1
|
Aschale Y, Getachew A, Yewhalaw D, De Cristofaro A, Sciarretta A, Atenafu G. Systematic review of sporozoite infection rate of Anopheles mosquitoes in Ethiopia, 2001-2021. Parasit Vectors 2023; 16:437. [PMID: 38008761 PMCID: PMC10680292 DOI: 10.1186/s13071-023-06054-y] [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: 04/09/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Adult mosquitoes of the genus Anopheles are important vectors of Plasmodium parasites, causative agents of malaria. The aim of this review was to synthesize the overall and species-specific proportion of Anopheles species infected with sporozoites and their geographical distribution in the last 2 decades (2001-2021). METHODS A comprehensive search was conducted using databases (PubMed, Google Scholar, Science Direct, Scopus, African Journals OnLine) and manual Google search between January 1 and February 15, 2022. Original articles describing work conducted in Ethiopia, published in English and reporting infection status, were included in the review. All the required data were extracted using a standardized data extraction form, imported to SPSS-24, and analyzed accordingly. The quality of each original study was assessed using a quality assessment tool adapted from the Joanna Briggs Institute critical appraisal checklist. This study was registered on PROSPERO (International Prospective Register of Systematic Reviews; registration no. CRD42022299078). RESULTS A search for published articles produced a total of 3086 articles, of which 34 met the inclusion criteria. Data on mosquito surveillance revealed that a total of 129,410 anophelines comprising 25 species were captured, of which 48,365 comprising 21 species were tested for sporozoites. Anopheles arabiensis was the dominant species followed by An. pharoensis and An. coustani complex. The overall proportion infected with sporozoites over 21 years was 0.87%. Individual proportions included Anopheles arabiensis (1.09), An. pharoensis (0.79), An. coustani complex (0.13), An. funestus (2.71), An. demeilloni (0.31), An. stephensi (0.70), and An. cinereus (0.73). Plasmodium falciparum sporozoites accounted 79.2% of Plasmodium species. Mixed infection of Plasmodium vivax and P. falciparum was only reported from one An. arabiensis sample. CONCLUSIONS Anopheles arebiensis was the dominant malaria vector over the years, with the highest sporozoite infection proportion of 2.85% and an average of 0.90% over the years. Other species contributing to malaria transmission in the area were An. pharoensis, An. coustani complex, An. funestus, An. stephensi, and An. coustani. The emergence of new vector species, in particular An. stephensi, is particularly concerning and should be investigated further.
Collapse
Affiliation(s)
- Yibeltal Aschale
- Department of Medical Laboratory Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Aklilu Getachew
- School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia
| | | | - Antonio De Cristofaro
- Department of Agriculture, Environment and Food Sciences, University of Molise, Molise, Italy
| | - Andrea Sciarretta
- Department of Agriculture, Environment and Food Sciences, University of Molise, Molise, Italy
| | - Getnet Atenafu
- Department of Biology, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
2
|
Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, W Kazura J, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. Malar J 2023; 22:341. [PMID: 37940948 PMCID: PMC10634149 DOI: 10.1186/s12936-023-04762-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Water resource development projects, such as dams and irrigation schemes, have a positive impact on food security and poverty reduction. However, such projects could increase prevalence of vector borne disease, such as malaria. This study investigate the impact of different agroecosystems and prevalence of malaria infection in Southwest Ethiopia. METHODS Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 study participants from 1449 households in Arjo and 546 households in Gambella enrolled in the study and blood samples were collected, respectively. All blood samples were microscopically examined and a subset of microscopy negative blood samples (n = 2244) were analysed by qPCR. Mixed effect logistic regression and generalized estimating equation were used to determine microscopic and submicroscopic malaria infection and the associated risk factors, respectively. RESULTS Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). On the other hand, of the 1713 and 531 samples analysed by qPCR from Arjo and Gambella the presence of submicroscopic infection was 1.2% and 12.8%, respectively. Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale were identified by qPCR in both sites. Irrigation was a risk factor for submicroscopic infection in both Arjo and Gambella. Irrigation, being a migrant worker, outdoor job, < 6 months length of stay in the area were risk factors for microscopic infection in Gambella. Moreover, school-age children and length of stay in the area for 1-3 years were significant predictors for submicroscopic malaria in Gambella. However, no ITN utilization was a predictor for both submicroscopic and microscopic infection in Arjo. Season was also a risk factor for microscopic infection in Arjo. CONCLUSION The study highlighted the potential importance of different irrigation practices impacting on submicroscopic malaria transmission. Moreover, microscopic and submicroscopic infections coupled with population movement may contribute to residual malaria transmission and could hinder malaria control and elimination programmes in the country. Therefore, strengthening malaria surveillance and control by using highly sensitive diagnostic tools to detect low-density parasites, screening migrant workers upon arrival and departure, ensuring adequate coverage and proper utilization of vector control tools, and health education for at-risk groups residing or working in such development corridors is needed.
