounding irrigated lands in northern Spain (e.g. Zaragoza, Logroño), mainland areas (e.g. Madrid, Toledo) and in the South (e.g. Huelva), presented a significant likelihood of A. maculipennis s.l. occurrence, with a large overlap with the presence of imported cases of malaria.While the risk of malaria re-emergence in Spain is low, it is not evenly distributed throughout the country. The four recorded local cases of mosquito-borne transmission occurred in areas with a high overlap of imported cases and mosquito presence. Integrating mosquito distribution with human incidence cases provides an effective tool for the quantification of large-scale geographic variation in transmission risk and pinpointing priority areas for targeted surveillance and prevention.
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Affiliation(s)
- Shirin Taheri
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
| | - Mikel Alexander González
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Ruiz-López
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sergio Magallanes
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah Delacour-Estrella
- The Agrifood Institute of Aragón (IA2), Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Javier Lucientes
- The Agrifood Institute of Aragón (IA2), Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Rubén Bueno-Marí
- Center of Excellence in Vector Control, Rentokil Initial, València, Spain
- Grupo de Investigación Parásitos y Salud, Universitat de València, València, Spain
| | - Josué Martínez-de la Puente
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Parasitología, Universidad de Granada, Granada, Spain
| | - Daniel Bravo-Barriga
- Departamento de Salud Animal, Grupo de Investigación en Salud Animal y Zoonosis (GISAZ), Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Eva Frontera
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Extremadura (UEx), Cáceres, Spain
| | - Alejandro Polina
- Departamento de Ecoloxía e Bioloxía Animal, Universidade de Vigo, Pontevedra, Spain
| | | | - José Manuel Pereira
- Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, A Coruña, Spain
| | - Josefina Garrido
- Departamento de Ecoloxía e Bioloxía Animal, Universidade de Vigo, Pontevedra, Spain
| | - Carles Aranda
- Servei de Control de Mosquits del Baix Llobregat, Sant Feliu del Llobregat, Barcelona, Spain
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alfonso Marzal
- Facultad de Biología, Universidad de Extremadura, Badajoz, Spain
- Grupo de Investigaciones en Fauna Silvestre, Universidad Nacional de San Martín, Tarapoto, Perú
| | - Ignacio Ruiz-Arrondo
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital Universitario San Pedro-CIBIR, La Rioja, Logroño, Spain
| | - José Antonio Oteo
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital Universitario San Pedro-CIBIR, La Rioja, Logroño, Spain
| | - Martina Ferraguti
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Gutíerrez-López
- Centro Nacional de Microbiología (CNM-ISCIII), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rosa Estrada
- The Agrifood Institute of Aragón (IA2), Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Miguel Ángel Miranda
- Universitat de les Illes Balears (UIB), Zoología Aplicada y de la Conservación, Palma, Spain
| | - Carlos Barceló
- Universitat de les Illes Balears (UIB), Zoología Aplicada y de la Conservación, Palma, Spain
| | - Rodrigo Morchón
- Zoonotic Diseases and One Health Group, Faculty of Pharmacy, Universidad de Salamanca, Salamanca, Spain
| | - Tomas Montalvo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agencia de Salut Publica de Barcelona, Barcelona, Spain
| | | | - Fátima Goiri
- NEIKER-Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Spain
| | | | - Santiago Ruiz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Servicio de Control de Mosquitos de la Diputación de Huelva, Huelva, Spain
| | - Beatriz Fernandez-Martinez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro Nacional de Epidemiologia (CNE-ISCIII), Madrid, Spain
| | - Diana Gómez-Barroso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro Nacional de Epidemiologia (CNE-ISCIII), Madrid, Spain
| | - Jordi Figuerola
- Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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García-García D, Fernández-Martínez B, Bartumeus F, Gómez-Barroso D. Modeling the Regional Distribution of International Travelers in Spain to Estimate Imported Cases of Dengue and Malaria: Statistical Inference and Validation Study. JMIR Public Health Surveill 2024; 10:e51191. [PMID: 38801767 PMCID: PMC11165286 DOI: 10.2196/51191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/18/2023] [Accepted: 03/05/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Understanding the patterns of disease importation through international travel is paramount for effective public health interventions and global disease surveillance. While global airline network data have been used to assist in outbreak prevention and effective preparedness, accurately estimating how these imported cases disseminate locally in receiving countries remains a challenge. OBJECTIVE This study aimed to describe and understand the regional distribution of imported cases of dengue and malaria upon arrival in Spain via air travel. METHODS We have proposed a method to describe the regional distribution of imported cases of dengue and malaria based on the computation of the "travelers' index" from readily available socioeconomic data. We combined indicators representing the main drivers for international travel, including tourism, economy, and visits to friends and relatives, to measure the relative appeal of each region in the importing country for travelers. We validated the resulting estimates by comparing them with the reported cases of malaria and dengue in Spain from 2015 to 2019. We also assessed which motivation provided more accurate estimates for imported cases of both diseases. RESULTS The estimates provided by the best fitted model showed high correlation with notified cases of malaria (0.94) and dengue (0.87), with economic motivation being the most relevant for imported cases of malaria and visits to friends and relatives being the most relevant for imported cases of dengue. CONCLUSIONS Factual descriptions of the local movement of international travelers may substantially enhance the design of cost-effective prevention policies and control strategies, and essentially contribute to decision-support systems. Our approach contributes in this direction by providing a reliable estimate of the number of imported cases of nonendemic diseases, which could be generalized to other applications. Realistic risk assessments will be obtained by combining this regional predictor with the observed local distribution of vectors.
