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Khan MAA, Maude RJ, Musa S, Khanum H. Epidemiology of malaria in Rohingya refugee camps in Bangladesh within 2017-2020. Malar J 2023; 22:288. [PMID: 37759299 PMCID: PMC10537203 DOI: 10.1186/s12936-023-04688-y] [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: 04/19/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Malaria causes significant morbidity and mortality in tropical and sub-tropical regions, particularly in humanitarian emergencies including refugee camps in malaria endemic areas. An epidemiological investigation was conducted on malaria disease distribution and risk factors in the world's largest refugee settlement, the Rohingya refugee camps on the south-eastern border area of Bangladesh, within 2017-2020. METHODS From February 2017 to March 2020, 30,460 febrile patients were tested for malaria using light microscopy and rapid diagnostic tests. Most were self-presenting symptomatic patients and a minority were from door-to-door malaria screening. Diagnostic tests were done by trained medical technologists upon the advice of the concerned physicians in the camps. Test positivity rate (%) and annual parasite incidence were calculated and compared using chi-squared (χ 2) test or odds ratios. RESULTS The overall average annual test positivity rate (TPR) was 0.05%. TPR was highest in people who had travelled to the forest in the previous 2 months, at 13.60%. Cases were clustered among male adults aged 15-60 years. There were no cases among children under five years or pregnant women and no deaths from malaria. CONCLUSION This study found very few malaria cases among Rohingya refugees with the majority of cases being imported from hilly forested areas, which were thus assumed to act as the reservoir for transmission.
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Affiliation(s)
- Md Ariful Anwar Khan
- Department of Zoology, Government Hazi Muhammad Mohsin College, Chattogram, Bangladesh.
| | - Richard James Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Open University, Milton Keynes, UK
| | - Sharmin Musa
- Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Hamida Khanum
- Department of Zoology, University of Dhaka, Dhaka, Bangladesh
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Kartal L, Mueller I, Longley RJ. Using Serological Markers for the Surveillance of Plasmodium vivax Malaria: A Scoping Review. Pathogens 2023; 12:791. [PMID: 37375481 DOI: 10.3390/pathogens12060791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The utilisation of serological surveillance methods for malaria has the potential to identify individuals exposed to Plasmodium vivax, including asymptomatic carriers. However, the application of serosurveillance varies globally, including variations in methodology and transmission context. No systematic review exists describing the advantages and disadvantages of utilising serosurveillance in various settings. Collation and comparison of these results is a necessary first step to standardise and validate the use of serology for the surveillance of P. vivax in specific transmission contexts. A scoping review was performed of P. vivax serosurveillance applications globally. Ninety-four studies were found that met predefined inclusion and exclusion criteria. These studies were examined to determine the advantages and disadvantages of serosurveillance experienced in each study. If studies reported seroprevalence results, this information was also captured. Measurement of antibodies serves as a proxy by which individuals exposed to P. vivax may be indirectly identified, including those with asymptomatic infections, which may be missed by other technologies. Other thematic advantages identified included the ease and simplicity of serological assays compared to both microscopy and molecular diagnostics. Seroprevalence rates varied widely from 0-93%. Methodologies must be validated across various transmission contexts to ensure the applicability and comparability of results. Other thematic disadvantages identified included challenges with species cross-reactivity and determining changes in transmission patterns in both the short- and long-term. Serosurveillance requires further refinement to be fully realised as an actionable tool. Some work has begun in this area, but more is required.
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Affiliation(s)
- Lejla Kartal
- School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
| | - Ivo Mueller
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville 3010, Australia
| | - Rhea J Longley
- Population Health and Immunity, The Walter and Eliza Hall Institute of Medical Research, Parkville 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville 3010, Australia
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3
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Oulton T, Obiero J, Rodriguez I, Ssewanyana I, Dabbs RA, Bachman CM, Greenhouse B, Drakeley C, Felgner PL, Stone W, Tetteh KKA. Plasmodium falciparum serology: A comparison of two protein production methods for analysis of antibody responses by protein microarray. PLoS One 2022; 17:e0273106. [PMID: 36037183 PMCID: PMC9423672 DOI: 10.1371/journal.pone.0273106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/02/2022] [Indexed: 12/02/2022] Open
Abstract
The evaluation of protein antigens as putative serologic biomarkers of infection has increasingly shifted to high-throughput, multiplex approaches such as the protein microarray. In vitro transcription/translation (IVTT) systems-a similarly high-throughput protein expression method-are already widely utilised in the production of protein microarrays, though purified recombinant proteins derived from more traditional whole cell based expression systems also play an important role in biomarker characterisation. Here we have performed a side-by-side comparison of antigen-matched protein targets from an IVTT and purified recombinant system, on the same protein microarray. The magnitude and range of antibody responses to purified recombinants was found to be greater than that of IVTT proteins, and responses between targets from different expression systems did not clearly correlate. However, responses between amino acid sequence-matched targets from each expression system were more closely correlated. Despite the lack of a clear correlation between antigen-matched targets produced in each expression system, our data indicate that protein microarrays produced using either method can be used confidently, in a context dependent manner, though care should be taken when comparing data derived from contrasting approaches.