Collapse
Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch, Ethiopia.
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia.
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch, Ethiopia
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Kassahun Habtamu
- Menelik II Medical & Health Science College, Addis Ababa, Ethiopia
- Department of Microbial, Cellular & Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University, Fort Collins, USA
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dawit Hawaria
- School of Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Arega Tsegaye
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Biology, College of Natural Science, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, OH, USA
- Center for Global Health & Disease School of Medicine Case, Western Reserve University, Cleveland, OH, USA
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA92697, USA
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| |
Collapse
|
3
|
Getachew H, Demissew A, Abossie A, Habtamu K, Wang X, Zhong D, Zhou G, Lee MC, Hemming-Schroeder E, Bradley L, Degefa T, Hawaria D, Tsegaye A, Kazura JW, Koepfli C, Yan G, Yewhalaw D. Asymptomatic and submicroscopic malaria infections in sugar cane and rice development areas of Ethiopia. RESEARCH SQUARE 2023:rs.3.rs-2692688. [PMID: 36993196 PMCID: PMC10055656 DOI: 10.21203/rs.3.rs-2692688/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background Water resource development projects such as dams and irrigation schemes have a positive impact on food security and poverty reduction but might result in increased prevalence of malaria. Methods Two cross-sectional surveys were conducted in the dry and wet seasons in irrigated and non-irrigated clusters of Arjo sugarcane and Gambella rice development areas of Ethiopia in 2019. A total of 4464 and 2176 blood samples were collected from Arjo and Gambella. A subset of 2244 microscopy negative blood samples were analyzed by PCR. Results Prevalence by microscopy was 2.0% (88/4464) in Arjo and 6.1% (133/2176) in Gambella. In Gambella, prevalence was significantly higher in irrigated clusters (10.4% vs 3.6%) than in non-irrigated clusters (p < 0.001), but no difference was found in Arjo (2.0% vs 2.0%; p = 0.993). Level of education was an individual risk factors associated with infection in Arjo [AOR: 3.2; 95%CI (1.27-8.16)] and in Gambella [AOR: 1.7; 95%CI (1.06-2.82)]. While duration of stay in the area for < 6 months [AOR: 4.7; 95%CI (1.84-12.15)] and being a migrant worker [AOR: 4.7; 95%CI (3.01-7.17)] were risk factors in Gambella. Season [AOR: 15.9; 95%CI (6.01-42.04)], no ITN utilization [AOR: 22.3; 95%CI (7.74-64.34)] were risk factors in Arjo, and irrigation [AOR: 2.4; 95%CI (1.45-4.07)] and family size [AOR: 2.3; 95%CI (1.30-4.09)] risk factors in Gambella. Of the 1713 and 531 randomly selected smear negative samples from Arjo and Gambella and analyzed by PCR the presence of Plasmodium infection was 1.2% and 12.8%, respectively. P. falciparum, P. vivax, and P. ovale were identified by PCR in both sites. Conclusion Strengthening malaria surveillance and control in project development areas and proper health education for at-risk groups residing or working in such development corridors is needed.
Collapse
Affiliation(s)
- Hallelujah Getachew
- Department of Medical Laboratory Technology, Arbaminch College of Health Sciences, Arbaminch
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo
| | - Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Arbaminch University, Arbaminch
| | | | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Elizabeth Hemming-Schroeder
- Center for Vector Born Infectious Diseases (CVID), Department of Microbiology Immunology and Pathology, Colorado State University
| | - Lauren Bradley
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Teshome Degefa
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
| | - Dawit Hawaria
- Hawassa University, School of Environmental Health, Hawassa
| | - Arega Tsegaye
- Department of Biology, College of Natural Science, Jimma University
| | - James W Kazura
- Biomedical Research Case Western Reserve University, Cleveland, Ohio
| | - Cristian Koepfli
- Department of Biological Sciences 319 Galvin Life Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA 92697
| | - Delenasaw Yewhalaw
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma
| |
Collapse
|
4
|
Bal M, Ghosal J, Das A, Sandeepta S, Pati S, Dutta A, Ranjit M. Impact of Sub-patent Malaria During Pregnancy on Birth-Weight in Odisha, India: Time-to-Event Analysis of Prospective Longitudinal Follow-Up of a Survey. J Epidemiol Glob Health 2023; 13:23-31. [PMID: 36650337 PMCID: PMC10006379 DOI: 10.1007/s44197-022-00082-0] [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: 08/18/2022] [Accepted: 11/18/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The current study aimed to estimate prevalence of malaria infection, especially sub-patent infection, in pregnant women residing in high malaria-endemic, hard-to-reach pockets of the Indian state of Odisha; and also measure its impact on birth-weight of their new-borns. METHOD A time-to-event analysis of prospective longitudinal follow-up study nested within a cross-sectional survey of people residing in high malaria-endemic six districts of Odisha was conducted during July-November 2019. Malaria status in pregnant mothers was categorized as malaria free; sub-patent, and patent. Hazards Ratio (HR) of low birth-weight (LBW; birth-weight < 2500 gms) was estimated in these three categories (n = 308) adjusted for residence (block), gravida, caste, age and gestational age at testing. RESULTS 50.3% pregnant women had sub-patent malaria infection, 3.9% had patent infection. In fully adjusted model, hazards ratio of LBW was 3.76 (95% CI 1.12, 12.64, p = 0.032) in pregnant women with patent infection and 1.82 (95% CI 0.87, 3.81, p = 0.109) in women with sub-patent infection when compared to no malaria group. CONCLUSION The study showed that half of the pregnant women in high-endemic pockets had sub-patent infection which posed deleterious influence on birth-weight of their new-borns. The study thereby flags the prevalence of sub-patent infection as a public health concern, because sub-patent infection in pregnant mothers may persist as a "silent" reservoir, with the potential to derail the malaria control program, especially when the country plans malaria elimination by 2030.