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Affiliation(s)
- David García-García
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
| | - Beatriz Fernández-Martínez
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
| | - Frederic Bartumeus
- Group of Theoretical and Computational Ecology, Centre for Advanced Studies of Blanes, Spanish Research Council, Blanes, Spain
- Ecological and Forestry Applications Research Centre, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Diana Gómez-Barroso
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Public Health Biomedical Network Research Consortium (CIBERESP), Madrid, Spain
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Fleitas PE, Sarasola LB, Ferrer DC, Muñoz J, Petrone P. Machine learning approach to identify malaria risk in travelers using real-world evidence. Heliyon 2024; 10:e28534. [PMID: 38560112 PMCID: PMC10979204 DOI: 10.1016/j.heliyon.2024.e28534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
Background Pre-travel consultation and chemoprophylaxis measures for malaria are a key component in the prevention of imported malaria in travelers. In this study we report a predictive tool for assessing personalized malaria risk in travelers based on the analysis of electronic medical records from travel consultations. The tool aims to guide physicians in the recommendation of appropriate prophylaxis prior to their trip. We also provide best-practice recommendations for pre-processing noisy and highly sparse real world evidence data. Methods We leveraged a large EMR dataset, containing demographic information about travelers and their destination. The data has been previously preprocessed using various strategies to handle missing and unbalanced data. We compared multiple machine learning approaches to assess the risk of malaria acquisition in travelers during their travels. Additionally, a feature importance analysis was performed using SHAP (SHapley Additive Explanations) values to identify patterns associated with malaria risk. Results Our study revealed that our XGB models achieved high predictive capacity (AUC >0.80). The most significant features predicting malaria infection during travel included travel destinations with low malaria risk, vaccination history, number of countries visited, age, and trip duration. Remarkably, we were able to obtain a reduced model with only five features. When comparing this model with a population of travelers recommended for malaria chemoprophylaxis, we observed that it was deemed necessary in only 40% of these travelers. This suggests that 60% received chemoprophylaxis despite having a low personalized risk of malaria. Conclusion We have developed an algorithmic tool that utilizes a concise survey to generate a personalized travel risk assessment, effectively minimizing the prescription of unnecessary malaria chemoprophylaxis. Through the identification of patterns linked to predictions, our model significantly enhances the efficacy of pre-travel consultations.
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Affiliation(s)
- Pedro Emanuel Fleitas
- Barcelona Institute for Global Health (ISGlobal) Hospital Clınic - Universitat de Barcelona, Barcelona, Spain
| | - Leire Balerdi Sarasola
- Barcelona Institute for Global Health (ISGlobal) Hospital Clınic - Universitat de Barcelona, Barcelona, Spain
| | - Daniel Camprubi Ferrer
- Barcelona Institute for Global Health (ISGlobal) Hospital Clınic - Universitat de Barcelona, Barcelona, Spain
| | - Jose Muñoz
- Corresponding author. Address: C/ del Rosselló, 132, 08036 Barcelona, Spain.
| | - Paula Petrone
- Corresponding author. Address: C/ del Dr. Aiguader, 88, 08003. Barcelona. Spain.
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Gallet S, Dard C, Bailly S, Thellier M, Houze S, Pelloux H, Epaulard O. Length of stay in at-risk areas and time to malaria attack on return. Infect Dis Now 2024; 54:104819. [PMID: 37890619 DOI: 10.1016/j.idnow.2023.104819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Experimental infection with Plasmodium falciparum results in malaria attack within a few days of exposure. However, we have regularly observed malaria attack within a short time after return, regardless of the time spent in an endemic area. We therefore aimed to assess whether the time before return and malaria attack varies according to length of stay. METHODS We used anonymized data from the French National Reference Centre for Malaria between 2006 and 2016. We analyzed 11,823 cases aged at least 1 year and diagnosed with P. falciparum malaria 1 day to 1 year after returning to France, after a stay of 1 day to 1 year in an at-risk area. RESULTS Trips had a median duration of 31 days [IQR: 19-56]. Median time between return from the endemic area and onset of malaria symptoms was 5 days [IQR: 0-10], and the median between return and malaria diagnosis was 9 days [IQR: 5-14]. Times to symptom onset or diagnosis were longer for stays of fewer than 15 days vs 15 days or more (for symptoms: 7 vs 4 days for longer stays, for diagnosis: 11 vs 9 days). For stays longer than 15 days, no variation was observed according to length of stay. CONCLUSIONS Aside from at-risk stays of fewer than 15 days, the time between return and malaria attack is constant and rather short, even after long stays. The 2 weeks following return should be considered as a risk period whatever the length of stay in an at-risk area.
