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Culleton R, Pain A, Snounou G. Plasmodium malariae: the persisting mysteries of a persistent parasite. Trends Parasitol 2023; 39:113-125. [PMID: 36517330 DOI: 10.1016/j.pt.2022.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
Plasmodium malariae is a 'neglected malaria parasite' in as much as the amount of research conducted on it pales into insignificance when compared to that pertaining to Plasmodium falciparum and Plasmodium vivax, its more notorious and pathogenic cousins. There has, however, been an increase in interest in this parasite over the past decade. Principally, this is because of the increasing use of sensitive molecular detection techniques that have revealed a wider than previously recorded prevalence in some regions (particularly in Africa), and high numbers of chronic, asymptomatic infections.
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Affiliation(s)
- Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Centre, Ehime University, Matsuyama, Japan; Department of Protozoology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Arnab Pain
- Pathogen Genomics Group, Bioscience Programme, Biological and Environmental Science and Engineering (BESE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Jeddah, Kingdom of Saudi Arabia
| | - Georges Snounou
- CEA-Université Paris Sud 11-INSERM U1184, Immunology of Viral Infections and Autoimmune Diseases (IMVA-HB), IDMIT Department, IBFJ, DRF, Fontenay-aux-Roses, France.
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2
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Fuehrer HP, Campino S, Sutherland CJ. The primate malaria parasites Plasmodium malariae, Plasmodium brasilianum and Plasmodium ovale spp.: genomic insights into distribution, dispersal and host transitions. Malar J 2022; 21:138. [PMID: 35505317 PMCID: PMC9066925 DOI: 10.1186/s12936-022-04151-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
During the twentieth century, there was an explosion in understanding of the malaria parasites infecting humans and wild primates. This was built on three main data sources: from detailed descriptive morphology, from observational histories of induced infections in captive primates, syphilis patients, prison inmates and volunteers, and from clinical and epidemiological studies in the field. All three were wholly dependent on parasitological information from blood-film microscopy, and The Primate Malarias” by Coatney and colleagues (1971) provides an overview of this knowledge available at that time. Here, 50 years on, a perspective from the third decade of the twenty-first century is presented on two pairs of primate malaria parasite species. Included is a near-exhaustive summary of the recent and current geographical distribution for each of these four species, and of the underlying molecular and genomic evidence for each. The important role of host transitions in the radiation of Plasmodium spp. is discussed, as are any implications for the desired elimination of all malaria species in human populations. Two important questions are posed, requiring further work on these often ignored taxa. Is Plasmodium brasilianum, circulating among wild simian hosts in the Americas, a distinct species from Plasmodium malariae? Can new insights into the genomic differences between Plasmodium ovale curtisi and Plasmodium ovale wallikeri be linked to any important differences in parasite morphology, cell biology or clinical and epidemiological features?
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Affiliation(s)
- Hans-Peter Fuehrer
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Susana Campino
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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3
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Oriero EC, Amenga-Etego L, Ishengoma DS, Amambua-Ngwa A. Plasmodium malariae, current knowledge and future research opportunities on a neglected malaria parasite species. Crit Rev Microbiol 2021; 47:44-56. [PMID: 33507842 DOI: 10.1080/1040841x.2020.1838440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Plasmodium malariae is often reported as a benign malaria parasite. There are limited data on its biology and disease burden in sub-Saharan Africa (sSA) possibly due to the unavailability of specific and affordable tools for routine diagnosis and large epidemiology studies. In addition, P. malariae occurs at low parasite densities and in co-infections with other species, predominately P. falciparum. The paucity of data on P. malariae infections limits the capacity to accurately determine its contribution to malaria and the effect of control interventions against P. falciparum on its prevalence. Here, we summarise the current knowledge on P. malariae epidemiology in sSA - overall prevalence ranging from 0-32%, as detected by different diagnostic methods; seroprevalence ranging from 0-56% in three countries (Mozambique, Benin and Zimbabwe), and explore the future application of next-generation sequencing technologies as a tool for enriching P. malariae genomic epidemiology. This will provide insights into important adaptive mechanisms of this neglected non-falciparum species, including antimalarial drug resistance, local and regional parasite transmission patterns and genomic signatures of selection. Improved diagnosis and genomic surveillance of non-falciparum malaria parasites in Africa would be helpful in evaluating progress towards elimination of all human Plasmodium species.