Collapse
Affiliation(s)
- Madhusmita Bal
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Jyoti Ghosal
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
- School of Public Health, KIIT Deemed to Be University, Bhubaneswar, Odisha, India
| | - Arundhuti Das
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Sonali Sandeepta
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Sanghmitra Pati
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Public Health Foundation of India, Plot No. 267/3408, Jaydev Vihar, Mayfair Lagoon Road, Bhubaneswar, Odisha, 751013, India.
| | - Manoranjan Ranjit
- Indian Council of Medical Research-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
| |
Collapse
|
5
|
Assefa A, Mohammed H, Anand A, Abera A, Sime H, Minta AA, Tadesse M, Tadesse Y, Girma S, Bekele W, Etana K, Alemayehu BH, Teka H, Dilu D, Haile M, Solomon H, Moriarty LF, Zhou Z, Svigel SS, Ezema B, Tasew G, Woyessa A, Hwang J, Murphy M. Therapeutic efficacies of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum and chloroquine and dihydroartemisinin-piperaquine for uncomplicated Plasmodium vivax infection in Ethiopia. Malar J 2022; 21:359. [PMID: 36451216 PMCID: PMC9714156 DOI: 10.1186/s12936-022-04350-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/27/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Routine monitoring of anti-malarial drugs is recommended for early detection of drug resistance and to inform national malaria treatment guidelines. In Ethiopia, the national treatment guidelines employ a species-specific approach. Artemether-lumefantrine (AL) and chloroquine (CQ) are the first-line schizonticidal treatments for Plasmodium falciparum and Plasmodium vivax, respectively. The National Malaria Control and Elimination Programme in Ethiopia is considering dihydroartemisinin-piperaquine (DHA/PPQ) as an alternative regimen for P. falciparum and P. vivax. METHODS The study assessed the clinical and parasitological efficacy of AL, CQ, and DHA/PPQ in four arms. Patients over 6 months and less than 18 years of age with uncomplicated malaria mono-infection were recruited and allocated to AL against P. falciparum and CQ against P. vivax. Patients 18 years or older with uncomplicated malaria mono-infection were recruited and randomized to AL or dihydroartemisinin-piperaquine (DHA/PPQ) against P. falciparum and CQ or DHA/PPQ for P. vivax. Patients were followed up for 28 (for CQ and AL) or 42 days (for DHA/PPQ) according to the WHO recommendations. Polymerase chain reaction (PCR)-corrected and uncorrected estimates were analysed by Kaplan Meier survival analysis and per protocol methods. RESULTS A total of 379 patients were enroled in four arms (n = 106, AL-P. falciparum; n = 75, DHA/PPQ- P. falciparum; n = 142, CQ-P. vivax; n = 56, DHA/PPQ-P. vivax). High PCR-corrected adequate clinical and parasitological response (ACPR) rates were observed at the primary end points of 28 days for AL and CQ and 42 days for DHA/PPQ. ACPR rates were 100% in AL-Pf (95% CI: 96-100), 98% in CQ-P. vivax (95% CI: 95-100) at 28 days, and 100% in the DHA/PPQ arms for both P. falciparum and P. vivax at 42 days. For secondary endpoints, by day three 99% of AL-P. falciparum patients (n = 101) cleared parasites and 100% were afebrile. For all other arms, 100% of patients cleared parasites and were afebrile by day three. No serious adverse events were reported. CONCLUSION This study demonstrated high therapeutic efficacy for the anti-malarial drugs currently used by the malaria control programme in Ethiopia and provides information on the efficacy of DHA/PPQ for the treatment of P. falciparum and P. vivax as an alternative option.