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Affiliation(s)
- Salomé Gallet
- Clinical Infectious Disease Unit, Grenoble-Alpes University Hospital, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC 1406 - Inserm - Université Grenoble Alpes, Grenoble, France.
| | - Céline Dard
- Parasitology-Mycology Laboratory, Grenoble-Alpes University Hospital, Grenoble, France
| | - Sébastien Bailly
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
| | - Marc Thellier
- Parasitology-Mycology Laboratory, Pitié Salpêtrière Hospital, APHP, Paris, France; Centre National de Référence du Paludisme, AP-HP, Paris, France
| | - Sandrine Houze
- Parasitology-Mycology Laboratory, APHP, Hôpital Bichat, Paris, France; Centre National de Référence du Paludisme, AP-HP, Paris, France
| | - Hervé Pelloux
- Parasitology-Mycology Laboratory, Grenoble-Alpes University Hospital, Grenoble, France
| | - Olivier Epaulard
- Clinical Infectious Disease Unit, Grenoble-Alpes University Hospital, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC 1406 - Inserm - Université Grenoble Alpes, Grenoble, France
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Liang S, Guo R, Zhuang J, Li P, Chang Z, Zhu W, Jin Z. Analysis of epidemiological changes and elimination effects for malaria in Handan city, the north China. Medicine (Baltimore) 2022; 101:e31722. [PMID: 36550922 PMCID: PMC9771291 DOI: 10.1097/md.0000000000031722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The elimination of malaria requires high-quality surveillance data to quickly detect and respond to individual cases. This study aims to analyze the epidemiological characteristics of malaria and ascertain the long-term epidemic trends of malaria by 2020 in Handan China. Case-level data for the period 2011 to 2020 were extracted from Chinese Information System for Disease Control and Prevention. The lamp trap method was used to capture mosquitoes so that the characteristics of mosquitoes can be analyzed. The incidence, accuracy, and timeliness of malaria case diagnosis, reporting and investigation were evaluated at the elimination stage (2011-2020) in Handan City, China. Between 2011 and 2020, 94 malaria cases were reported in Handan City, of which 93 malaria cases were male and all of which were imported from abroad. The annual average incidence decreased from 622.33/100,000 to 0.11/100,000 in the elimination stage. Since the initiation of the National Malaria Elimination Program in 2010, malaria cases have been consistent with the increase in overseas export channels and labor personnel service. There is a need to strengthen malaria surveillance of returning workers from Africa and to conduct timely blood tests to diagnose and treat imported infections. Local authorities ensure that imported malaria cases can be timely diagnosed, reported, treated and investigated at local level.
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Affiliation(s)
- Shuang Liang
- School of Medicine, Hebei University of Engineering, Handan, China
- Handan Key Laboratory of Integrated Medical and Industrial Application in Basic Medicine, Handan, China
| | - Ruiling Guo
- Handan Municipal Centre for Disease Control and Prevention, Handan, China
| | - Jing Zhuang
- Handan Municipal Centre for Disease Control and Prevention, Handan, China
| | - Penghui Li
- School of Medicine, Hebei University of Engineering, Handan, China
- Handan Key Laboratory of Integrated Medical and Industrial Application in Basic Medicine, Handan, China
| | - Zhongzheng Chang
- School of Medicine, Hebei University of Engineering, Handan, China
- Handan Key Laboratory of Integrated Medical and Industrial Application in Basic Medicine, Handan, China
| | - Wangdong Zhu
- School of Medicine, Hebei University of Engineering, Handan, China
- Handan Key Laboratory of Integrated Medical and Industrial Application in Basic Medicine, Handan, China
| | - Zengjun Jin
- School of Medicine, Hebei University of Engineering, Handan, China
- Handan Key Laboratory of Integrated Medical and Industrial Application in Basic Medicine, Handan, China
- Handan Municipal Centre for Disease Control and Prevention, Handan, China
- * Correspondence: Zengjun Jin, School of Medicine, Hebei University of Engineering, Handan, Hebei 056038, China (e-mail: )
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Gautam R, Pokharel A, Adhikari K, Uprety KN, Vaidya NK. Modeling malaria transmission in Nepal: impact of imported cases through cross-border mobility. JOURNAL OF BIOLOGICAL DYNAMICS 2022; 16:528-564. [PMID: 35833562 DOI: 10.1080/17513758.2022.2096935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
The cross-border mobility of malaria cases poses an obstacle to malaria elimination programmes in many countries, including Nepal. Here, we develop a novel mathematical model to study how the imported malaria cases through the Nepal-India open-border affect the Nepal government's goal of eliminating malaria by 2026. Mathematical analyses and numerical simulations of our model, validated by malaria case data from Nepal, indicate that eliminating malaria from Nepal is possible if strategies promoting the absence of cross-border mobility, complete protection of transmission abroad, or strict border screening and isolation are implemented. For each strategy, we establish the conditions for the elimination of malaria. We further use our model to identify the control strategies that can help maintain a low endemic level. Our results show that the ideal control strategies should be designed according to the average mosquito biting rates that may depend on the location and season.