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Affiliation(s)
- Eniyou C Oriero
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Lucas Amenga-Etego
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Deus S Ishengoma
- Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania
| | - Alfred Amambua-Ngwa
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
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4
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Sutherland CJ. A New Window on Plasmodium malariae Infections. J Infect Dis 2020; 221:864-866. [PMID: 30855671 DOI: 10.1093/infdis/jiz103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Colin J Sutherland
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
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5
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Characteristics of imported Plasmodium ovale spp. and Plasmodium malariae in Hubei Province, China, 2014-2018. Malar J 2020; 19:264. [PMID: 32698906 PMCID: PMC7374957 DOI: 10.1186/s12936-020-03337-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/14/2020] [Indexed: 01/19/2023] Open
Abstract
Background There have been an increasing number of imported cases of malaria in Hubei Province in recent years. In particular, the number of cases of Plasmodium ovale spp. and Plasmodium malariae significantly increased, which resulted in increased risks during the malaria elimination phase. The purpose of this study was to acquire a better understanding of the epidemiological characteristics of P. ovale spp. and P. malariae imported to Hubei Province, China, so as to improve case management. Methods Data on all malaria cases from January 2014 to December 2018 in Hubei Province were extracted from the China national diseases surveillance information system (CNDSIS). This descriptive study was conducted to analyse the prevalence trends, latency periods, interval from onset of illness to diagnosis, and misdiagnosis of cases of P. ovale spp. and P. malariae malaria. Results During this period, 634 imported malaria cases were reported, of which 87 P. ovale spp. (61 P. ovale curtisi and 26 P. ovale wallikeri) and 18 P. malariae cases were confirmed. The latency periods of P. ovale spp., P. malariae, Plasmodium vivax, and Plasmodium falciparum differed significantly, whereas those of P. ovale curtisi and P. ovale wallikeri were no significant difference. The proportion of correct diagnosis of P. ovale spp. and P. malariae malaria cases were 48.3% and 44.4%, respectively, in the hospital or lower-level Centers for Disease Control and Prevention (CDC). In the Provincial Reference Laboratory, the sensitivity of microscopy and rapid diagnostic tests was 94.3% and 70.1%, respectively, for detecting P. ovale spp., and 88.9% and 38.9%, respectively, for detecting P. malariae. Overall, 97.7% (85/87) of P. ovale spp. cases and 94.4% (17/18) of P. malariae cases originated from Africa. Conclusion The increase in the number of imported P. ovale spp. and P. malariae cases, long latency periods, and misdiagnosis pose a challenge to this region. Therefore, more attention should be paid to surveillance of imported cases of P. ovale spp. and P. malariae infection to reduce the burden of public health and potential risk of malaria.
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Selective whole genome amplification of Plasmodium malariae DNA from clinical samples reveals insights into population structure. Sci Rep 2020; 10:10832. [PMID: 32616738 PMCID: PMC7331648 DOI: 10.1038/s41598-020-67568-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/05/2020] [Indexed: 02/03/2023] Open
Abstract
The genomic diversity of Plasmodium malariae malaria parasites is understudied, partly because infected individuals tend to present with low parasite densities, leading to difficulties in obtaining sufficient parasite DNA for genome analysis. Selective whole genome amplification (SWGA) increases the relative levels of pathogen DNA in a clinical sample, but has not been adapted for P. malariae parasites. Here we design customized SWGA primers which successfully amplify P. malariae DNA extracted directly from unprocessed clinical blood samples obtained from patients with P. malariae-mono-infections from six countries, and further test the efficacy of SWGA on mixed infections with other Plasmodium spp. SWGA enables the successful whole genome sequencing of samples with low parasite density (i.e. one sample with a parasitaemia of 0.0064% resulted in 44% of the genome covered by ≥ 5 reads), leading to an average 14-fold increase in genome coverage when compared to unamplified samples. We identify a total of 868,476 genome-wide SNPs, of which 194,709 are unique across 18 high-quality isolates. After exclusion of the hypervariable subtelomeric regions, a high-quality core subset of 29,899 unique SNPs is defined. Population genetic analysis suggests that P. malariae parasites display clear geographical separation by continent. Further, SWGA successfully amplifies genetic regions of interest such as orthologs of P. falciparum drug resistance-associated loci (Pfdhfr, Pfdhps, Pfcrt, Pfk13 and Pfmdr1), and several non-synonymous SNPs were detected in these genes. In conclusion, we have established a robust SWGA approach that can assist whole genome sequencing of P. malariae, and thereby facilitate the implementation of much-needed large-scale multi-population genomic studies of this neglected malaria parasite. As demonstrated in other Plasmodia, such genetic diversity studies can provide insights into the biology underlying the disease and inform malaria surveillance and control measures.