Collapse
Affiliation(s)
- Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia. .,Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hussein Mohammed
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anjoli Anand
- grid.416738.f0000 0001 2163 0069Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA ,grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Adugna Abera
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Heven Sime
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anna A. Minta
- grid.416738.f0000 0001 2163 0069Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA ,grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | | | - Samuel Girma
- ICAP at Columbia University, Addis Ababa, Ethiopia ,U.S. President’s Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Worku Bekele
- World Health Organization, Addis Ababa, Ethiopia
| | - Kebede Etana
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Hiwot Teka
- U.S. President’s Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Dereje Dilu
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Mebrahtom Haile
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Leah F. Moriarty
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Zhiyong Zhou
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Samaly Souza Svigel
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Bryan Ezema
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Geremew Tasew
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jimee Hwang
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Matthew Murphy
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
| |
Collapse
|
6
|
Awosolu OB, Yahaya ZS, Farah Haziqah MT, Olusi TA. Performance Evaluation of Nested Polymerase Chain Reaction (Nested PCR), Light Microscopy, and Plasmodium falciparum Histidine-Rich Protein 2 Rapid Diagnostic Test (PfHRP2 RDT) in the Detection of Falciparum Malaria in a High-Transmission Setting in Southwestern Nigeria. Pathogens 2022; 11:1312. [PMID: 36365063 PMCID: PMC9694681 DOI: 10.3390/pathogens11111312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 09/16/2023] Open
Abstract
Malaria remains a major public health challenge worldwide. In order to ensure a prompt and accurate malaria diagnosis, the World Health Organization recommended the confirmatory parasitological diagnosis of malaria by microscopy and malaria rapid diagnostic test (RDT) prior to antimalarial administration and treatment. This study was designed to evaluate the performance of nested polymerase chain reaction (nested PCR), light microscopy, and Plasmodium falciparum histidine-rich protein 2 rapid diagnostic test (PfHRP2 RDT) in the detection of falciparum malaria in Akure, Nigeria. A cross-sectional and hospital-based study involving 601 febrile volunteer participants was conducted in Akure, Nigeria. Approximately 2-3 mL venous blood samples were obtained from each study participant for parasitological confirmation by microscopy and PfHRP2-based malaria RDT. Thick and thin films were prepared and viewed under the light microscope for parasite detection, parasite density quantification, and species identification, respectively. Dry blood spot samples were prepared on 3MM Whatman filter paper for nested PCR. The overall prevalence of microscopy, PfHRP2 RDT, and nested PCR were 64.89% (390/601), 65.7% (395/601), and 67.39% (405/601), respectively. The estimates of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and Youden's j index of microscopy and RDT were 96.30, 100.00, 100.00, 92.89, 97.50, 0.963, and 95.06, 94.90, 97.47, 90.29, 95.01, and 0.899, respectively. Malaria RDT recorded higher false negativity, compared microscopy (4.94% vs. 3.70%). A near perfect agreement was reported between microscopy and nested PCR, and between PfHRP2 RDT and nested PCR with Cohen's kappa (k) values of 0.94 and 0.88, respectively. This study revealed that PfHRP2 RDT and microscopy continues to remain sensitive and specific for falciparum malaria diagnosis in the study area.
Collapse
Affiliation(s)
- Oluwaseun Bunmi Awosolu
- School of Biological Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Vector Control Research Unit, Universiti Sains Malaysia, Minden, Penang 11800, Malaysia
- Department of Biology, Federal University of Technology, Akure 340252, Nigeria
| | - Zary Shariman Yahaya
- School of Biological Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Vector Control Research Unit, Universiti Sains Malaysia, Minden, Penang 11800, Malaysia
| | | | - Titus Adeniyi Olusi
- Vector Control Research Unit, Universiti Sains Malaysia, Minden, Penang 11800, Malaysia
| |
Collapse
|
7
|
The use of a chimeric antigen for Plasmodium falciparum and P. vivax seroprevalence estimates from community surveys in Ethiopia and Costa Rica. PLoS One 2022; 17:e0263485. [PMID: 35613090 PMCID: PMC9132309 DOI: 10.1371/journal.pone.0263485] [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: 01/18/2022] [Accepted: 05/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background In low-transmission settings, accurate estimates of malaria transmission are needed to inform elimination targets. Detection of antimalarial antibodies provides exposure history, but previous studies have mainly relied on species-specific antigens. The use of chimeric antigens that include epitopes from multiple species of malaria parasites in population-based serological surveys could provide data for exposure to multiple Plasmodium species circulating in an area. Here, the utility of P. vivax/P. falciparum chimeric antigen for assessing serological responses was evaluated in Ethiopia, an endemic country for all four human malarias, and Costa Rica, where P. falciparum has been eliminated with reports of sporadic P. vivax cases. Methods A multiplex bead-based assay was used to determine the seroprevalence of IgG antibodies against a chimeric malaria antigen (PvRMC-MSP1) from blood samples collected from household surveys in Ethiopia in 2015 (n = 7,077) and Costa Rica in 2015 (n = 851). Targets specific for P. falciparum (PfMSP1) and P. vivax (PvMSP1) were also included in the serological panel. Seroprevalence in the population and seroconversion rates were compared among the three IgG targets. Results Seroprevalence in Costa Rica was 3.6% for PfMSP1, 41.5% for PvMSP1 and 46.7% for PvRMC-MSP1. In Ethiopia, seroprevalence was 27.6% for PfMSP1, 21.4% for PvMSP1, and 32.6% for PvRMC-MSP1. IgG levels in seropositive individuals were consistently higher for PvRMC-MSP1 when compared to PvMSP1 in both studies. Seroconversion rates were 0.023 for PvMSP1 and 0.03 for PvRMC-MSP1 in Costa Rica. In Ethiopia, seroconversion rates were 0.050 for PfMSP1, 0.044 for PvMSP1 and 0.106 for PvRMC-MSP1. Conclusions Our data indicate that chimeric antigen PvRMC-MSP1 is able to capture antibodies to multiple epitopes from both prior P. falciparum and P. vivax infections, and suitable chimeric antigens can be considered for use in serosurveys with appropriate validation.