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Affiliation(s)
- Ramesh Gautam
- Ratna Rajya Laxmi Campus, Tribhuvan University, KTM, Nepal
| | - Anjana Pokharel
- Padma Kanya Multiple Campus, Tribhuvan University, KTM, Nepal
| | | | | | - Naveen K Vaidya
- Department of Mathematics and Statistics, San Diego State University, San Diego, CA, USA
- Computational Science Research Center, San Diego State University, San Diego, CA, USA
- Viral Information Institute, San Diego State University, San Diego, CA, USA
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Gómez I, Pérez-Vázquez MD, Tarragó D. Molecular epidemiology of Kaposi sarcoma virus in Spain. PLoS One 2022; 17:e0274058. [PMID: 36282878 PMCID: PMC9595507 DOI: 10.1371/journal.pone.0274058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/21/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Since human herpesvirus 8 (HHV-8) infection may be underestimated and HHV-8 subtype circulation in Spain remains unknown, a molecular epidemiologic study is highly desirable. OBJECTIVES This study aimed to analyse HHV-8 subtype diversity and their distribution in Spain. STUDY DESIGN The study included 142 HHV-8 infected patients. A nested PCR was developed in order to permit Sanger sequencing of HHV-8 K1 ORF directly from clinical samples received at the CNM from 2013 to 2021. Phylogenetic characterization was performed. RESULTS Genotypes A and C comprised 55.6% and 42.3% of strains. Regarding subtypes, 25.4% of strains were C3, 19.7% were A3, 14.1% were A5, and C2, A1, A4, C1, A2, C7 were 11.3%, 11.3%, 8.5%, 4.2%, 2.1% and 1.4%, respectively. Subtype E1, E2 and B1 were found in only one patient each (0.7%). The Madrid region accounted for 52.1% of patients and showed a significantly different subtype distribution compared to the others (P = 0.018). Subtypes B1, E1, and E2 were observed to appear sporadically, although overall genotypes A and subtype C3 remained the most frequent and unwavering. Subtype A3 presented the highest diversity as displayed by the highest number of clusters in phylogenetic analysis. Non-significant differences in viral loads between genotypes were found, but significantly higher viral loads in subtype C2 compared to subtype C3 was found, while no significant subtype differences were observed between subtypes within genotype A. Infections with HHV-8 were detected in 94 (66.2%) patients without KS and compared to patients with KS non-significant differences in subtype distribution were found. CONCLUSIONS Subtype prevalence and regional distribution followed a similar pattern compared to other western European countries. Our study is the first to report HHV-8 subtypes E1 and E2 circulating in Europe that might be reflective of migration of population from Caribbean countries. Our study suggests that infection by HHV-8 is underestimated, and wider screening should be recommended for risk groups.
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Affiliation(s)
- Inmaculada Gómez
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Spain
| | | | - David Tarragó
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- * E-mail:
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Arifin MA, Su Peng C, Baharudin UM, Baharudin MH, Rahim MAA, Rahim SSSA, Atil A, Madrim MF, Ahmad ZNBS, Mokti K, Ramdzan AR, Jeffree MS, Hassan MR. A Systematic Review of Tropical Disease Prevalence among Migrants. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND: Few studies have assessed the burden of tropical diseases among migrants into non-endemic countries.
AIM: This study aimed to systematically review the existing data of the prevalence of tropical diseases globally, including neglected tropical diseases globally.
MATERIALS AND METHODS: The authors conducted a systematic review reporting prevalence (including seroprevalence) of tropical diseases following the PRISMA guidelines and based on the database from PUBMED, WoS, and PROQUEST. All the identified records were screened according to the inclusion and exclusion criteria. The selected articles’ quality was appraised using the mixed methods appraisal tool to ensure its quality.
RESULTS: Overall, 19 studies conducted in 13 countries published between the year 2017–2020 were included in the study. Based on the thematic analysis, two themes (type of organism) and 11 sub-themes (disease) were used. The prevalence of tropical diseases among migrants ranged from 0.2 to 31% for malaria; 3–20% for Chagas Disease; 3.2–3.5% for Giardiasis; 31.7–57.4% for Toxoplasmosis; 0.1–51%, for Schistosomiasis; 0.1–15.8%, for Strongyloidiasis; 0.3–3.8% for Trichuriasis; 0.2–0.9% for Ascariasis; 6.4–9.7% for Toxocariasis; 0.3% for Loiasis; and 0.5% for Filariasis. All migrants warrant thorough screening and testing, based on the country of origin of their last visit. Routine screening and follow-up may reduce the re-emergence of tropical disease in non-endemic countries.
CONCLUSION: Multiple approaches in managing social and health issues among migrants are vital to secure healthy labor forces for the country’s economy and development. Public health sectors should implement strategic promotive, preventive, and curative programs targeted to this group.
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Martín-Ramírez A, Lanza-Suárez M, Muñoz-García C, Hisam SR, Perez-Ayala A, Rubio JM. Usefulness of Malachite-Green LAMP for Diagnosis of Plasmodium and Five Human Malaria Species in a Nonendemic Setting. Am J Trop Med Hyg 2022; 106:tpmd211151. [PMID: 35292597 PMCID: PMC9128691 DOI: 10.4269/ajtmh.21-1151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/22/2021] [Indexed: 11/07/2022] Open
Abstract
Molecular methods are necessary to detect low-density malaria infections. The purpose of this study was to assess the diagnostic performance of six malachite-green loop-mediated amplification method (MG-LAMP) assays (MG-LAMP-Pf, MG-LAMP-Pv, MG-LAMP-Po, MG-LAMP-Pm, MG-LAMP-Pk, and MG-LAMP-Pspp) for the species-specific detection of each human Plasmodium, including P. knowlesi, and the Plasmodium genus compared with the nested-multiplex malaria polymerase chain reaction (NM-PCR), using 161 malaria-positive and 274 malaria-negative samples. MG-LAMP-Pspp assay detected the five human Plasmodium species and each species-specific MG-LAMP assay detected only its corresponding species. Sensitivity, specificity, and predictive values of MG-LAMP assays, compared with NM-PCR, were > 90%, except in the case of the MG-LAMP-Pm assay, which dropped to 47%. Limit of detection for MG-LAMP-Pspp assay ranged from 0.1 parasites/µL for P. falciparum to 16.9 parasites/µL for P. malariae samples, and it was similar for the rest of MG-LAMP assays except for the MG-LAMP-Pm assay. Turnaround time was estimated to be 2 hours and 35 minutes for one MG-LAMP assay and 4 hours and 15 minutes if all species-specific MG-LAMP is set up, whereas for the NM-PCR, turnaround time was ∼6 hours and 15 minutes. Costs per determination ranged from 1 to 6 euros for MG-LAMP assays and 5 euros for NM-PCR. Therefore, MG-LAMP assays appear to have good concordance compared with the reference method, except for the MG-LAMP-Pm assay. They can detect low parasitemia and identify malaria species, with lower costs and shorter time to obtain results, and they are suitable tools to be used in endemic and non-endemic countries for malaria detection.