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Affiliation(s)
- Tate Oulton
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joshua Obiero
- Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA, United States of America
| | - Isabel Rodriguez
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Isaac Ssewanyana
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Rebecca A. Dabbs
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Bryan Greenhouse
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Phil L. Felgner
- Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA, United States of America
| | - Will Stone
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kevin K. A. Tetteh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Gwyn S, Abubakar A, Akinmulero O, Bergeron E, Blessing UN, Chaitram J, Coughlin MM, Dawurung AB, Dickson FN, Esiekpe M, Evbuomwan E, Greby SM, Iriemenam NC, Kainulainen MH, Naanpoen TA, Napoloen L, Odoh I, Okoye M, Olaleye T, Schuh AJ, Owen SM, Samuel A, Martin DL. Performance of SARS-CoV-2 Antigens in a Multiplex Bead Assay for Integrated Serological Surveillance of Neglected Tropical and Other Diseases. Am J Trop Med Hyg 2022; 107:260-267. [PMID: 35895418 PMCID: PMC9393470 DOI: 10.4269/ajtmh.22-0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/26/2022] [Indexed: 11/21/2022] Open
Abstract
Serosurveillance can provide estimates of population-level exposure to infectious pathogens and has been used extensively during the COVID-19 pandemic. Simultaneous, serological testing for multiple pathogens can be done using bead-based immunoassays to add value to disease-specific serosurveys. We conducted a validation of four SARS-CoV-2 antigens-full-length spike protein, two receptor binding domain proteins, and the nucleocapsid protein-on our existing multiplex bead assay (MBA) for enteric diseases, malaria, and vaccine preventable diseases. After determining the optimal conditions for coupling the antigens to microsphere beads, the sensitivity and specificity of the assay were determined on two instruments (Luminex-200 and MAGPIX) when testing singly (monoplex) versus combined (multiplex). Sensitivity was assessed using plasma from 87 real-time reverse transcription polymerase chain reaction (rRT-PCR) positive persons collected in March-May of 2020 and ranged from 94.3% to 96.6% for the different testing conditions. Specificity was assessed using 98 plasma specimens collected prior to December 2019 and plasma from 19 rRT-PCR negative persons and ranged from 97.4% to 100%. The positive percent agreement was 93.8% to 97.9% using 48 specimens collected > 21 days post-symptom onset, while the negative percent agreement was ≥ 99% for all antigens. Test performance was similar using monoplex or multiplex testing. Integrating SARS-CoV-2 serology with other diseases of public health interest could add significant value to public health programs that have suffered severe programmatic setbacks during the COVID-19 pandemic.
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Affiliation(s)
- Sarah Gwyn
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Eric Bergeron
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jasmine Chaitram
- Division of Laboratory Systems, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Melissa M. Coughlin
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Stacie M. Greby
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C. Iriemenam
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Markus H. Kainulainen
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - McPaul Okoye
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | - Amy J. Schuh
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S. Michele Owen
- National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, Georgia
| | | | - Diana L. Martin
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions among patients in the DRC enrolled from 2017 to 2018. Sci Rep 2021; 11:22979. [PMID: 34837020 PMCID: PMC8626453 DOI: 10.1038/s41598-021-02452-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
Rapid diagnostic tests (RDTs) detecting histidine-rich protein 2 (HRP2) and HRP3 are widely used throughout sub-Saharan Africa (SSA) to diagnose Plasmodium falciparum malaria. However, multiple SSA countries have reported pfhrp2 and pfhrp3 (pfhrp2/3) gene deletions. Blood samples (n = 1109) collected from patients with P. falciparum infection from six health facilities throughout the Democratic Republic of the Congo (DRC) from March 2017 to January 2018 were evaluated for pfhrp2/3 deletions. Samples were assayed for HRP2, pan-Plasmodium LDH (pLDH) and aldolase (pAldolase) antigens by bead-based multiplex antigen assay. Samples with low HRP2 concentration compared to pLDH and pAldolase antigens were selected for further pfhrp2/3 genotyping PCRs. The majority of blood samples (93.3%, 1035/1109) had high concentrations of the HRP2 antigen. Single deletions of pfhrp2 were identified in 0.27% (3/1109) of screened samples, with one sample from each of the Kapolowe, Mikalayi, and Rutshuru study sites. A pfhrp3 single deletion (0.09%, 1/1109) was found in the Kapolowe site. Dual pfhrp2 and pfhrp3 deletions were not observed. Due to, the low numbers of pfhrp2 deletions and the sporadic locations of these deletions, the use of HRP2-based RDTs appears to still be appropriate for these locations in DRC.
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