Collapse
|
8
|
Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods. J Trop Med 2022; 2022:5883173. [PMID: 35502242 PMCID: PMC9056208 DOI: 10.1155/2022/5883173] [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: 10/18/2021] [Revised: 12/27/2021] [Accepted: 04/09/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/μL. The threshold pyrogen of the parasitic density was around 10.000 parasites/μL for patients between 0 and 11 months of age, between 1 and 4 years of age, and between 5 and 14 years of age. This threshold was lower for patients over 15 years of age. The study reported some issues in the findings: 60.88% (607/997) cases of fever without positivity of the blood thick smear and 40.13% (284/674) cases of positivity of the thick drop without fever. The positive predictive value of malaria was between 80 and 85% for patients under 5 years of age. This value is lower for patients between 5 and 14 years of age and patients over 15 years of age. Conclusion A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered.
Collapse
|
9
|
Otambo WO, Olumeh JO, Ochwedo KO, Magomere EO, Debrah I, Ouma C, Onyango P, Atieli H, Mukabana WR, Wang C, Lee MC, Githeko AK, Zhou G, Githure J, Kazura J, Yan G. Health care provider practices in diagnosis and treatment of malaria in rural communities in Kisumu County, Kenya. Malar J 2022; 21:129. [PMID: 35459178 PMCID: PMC9034626 DOI: 10.1186/s12936-022-04156-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/07/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Accurate malaria diagnosis and appropriate treatment at local health facilities are critical to reducing morbidity and human reservoir of infectious gametocytes. The current study assessed the accuracy of malaria diagnosis and treatment practices in three health care facilities in rural western Kenya. METHODS The accuracy of malaria detection and treatment recommended compliance was monitored in two public and one private hospital from November 2019 through March 2020. Blood smears from febrile patients were examined by hospital laboratory technicians and re-examined by an expert microscopists thereafter subjected to real-time polymerase chain reaction (RT-PCR) for quality assurance. In addition, blood smears from patients diagnosed with malaria rapid diagnostic tests (RDT) and presumptively treated with anti-malarial were re-examined by an expert microscopist. RESULTS A total of 1131 febrile outpatients were assessed for slide positivity (936), RDT (126) and presumptive diagnosis (69). The overall positivity rate for Plasmodium falciparum was 28% (257/936). The odds of slide positivity was higher in public hospitals, 30% (186/624, OR:1.44, 95% CI = 1.05-1.98, p < 0.05) than the private hospital 23% (71/312, OR:0.69, 95% CI = 0.51-0.95, p < 0.05). Anti-malarial treatment was dispensed more at public hospitals (95.2%, 177/186) than the private hospital (78.9%, 56/71, p < 0.0001). Inappropriate anti-malarial treatment, i.e. artemether-lumefantrine given to blood smear negative patients was higher at public hospitals (14.6%, 64/438) than the private hospital (7.1%, 17/241) (p = 0.004). RDT was the most sensitive (73.8%, 95% CI = 39.5-57.4) and specific (89.2%, 95% CI = 78.5-95.2) followed by hospital microscopy (sensitivity 47.6%, 95% CI = 38.2-57.1) and specificity (86.7%, 95% CI = 80.8-91.0). Presumptive diagnosis had the lowest sensitivity (25.7%, 95% CI = 13.1-43.6) and specificity (75.0%, 95% CI = 50.6-90.4). RDT had the highest non-treatment of negatives [98.3% (57/58)] while hospital microscopy had the lowest [77.3% (116/150)]. Health facilities misdiagnosis was at 27.9% (77/276). PCR confirmed 5.2% (4/23) of the 77 misdiagnosed cases as false positive and 68.5% (37/54) as false negative. CONCLUSIONS The disparity in malaria diagnosis at health facilities with many slide positives reported as negatives and high presumptive treatment of slide negative cases, necessitates augmenting microscopic with RDTs and calls for Ministry of Health strengthening supportive infrastructure to be in compliance with treatment guidelines of Test, Treat, and Track to improve malaria case management.