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Affiliation(s)
- Alexandra Martín-Ramírez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Lanza-Suárez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Carlota Muñoz-García
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Shamilah R. Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Ana Perez-Ayala
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José M. Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
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10
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Dorrucci M, Boccolini D, Bella A, Lucarelli C, D'Amato S, Caraglia A, Maraglino FP, Severini C, Gradoni L, Pezzotti P. Malaria surveillance system and Hospital Discharge Records: Assessing differences in Italy, 2011–2017 database analysis. Travel Med Infect Dis 2022; 48:102322. [DOI: 10.1016/j.tmaid.2022.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/17/2022] [Accepted: 03/27/2022] [Indexed: 11/16/2022]
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11
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Garcia-Ruiz de Morales A, Morcate C, Isaba-Ares E, Perez-Tanoira R, Perez-Molina JA. High prevalence of malaria in a non-endemic setting among febrile episodes in travellers and migrants coming from endemic areas: a retrospective analysis of a 2013-2018 cohort. Malar J 2021; 20:449. [PMID: 34838010 PMCID: PMC8627073 DOI: 10.1186/s12936-021-03984-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background The study aimed to analyse the likelihood of imported malaria in people with a suggestive clinical picture and its distinctive characteristics in a hospital in the south of Madrid, Spain. Methods Observational retrospective study that consisted of a review of all medical files of patients with any malaria test registered at Móstoles University Hospital between April 2013 and April 2018. All suspected malaria cases were confirmed by Plasmodium spp. polymerase chain reaction (PCR). Results Of the 328 patients with suspected malaria (53.7% migrant-travellers; 38.7% visitors; 7.6% travellers), 108 cases were confirmed (101 by Plasmodium falciparum), accounting for a 33% positive sample rate. Sixteen cases were diagnosed only by PCR. Patients with malaria, compared to those without, presented predominantly with fever (84% vs. 65%), were older (34 vs. 24 years), sought medical attention earlier (17d vs. 32d), had a greater number of previous malaria episodes (74% vs. 60%), lower levels of platelets (110,500µL vs. 250,000µL), and higher of bilirubin (0.6 mg/dL vs. 0.5 mg/dL). Severe malaria was present in 13 cases; no deaths were recorded. Malaria diagnosis showed a bimodal distribution with two peaks: June to September and November to January. Conclusions Malaria is still a common diagnosis among febrile patients coming from the tropics specially among migrant travellers. Fever, thrombocytopenia, and/or high bilirubin levels should raise suspicion for this parasitic infection. Prompt diagnosis is crucial to avoid severe cases and deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03984-9.
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Affiliation(s)
- Alejandro Garcia-Ruiz de Morales
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER de Enfermedades Infecciosas, 28034, Madrid, Spain.,Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Covadonga Morcate
- Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Elena Isaba-Ares
- Internal Medicine Department, Móstoles University Hospital, Móstoles, Spain
| | - Ramon Perez-Tanoira
- Clinical Microbiology Department, Príncipe de Asturias University Hospital, Madrid, Spain.,Biomedicine and Biotechnology Department, Faculty of Medicine, Alcalá de Henares University, Alcalá de Henares, Spain
| | - Jose A Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBER de Enfermedades Infecciosas, 28034, Madrid, Spain.
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12
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Linares-Rufo M, Santos-Larrégola L, Hernández-de-Mora MG, Ramos-Rincón JM. Contents and quality of travel tips on malaria in English and Spanish travel blogs. Malar J 2021; 20:342. [PMID: 34399776 PMCID: PMC8365983 DOI: 10.1186/s12936-021-03864-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Europe has about 10,000 imported cases of malaria each year, or around 80 cases per 100,000 trips to endemic areas. Non-use of chemoprophylaxis in travellers remains the main reason for this. The proliferation of online travel blogs as a source of advice (sometimes the only one used) for preparing a trip to an endemic area may play a role in the decision to use chemoprophylaxis. The aim of this study was to analyse the information offered on malaria in the main travel blogs in English and Spanish. METHODS Five hundred travel blogs in English and 100 in Spanish, considered highly relevant were analysed. The relevance were according to different metrics: (1) Alexa Rank; (2) social networks (RRSS) measuring the total followers of Facebook, Twitter, Instagram and YouTube; (3) number of monthly visits using the SEMrush tool; (4) domain authority; and (5) number of backlinks or incoming links using the SEMrush tool. RESULTS Of the included travel blogs, 57% of those in English and 64% of those in Spanish offered information on malaria, and 79 and 75%, respectively, featured a discussion on malaria written as a blog post or in forum comments. Information on chemoprophylaxis was available in 56.1% of English-language blogs and 10.7% of Spanish-speaking blogs, while its side effects were discussed in 38.6 and 68.8%, respectively (p < 0.001). Content analysis revealed that the information was usually insufficient, incomplete or, more seriously, inaccurate. In many cases, this could discourage users from taking appropriate preventive measures. CONCLUSIONS Travel blogs in English and Spanish provide low-quality information on malaria. The so-called "travel influencers" must communicate reliable, verified and quality information on malaria on their channels in a way that could contribute to reducing the burden of the disease in travellers.