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Lubis IND, Wijaya H, Lubis M, Lubis CP, Beshir KB, Staedke SG, Sutherland CJ. Recurrence of Plasmodium malariae and P. falciparum Following Treatment of Uncomplicated Malaria in North Sumatera With Dihydroartemisinin-Piperaquine or Artemether-Lumefantrine. Open Forum Infect Dis 2020; 7:ofaa116. [PMID: 32420402 PMCID: PMC7216766 DOI: 10.1093/ofid/ofaa116] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/01/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We assessed the efficacy of artemisinin-based combination therapies for treatment of uncomplicated falciparum malaria, with or without co-infecting Plasmodium spp., in Sumatera, Indonesia. METHODS Febrile patients aged >6 months with uncomplicated P. falciparum were randomized to receive dihydroartemisinin-piperaquine or artemether-lumefantrine, plus single-dose primaquine, and were followed for 42 days. Mixed Plasmodium infections were included; P. vivax infections received 14 days of primaquine. We retrospectively restricted the analysis to cases with polymerase chain reaction (PCR)-confirmed parasitemia. Recurrent parasitemia in follow-up was identified by species-specific nested PCR. RESULTS Of the 3731 participants screened, 302 were enrolled and randomized. In the dihydroartemisinin-piperaquine arm, P. falciparum infections were confirmed by PCR in 59 participants, with mixed infections in 23 (39.0%). In the artemether-lumefantrine arm, P. falciparum infections were confirmed by PCR in 55 participants, with mixed infections in 16 (29.0%). Both regimens were well tolerated, and symptoms improved rapidly in all treated participants. In the dihydroartemisinin-piperaquine arm, 1 P. falciparum recurrence (on day 7) and 6 P. malariae recurrences (1 had a mixed infection with P. falciparum) were identified during days 3-42 of follow-up. In the artemether-lumefantrine arm, 1 P. falciparum/P. malariae/P. vivax recurrence occurred on day 35. Submicroscopic persistence occurred during follow-up in 21 (37%) of 57 receiving dihydroartemisinin-piperaquine and 20 (39%) of 51 receiving artemether-lumefantrine. CONCLUSIONS In Sumatera, both regimens effectively cleared initial parasitemia, but P. falciparum and P. malariae persisted in some individuals. Molecular species detection should be deployed in antimalarial efficacy trials in Indonesia. TRIAL REGISTRATION NCT02325180.
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Affiliation(s)
- Inke Nadia D Lubis
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Infection and Immunity Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hendri Wijaya
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Munar Lubis
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Chairuddin P Lubis
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Khalid B Beshir
- Infection and Immunity Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sarah G Staedke
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Colin J Sutherland
- Infection and Immunity Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- PHE Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
PURPOSE OF REVIEW To review the current status of 8-aminoquinolines in the prophylaxis of malaria among travelers, in light of the recent approval of tafenoquine. RECENT FINDINGS Primaquine continues to provide excellent primary prophylaxis against all Plasmodium species. Tafenoquine provides similarly good prophylaxis, with the benefit of weekly dosing. Both agents require glucose-6-phosphate dehydrogenase activity testing before use and are contraindicated in pregnancy. Pharmacodynamic variability relating to CYP2D6 may underlie some cases of primaquine failure; the effects of CYP2D6 on tafenoquine efficacy require further study. Tafenoquine and primaquine are the only current drugs that provide complete malaria prophylaxis, and should be considered the agents of choice in areas where both P. vivax and falciparum are frequent. Monthly tafenoquine is promising and should be further studied in travelers.