Collapse
Affiliation(s)
- Wilfred Ouma Otambo
- grid.442486.80000 0001 0744 8172Department of Zoology, Maseno University, Kisumu, Kenya ,International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Julius O. Olumeh
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Kevin O. Ochwedo
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Edwin O. Magomere
- grid.8301.a0000 0001 0431 4443Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya
| | - Isaiah Debrah
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.8652.90000 0004 1937 1485West Africa Centre for Cell Biology of Infectious Pathogen, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Collins Ouma
- grid.442486.80000 0001 0744 8172Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya
| | - Patrick Onyango
- grid.442486.80000 0001 0744 8172Department of Zoology, Maseno University, Kisumu, Kenya
| | - Harrysone Atieli
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Wolfgang R. Mukabana
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Chloe Wang
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - Ming-Chieh Lee
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - Andrew K. Githeko
- grid.33058.3d0000 0001 0155 5938Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Guofa Zhou
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - John Githure
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - James Kazura
- grid.67105.350000 0001 2164 3847Centre for Global Health and Diseases, Case Western University Reserve, Cleveland, OH USA
| | - Guiyun Yan
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| |
Collapse
|
10
|
Carlier L, Baker SC, Huwe T, Yewhalaw D, Haileselassie W, Koepfli C. qPCR in a suitcase for rapid Plasmodium falciparum and Plasmodium vivax surveillance in Ethiopia. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000454. [PMID: 36962431 PMCID: PMC10021179 DOI: 10.1371/journal.pgph.0000454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/23/2022] [Indexed: 11/19/2022]
Abstract
Many Plasmodium spp. infections, both in clinical and asymptomatic patients, are below the limit of detection of light microscopy or rapid diagnostic test (RDT). Molecular diagnosis by qPCR can be valuable for surveillance, but is often hampered by absence of laboratory capacity in endemic countries. To overcome this limitation, we optimized and tested a mobile qPCR laboratory for molecular diagnosis in Ziway, Ethiopia, where transmission intensity is low. Protocols were optimized to achieve high throughput and minimize costs and weight for easy transport. 899 samples from febrile patients and 1021 samples from asymptomatic individuals were screened by local microscopy, RDT, and qPCR within a period of six weeks. 34/52 clinical Plasmodium falciparum infections were missed by microscopy and RDT. Only 4 asymptomatic infections were detected. No hrp2 deletions were observed among 25 samples typed, but 19/24 samples carried hrp3 deletions. The majority (25/41) of Plasmodium vivax infections (1371 samples screened) were found among asymptomatic individuals. All asymptomatic P. vivax infections were negative by microscopy and RDT. In conclusion, the mobile laboratory described here can identify hidden parasite reservoirs within a short period of time, and thus inform malaria control activities.
Collapse
Affiliation(s)
- Lise Carlier
- Trinity College Dublin, Dublin, Ireland
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Sarah Cate Baker
- Trinity College Dublin, Dublin, Ireland
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - Tiffany Huwe
- Department of Biological Sciences & Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Delenasaw Yewhalaw
- Tropical and Infectious Disease Research Center, Jimma University, Jimma, Ethiopia
| | | | - Cristian Koepfli
- Department of Biological Sciences & Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana, United States of America
| |
Collapse
|
11
|
Singh B, McCaffery JN, Kong A, Ah Y, Wilson S, Chatterjee S, Tomar D, Aidoo M, Udhayakumar V, Rogier E. Purification of native histidine-rich protein 2 (nHRP2) from Plasmodium falciparum culture supernatant, infected RBCs, and parasite lysate. Malar J 2021; 20:405. [PMID: 34657602 PMCID: PMC8522059 DOI: 10.1186/s12936-021-03946-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background Despite the widespread use of histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs), purified native HRP2 antigen is not standardly used in research applications or assessment of RDTs used in the field. Methods This report describes the purification of native HRP2 (nHRP2) from the HB3 Plasmodium falciparum culture strain. As this culture strain lacks pfhrp3 from its genome, it is an excellent source of HRP2 protein only and does not produce the closely-related HRP3. The nHRP2 protein was isolated from culture supernatant, infected red blood cells (iRBCs), and whole parasite lysate using nickel-metal chelate chromatography. Biochemical characterization of nHRP2 from HB3 culture was conducted by SDS-PAGE and western blotting, and nHRP2 was assayed by RDT, ELISA, and bead-based immunoassay. Results Purified nHRP2 was identified by SDS-PAGE and western blot as a − 60 kDa protein that bound anti-HRP-2 monoclonal antibodies. Mouse anti-HRP2 monoclonal antibody was found to produce high optical density readings between dilutions of 1:100 and 1:3,200 by ELISA with assay signal observed up to a 1:200,000 dilution. nHRP2 yield from HB3 culture by bead-based immunoassay revealed that both culture supernatant and iRBC lysate were practical sources of large quantities of this antigen, producing a total yield of 292.4 µg of nHRP2 from two pooled culture preparations. Assessment of nHRP2 recognition by RDTs revealed that Carestart Pf HRP2 and HRP2/pLDH RDTs detected purified nHRP2 when applied at concentrations between 20.6 and 2060 ng/mL, performing within a log-fold dilution of commercially-available recombinant HRP2. The band intensity observed for the nHRP2 dilutions was equivalent to that observed for P. falciparum culture strain dilutions of 3D7 and US06 F Nigeria XII between 12.5 and 1000 parasites/µL. Conclusions Purified nHRP2 could be a valuable reagent for laboratory applications as well as assessment of new and existing RDTs prior to their use in clinical settings. These results establish that it is possible to extract microgram quantities of the native HRP2 antigen from HB3 culture and that this purified protein is well recognized by existing monoclonal antibody lines and RDTs. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03946-1.