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Affiliation(s)
- Manuel Linares-Rufo
- Microbiology Service, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Foundation iO, Madrid, Spain
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13
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Chen TT, Ljungqvist FC, Castenbrandt H, Hildebrandt F, Ingholt MM, Hesson JC, Ankarklev J, Seftigen K, Linderholm HW. The spatiotemporal distribution of historical malaria cases in Sweden: a climatic perspective. Malar J 2021; 20:212. [PMID: 33933085 PMCID: PMC8088552 DOI: 10.1186/s12936-021-03744-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background Understanding of the impacts of climatic variability on human health remains poor despite a possibly increasing burden of vector-borne diseases under global warming. Numerous socioeconomic variables make such studies challenging during the modern period while studies of climate–disease relationships in historical times are constrained by a lack of long datasets. Previous studies have identified the occurrence of malaria vectors, and their dependence on climate variables, during historical times in northern Europe. Yet, malaria in Sweden in relation to climate variables is understudied and relationships have never been rigorously statistically established. This study seeks to examine the relationship between malaria and climate fluctuations, and to characterise the spatio-temporal variations at parish level during severe malaria years in Sweden 1749–1859. Methods Symptom-based annual malaria case/death data were obtained from nationwide parish records and military hospital records in Stockholm. Pearson (rp) and Spearman’s rank (rs) correlation analyses were conducted to evaluate inter-annual relationship between malaria data and long meteorological series. The climate response to larger malaria events was further explored by Superposed Epoch Analysis, and through Geographic Information Systems analysis to map spatial variations of malaria deaths. Results The number of malaria deaths showed the most significant positive relationship with warm-season temperature of the preceding year. The strongest correlation was found between malaria deaths and the mean temperature of the preceding June–August (rs = 0.57, p < 0.01) during the 1756–1820 period. Only non-linear patterns can be found in response to precipitation variations. Most malaria hot-spots, during severe malaria years, concentrated in areas around big inland lakes and southern-most Sweden. Conclusions Unusually warm and/or dry summers appear to have contributed to malaria epidemics due to both indoor winter transmission and the evidenced long incubation and relapse time of P. vivax, but the results also highlight the difficulties in modelling climate–malaria associations. The inter-annual spatial variation of malaria hot-spots further shows that malaria outbreaks were more pronounced in the southern-most region of Sweden in the first half of the nineteenth century compared to the second half of the eighteenth century.
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Affiliation(s)
- Tzu Tung Chen
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden.
| | - Fredrik Charpentier Ljungqvist
- Department of History, Stockholm University, 106 91, Stockholm, Sweden.,Bolin Centre for Climate Research, Stockholm University, 106 91, Stockholm, Sweden.,Swedish Collegium for Advanced Study, Linneanum, Thunbergsvägen 2, 752 38, Uppsala, Sweden
| | | | - Franziska Hildebrandt
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Mathias Mølbak Ingholt
- PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Jenny C Hesson
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Johan Ankarklev
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Kristina Seftigen
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden.,Dendro Sciences Group, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
| | - Hans W Linderholm
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden
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14
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Sousa A, Aguilar-Alba M, Vetter M, García-Barrón L, Morales J. Drivers of autochthonous and imported malaria in Spain and their relationship with meteorological variables. EURO-MEDITERRANEAN JOURNAL FOR ENVIRONMENTAL INTEGRATION 2021; 6:33. [PMID: 33614904 PMCID: PMC7885756 DOI: 10.1007/s41207-021-00245-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED Since the early twentieth century, the intensity of malaria transmission has decreased sharply worldwide, although it is still an infectious disease with a yearly estimate of 228 million cases. The aim of this study was to expand our knowledge on the main drivers of malaria in Spain. In the case of autochthonous malaria, these drivers were linked to socioeconomic and hygienic and sanitary conditions, especially in rural areas due to their close proximity to the wetlands that provide an important habitat for anopheline reproduction. In the case of imported malaria, the main drivers were associated with urban areas, a high population density and international communication nodes (e.g. airports). Another relevant aspect is that the major epidemic episodes of the twentieth century were strongly influenced by war and military conflicts and overcrowding of the healthcare system due to the temporal overlap with the pandemic flu of 1918. Therefore, military conflicts and overlap with other epidemics or pandemics are considered to be drivers of malaria that can-in a temporary manner-exponentially intensify transmission of the disease. Climatic factors did not play a relevant role as drivers of malaria in Spain (at least directly). However, they did influence the seasonality of the disease and, during the epidemic outbreak of 1940-1944, the climate conditions favored or coadjuvated its spread. The results of this study provide additional knowledge on the seasonal and interannual variability of malaria that can help to develop and implement health risk control measures. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s41207-021-00245-8.