Collapse
Affiliation(s)
- Balwan Singh
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jessica N McCaffery
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Amy Kong
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Yong Ah
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Scott Wilson
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Deepak Tomar
- Department of Medicine, Division of Rheumatology, Emory University, Atlanta, GA, USA.,Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA
| | - Michael Aidoo
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Venkatachalam Udhayakumar
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| |
Collapse
|
12
|
Leonard CM, Assefa A, Sime H, Mohammed H, Kebede A, Solomon H, Drakeley C, Murphy M, Hwang J, Rogier E. Spatial distribution of Plasmodium falciparum and P. vivax in northern Ethiopia by microscopy, rapid diagnostic test, laboratory antibody and antigen data. J Infect Dis 2021; 225:881-890. [PMID: 34628501 DOI: 10.1093/infdis/jiab489] [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: 06/14/2021] [Accepted: 09/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Determining malaria transmission within regions of low, heterogenous prevalence is difficult. A variety of malaria tests exist and range from identification of diagnostic infection to testing for prior exposure. This study describes concordance of multiple malaria tests using data from a 2015 household survey conducted in Ethiopia. METHODS Blood samples (n= 2,279) from three regions in northern Ethiopia were assessed for Plasmodium falciparum and P. vivax by microscopy, rapid diagnostic test (RDT), multiplex antigen assay, and multiplex assay for IgG antibodies. Geospatial analysis was conducted with spatial scan statistics and kernel density estimation to identify hotspots of malaria by different test results. RESULTS Prevalence of malaria infection was low (1.4% by RDT, 1.0% by microscopy, and 1.8% by laboratory antigen assay). For P. falciparum, overlapping spatial clusters for all tests and an additional five unique IgG clusters were identified. For P. vivax, clusters identified for bead antigen assay, microscopy, and IgG with partial overlap. CONCLUSIONS Assessing the spatial distribution of malaria exposure using multiple metrics can improve the understanding of malaria transmission dynamics in a region. The relative abundance of antibody clusters indicates that in areas of low-transmission, IgG antibodies are a more useful marker to assess malaria exposure.
Collapse
Affiliation(s)
- Colleen M Leonard
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.,Infectious Disease ecology and epidemiology lab, University of North Carolina at Chapel Hill, USA
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Amha Kebede
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Chris Drakeley
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matt Murphy
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jimee Hwang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.,U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
13
|
França ACB, Françoso KS, Marques RF, Trossini GHG, Gomes RA, Póvoa MM, Cunha MG, Silveira ELV, Soares IS. Antibodies Against the Plasmodium vivax Apical Membrane Antigen 1 From the Belem Strain Share Common Epitopes Among Other Worldwide Variants. Front Cell Infect Microbiol 2021; 11:616230. [PMID: 33796476 PMCID: PMC8009186 DOI: 10.3389/fcimb.2021.616230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
Malaria is a human parasitic disease distributed in many tropical countries and caused by various Plasmodium species. Plasmodium vivax has the largest geographical distribution of the Plasmodium species and is predominant in the Americas, including Brazil. Only a small number of P. vivax vaccine formulations have successfully reached clinical trials relative to their P. falciparum counterparts. One of the candidate antigens for a blood-stage P. vivax vaccine is apical membrane antigen 1 (PvAMA-1). Due to the worldwide distribution of Plasmodium parasites, a high degree of variability has been detected in this antigen sequence, representing a considerable challenge to the development of a universal vaccine against malaria. In this study, we evaluated how PvAMA-1 polymorphisms influence vaccine-derived immune responses in P. vivax malaria. To this end, we expressed 9 recombinant protein representatives of different PvAMA-1 allelic variants in the yeast Pichia pastoris: Belem, Chesson I, Sal-1, Indonesia XIX, SK0814, TC103, PNG_05_ESP, PNG_62_MU, and PNG_68_MAS. After protein expression and purification, we evaluated the breadth of the immune responses derived from malaria-exposed individuals from the Amazon region. From 611 serum samples of malaria-exposed individuals, 53.68% of them reacted against the PvAMA-1 Belem through ELISA. Positive samples were further tested against recombinant proteins representing the other PvAMA-1 allelic variants. Whereas Sal-1, Chesson I and SK0814 variants were highly recognized by tested serum samples, Indonesia XIX, TC103, PNG_05_ESP, PNG_62_MU, and PNG_68_MAS were only slightly recognized. Moreover, polyclonal sera derived from C57BL/6 mice immunized with the PvAMA-1 Belem protein predominantly recognized Belem, Sal-1, Chesson I, SK0814, and Indonesia XIX through ELISA. Last, ELISA-based competition assays demonstrated that a previous interaction between anti-Belem polyclonal serum and Sal-1, Chesson I, SK0814, or Indonesia XIX proteins could further inhibit antibody binding to the Belem variant. Our human and mouse data suggest the presence of common epitopes or cross-reactivity between Belem, Sal-1, Chesson I, and SK0814 variants. Although the PvAMA-1 Belem variant induces strain-transcendent antibodies, PvAMA-1 variants from Thailand and Papua New Guinea may need to be included in a universal vaccine formulation to achieve protection against P. vivax malaria.