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Affiliation(s)
- Arturo Sousa
- Department of Plant Biology and Ecology, Universidad de Sevilla, 41012 Seville, Spain
| | - Mónica Aguilar-Alba
- Department of Physical Geography and AGR, Universidad de Sevilla, 41004 Seville, Spain
| | - Mark Vetter
- Geovisualization, Würzburg University of Applied Sciences, Würzburg, Germany
| | | | - Julia Morales
- Department of Plant Biology and Ecology, Universidad de Sevilla, 41012 Seville, Spain
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15
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Penot M, Linard C, Taudon N. A Validated Volumetric Absorptive Microsampling-Liquid Chromatography Tandem Mass Spectrometry Method to Quantify Doxycycline Levels in Urine: An Application to Monitor the Malaria Chemoprophylaxis Compliance. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2020; 2020:8868396. [PMID: 33489416 PMCID: PMC7787799 DOI: 10.1155/2020/8868396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
Because of logistics and cost constraints, monitoring of the compliance to antimalarial chemoprophylaxis by the quantitation of drugs in biological samples is not a simple operation on the field. Indeed, analytical devices are fragile to transport and must be used in a perfectly controlled environment. This is also the case for reagents and supplies, and the waste management is constraining. Thus, samples should be repatriated. They should be frozen after collection and transported with no rupture in the cold chain. This is crucial to generate available and interpretable data but often without any difficulties. Hence, to propose an alternative solution easier to implement, a quantitation method of determining doxycycline in urine has been validated using a volumetric absorptive microsampling (VAMS®) device. As blotting paper, the device is dried after collection and transferred at room temperature, but contrarily to dried spot, the collection volume is perfectly repeatable. Analysis of VAMS® was performed with a high-performance liquid chromatography coupled to a mass spectrometer. The chromatographic separation was achieved on a core-shell C18 column. The mean extraction recovery was 109% (mean RSD, 5.4%, n = 6) for doxycycline and 102% (mean RSD, 7.0%) for the internal standard. No matrix effect has been shown. Within-run as within-day precision and accuracy were, respectively, below 14% and ranged from 96 to 106%. The signal/concentration ratio was studied in the 0.25-50 µg/mL range, and recoveries from back-calculated concentrations were in the 96-105% range (RSD < 11.0%). The RSD on slope was 10%. To achieve the validation, this new quantitation method was applied to real samples. In parallel, samples were analyzed directly after a simple dilution. No statistical difference was observed, confirming that the use of VAMS® is an excellent alternative device to monitor the doxycycline compliance.
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Affiliation(s)
- Mylène Penot
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
| | - Cyril Linard
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
| | - Nicolas Taudon
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
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16
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Pomari E, Silva R, Moro L, La Marca G, Perandin F, Verra F, Bisoffi Z, Piubelli C. Droplet Digital PCR for the Detection of Plasmodium falciparum DNA in Whole Blood and Serum: A Comparative Analysis with Other Molecular Methods. Pathogens 2020; 9:pathogens9060478. [PMID: 32560386 PMCID: PMC7350319 DOI: 10.3390/pathogens9060478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The estimation of Plasmodium falciparum parasitaemia can vary according to the method used. Recently, droplet digital PCR (ddPCR) has been proposed as a promising approach in the molecular quantitation of Plasmodium, but its ability to predict the actual parasitaemia on clinical samples has not been largely investigated. Moreover, the possibility of applying the ddPCR-sensitive method to serum samples has never been explored. Methods: We used, for the first time, ddPCR on both blood and serum to detect the DNA of P. falciparum in 52 paired samples from 26 patients. ddPCR was compared with loop-mediated isothermal amplification (LAMP) and rtPCR. The correlation between the ddPCR results, microscopy, and clinical parameters was examined. Results: ddPCR and microscopy were found to be strongly correlated (ρ(26) = 0.83111, p < 0.0001) in blood. Samples deviating from the correlation were partially explained by clinical parameters. In serum samples, ddPCR revealed the best performance in detecting P. falciparum DNA, with 77% positive samples among malaria subjects. Conclusion: Absolute quantitation by ddPCR can be a flexible technique for Plasmodium detection, with potential application in the diagnosis of malaria. In particular, ddPCR is a powerful approach for Plasmodium DNA analysis on serum when blood samples are unavailable.
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Affiliation(s)
- Elena Pomari
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
- Correspondence: (E.P.); (C.P.)
| | - Ronaldo Silva
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
| | - Lucia Moro
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
| | - Giulia La Marca
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
| | - Francesca Perandin
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
| | - Federica Verra
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
| | - Zeno Bisoffi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Chiara Piubelli
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (R.S.); (L.M.); (G.L.M.); (F.P.); (F.V.); (Z.B.)
- Correspondence: (E.P.); (C.P.)
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Abstract
Malaria is one of the most cited vector-borne infectious diseases by climate change expert panels. Malaria vectors often need water sheets or wetlands to complete the disease life cycle. The current context of population mobility and global change requires detailed monitoring and surveillance of malaria in all countries. This study analysed the spatiotemporal distribution of death and illness cases caused by autochthonous and imported malaria in Spain during the 20th and 21st centuries using multidisciplinary sources, Geographic Information System (GIS) and geovisualisation. The results obtained reveal that, in the 20th and 21st centuries, malaria has not had a homogeneous spatial distribution. Between 1916 and 1930, 77% of deaths from autochthonous malaria were concentrated in only 20% of Spanish provinces; in 1932, 88% of patients treated in anti-malarial dispensaries were concentrated in these same provinces. These last data reveal the huge potential that anti-malarial dispensaries could have as a tool to reconstruct historical epidemiology. Spanish autochthonous malaria has presented epidemic upsurge episodes, especially those of 1917–1922 and 1939–1944, influenced by armed conflict, population movement and damaged health and hygiene conditions. Although meteorological variables have not played a key role in these epidemic episodes, they contributed by providing suitable conditions for their intensification. After the eradication of autochthonous malaria in 1961, imported malaria cases began to be detected in 1973, reaching more than 700 cases per year at the end of the second decade of the 21st century. Therefore, consistent and detailed historical studies are necessary to better understand the drivers that have led to the decline and elimination of malaria in Europe and other temperate countries.