Collapse
Affiliation(s)
- Ana Caroline Barbosa França
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Kátia Sanches Françoso
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rodolfo Ferreira Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Gustavo H. G. Trossini
- Department of Pharmacy, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Renan A. Gomes
- Department of Pharmacy, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Maristela G. Cunha
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Eduardo L. V. Silveira
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Irene S. Soares
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
14
|
Hailemeskel E, Tebeje SK, Behaksra SW, Shumie G, Shitaye G, Keffale M, Chali W, Gashaw A, Ashine T, Drakeley C, Bousema T, Gadisa E, Tadesse FG. The epidemiology and detectability of asymptomatic plasmodium vivax and plasmodium falciparum infections in low, moderate and high transmission settings in Ethiopia. Malar J 2021; 20:59. [PMID: 33482841 PMCID: PMC7821398 DOI: 10.1186/s12936-021-03587-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND As countries move to malaria elimination, detecting and targeting asymptomatic malaria infections might be needed. Here, the epidemiology and detectability of asymptomatic Plasmodium falciparum and Plasmodium vivax infections were investigated in different transmission settings in Ethiopia. METHOD A total of 1093 dried blood spot (DBS) samples were collected from afebrile and apparently healthy individuals across ten study sites in Ethiopia from 2016 to 2020. Of these, 862 were from community and 231 from school based cross-sectional surveys. Malaria infection status was determined by microscopy or rapid diagnostics tests (RDT) and 18S rRNA-based nested PCR (nPCR). The annual parasite index (API) was used to classify endemicity as low (API > 0 and < 5), moderate (API ≥ 5 and < 100) and high transmission (API ≥ 100) and detectability of infections was assessed in these settings. RESULTS In community surveys, the overall prevalence of asymptomatic Plasmodium infections by microscopy/RDT, nPCR and all methods combined was 12.2% (105/860), 21.6% (183/846) and 24.1% (208/862), respectively. The proportion of nPCR positive infections that was detectable by microscopy/RDT was 48.7% (73/150) for P. falciparum and 4.6% (2/44) for P. vivax. Compared to low transmission settings, the likelihood of detecting infections by microscopy/RDT was increased in moderate (Adjusted odds ratio [AOR]: 3.4; 95% confidence interval [95% CI] 1.6-7.2, P = 0.002) and high endemic settings (AOR = 5.1; 95% CI 2.6-9.9, P < 0.001). After adjustment for site and correlation between observations from the same survey, the likelihood of detecting asymptomatic infections by microscopy/RDT (AOR per year increase = 0.95, 95% CI 0.9-1.0, P = 0.013) declined with age. CONCLUSIONS Conventional diagnostics missed nearly half of the asymptomatic Plasmodium reservoir detected by nPCR. The detectability of infections was particularly low in older age groups and low transmission settings. These findings highlight the need for sensitive diagnostic tools to detect the entire parasite reservoir and potential infection transmitters.
Collapse
Affiliation(s)
- Elifaged Hailemeskel
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
- Department of Biomedical Sciences, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
- Department of Biology, College of Natural and Computational Sciences, Wollo University, PO Box, 1145, Dessie, Ethiopia
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Surafel K Tebeje
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Sinknesh W Behaksra
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Girma Shumie
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Getasew Shitaye
- Department of Biomedical Sciences, School of Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Migbaru Keffale
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Wakweya Chali
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Abrham Gashaw
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Temesgen Ashine
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Endalamaw Gadisa
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Fitsum G Tadesse
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands.
- Institute of Biotechnology, Addis Ababa University, PO Box, 1176, Addis Ababa, Ethiopia.
| |
Collapse
|