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18
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Domínguez García M, Feja Solana C, Vergara Ugarriza A, Bartolomé Moreno C, Melús Palazón E, Magallón Botaya R. Imported malaria cases: the connection with the European ex-colonies. Malar J 2019; 18:397. [PMID: 31801538 PMCID: PMC6891950 DOI: 10.1186/s12936-019-3042-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/27/2019] [Indexed: 12/03/2022] Open
Abstract
Background Imported malaria is increasing in non-endemic areas due to the increment of international travels, migration and, probably, other unknown factors. The objective of this study was to describe the epidemiological and clinical characteristics of malaria cases in a region of Spain; analyse the possible association between the variables of interest; compare this series with others; and evaluate the characteristics of imported malaria cases according to the country of origin, particularly cases from Equatorial Guinea (Spanish ex-colony) and from the rest of sub-Saharan Africa. Methods A descriptive observational study was carried out with a retrospective data collection of cases of malaria reported in Aragon from 1996 to 2017. Univariate and bivariate analysis of clinical–epidemiological variables was performed. In addition, an analysis of cases from sub-Saharan Africa was carried out using logistic regression, calculating odds ratio with its 95% confidence interval. Results 609 cases of malaria were recorded in Aragon from 1996 to 2017. An autochthonous case in 2010. 50.33% were between 15 and 39 years old. 45.65% of the cases were notified of the 4-weeks 9 to 12. 82.6% reside in the main province, urban area, of which 65.4% were VFR (Visiting Friends and Relatives), 23.8% new immigrants and 10.9% travellers. The infectious Plasmodium species par excellence was Plasmodium falciparum (88%). Analysing the cases from sub-Saharan Africa (95.2% of the total), 48.1% were from Equatorial Guinea. Comparing these with the cases from the rest of sub-Saharan Africa, it was observed that the cases from the Spanish ex-colony have association with the female gender, being under 5 years old, residing in the main province (urban area) and being a new immigrant. Conclusions The epidemiological profile of imported malaria cases can be defined as VFR between 15 and 39 years old, coming from sub-Saharan Africa, particularly from Equatorial Guinea. Immigrants education about the importance of chemoprophylaxis when travelling to visit friends and relatives, emphasizing on those who are originally from the ex-colonies of destination country, is necessary; as well as to raise awareness among health professionals to make advice in consultations, specially before summer vacations.
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Affiliation(s)
- Marta Domínguez García
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain. .,Aragonese Health Service, Zaragoza, Spain. .,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.
| | | | | | - Cruz Bartolomé Moreno
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain
| | - Elena Melús Palazón
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón Botaya
- Aragonese Primary Care Research Group, IIS (Instituto de Investigación Sanitaria Aragón) GIIS-011, 50015, Zaragoza, Spain.,Aragonese Health Service, Zaragoza, Spain.,Aragonese Primary Care Research Group, B21-17R, Aragon Government, Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
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19
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Del Prete V, Mateo-Urdiales A, Bueno-Cavanillas A, Ferrara P. Malaria prevention in the older traveller: a systematic review. J Travel Med 2019; 26:5562848. [PMID: 31509199 DOI: 10.1093/jtm/taz067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/14/2019] [Accepted: 08/27/2019] [Indexed: 12/15/2022]
Abstract
Older travellers are at higher risk of malaria-related morbidity and mortality compared with younger people. Yet, prevention of malaria in this specific group of travellers is a long-standing issue in travel medicine. The aim of this research was to synthetize the existing evidence about this important topic, highlighting older travellers' attitudes and practises toward malaria prevention. Searches were performed on PubMed, Embase, EuropePMC, Web of Science, WHOLIS and LILACS databases for relevant studies reporting malaria prevention measures in older travellers. To measure malaria prevention in the older traveller population, the main information outcomes were obtained from the ABCD framework that included travellers' 'Awareness' towards pre-travel health advice, their utilisation of 'Bite-prevention measures' and adherence to 'Chemoprophylaxis'. Data on 'Diagnosis'-related outcomes were excluded for not being measures of malaria prevention. Three evaluators independently selected studies, extracted data and assessed the quality of the included articles. The research protocol was registered with PROSPERO (protocol number CRD42019124202). Out of the 899 titles and abstracts screened, 13 articles were included in this review synthesis. These studies included a wide range of interventions for malaria prevention: no relevant differences in pre-travel healthcare attendance were found depending on age; older travellers were found to be less likely to comply with bite-prevention measures; three high-quality studies reported that adherence to chemoprophylaxis significantly increased with age, while three studies did not find age-related differences in travellers' adherence. Overall, prevention of malaria in the older traveller has received limited attention from the scientific community. Older travellers seem to be less likely to comply with bite-prevention measures, but there was high heterogeneity across the reports. This population group demands particular attention and tailored health advice before travelling to malaria endemic areas. More research is required on how to improve malaria prevention in the older traveller.
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Affiliation(s)
- Viola Del Prete
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Mateo-Urdiales
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
- School of Public Health, Health Education North West, Manchester, UK
| | | | - Pietro Ferrara
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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