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Affiliation(s)
- Eyal Meltzer
- Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, 52621, Tel Hashomer, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Eli Schwartz
- Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, 52621, Tel Hashomer, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Brashear AM, Roobsoong W, Siddiqui FA, Nguitragool W, Sattabongkot J, López-Uribe MM, Miao J, Cui L. A glance of the blood stage transcriptome of a Southeast Asian Plasmodium ovale isolate. PLoS Negl Trop Dis 2019; 13:e0007850. [PMID: 31730621 PMCID: PMC6881071 DOI: 10.1371/journal.pntd.0007850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/27/2019] [Accepted: 10/16/2019] [Indexed: 11/24/2022] Open
Abstract
Plasmodium ovale accounts for a disproportionate number of travel-related malaria cases. This parasite is understudied since there is a reliance on clinical samples. We collected a P. ovale curtisi parasite isolate from a clinical case in western Thailand and performed RNA-seq analysis on the blood stage transcriptomes. Using both de novo assembly and alignment-based methods, we detected the transcripts for 6628 out of 7280 annotated genes. For those lacking evidence of expression, the vast majority belonged to the PIR and STP1 gene families. We identified new splicing patterns for over 2500 genes, and mapped at least one untranslated region for over half of all annotated genes. Our analysis also detected a notable presence of anti-sense transcripts for over 10% of P. ovale curtisi genes. This transcriptomic analysis provides new insights into the blood-stage biology of this neglected parasite.
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Affiliation(s)
- Awtum M. Brashear
- Department of Entomology, Pennsylvania State University, Department of Entomology, University Park, Pennsylvania, United States of America
- Department of Internal Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Wanlapa Roobsoong
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Faiza A. Siddiqui
- Department of Internal Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Wang Nguitragool
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Margarita M. López-Uribe
- Department of Entomology, Pennsylvania State University, Department of Entomology, University Park, Pennsylvania, United States of America
| | - Jun Miao
- Department of Internal Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, Department of Entomology, University Park, Pennsylvania, United States of America
- Department of Internal Medicine, University of South Florida, Tampa, Florida, United States of America
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10
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Grande R, Antinori S, Meroni L, Menegon M, Severini C. A case of Plasmodium malariae recurrence: recrudescence or reinfection? Malar J 2019; 18:169. [PMID: 31088460 PMCID: PMC6515619 DOI: 10.1186/s12936-019-2806-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/07/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Plasmodium malariae is the most neglected of the six human malaria species and it is still unknown which is the mechanism underlying the long latency of this Plasmodium. CASE PRESENTATION A case of PCR-confirmed P. malariae recurrence in a 52-year old Italian man was observed 5 months after a primary attack. In the interval between the two observed episodes of malaria the patient denied any further stay in endemic areas except for a visit to Libya, a country considered malaria-free. Genomic DNA of the P. malariae strain using five microsatellites (PM2, PM9, PM11, PM25, PM34) and the antigen marker of circumsporozoite (csp) was amplified and sequenced. Analysis of polymorphisms of the P. malariae csp central repeat region showed differences between the strains responsible of the first and second episode of malaria. A difference in the allele size was also observed for the sequence analysis of PM2 microsatellites. CONCLUSIONS Plasmodium malariae is a challenging human malaria parasite and even with the use of molecular techniques the pathogenesis of recurrent episodes cannot be precisely explained.
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Affiliation(s)
- Romualdo Grande
- Clinical Microbiology, Virology and Bioemergency, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.
| | - Luca Meroni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Michela Menegon
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Severini
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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11
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Nabarro LEB, Nolder D, Broderick C, Nadjm B, Smith V, Blaze M, Checkley AM, Chiodini PL, Sutherland CJ, Whitty CJM. Geographical and temporal trends and seasonal relapse in Plasmodium ovale spp. and Plasmodium malariae infections imported to the UK between 1987 and 2015. BMC Med 2018; 16:218. [PMID: 30477484 PMCID: PMC6260574 DOI: 10.1186/s12916-018-1204-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasmodium ovale spp. and P. malariae cause illness in endemic regions and returning travellers. Far less is known about these species than P. falciparum and P. vivax. METHODS The UK national surveillance data, collected 1987 to 2015, were collated with the International Passenger Survey and climatic data to determine geographical, temporal and seasonal trends of imported P. ovale spp. and P. malariae infection. RESULTS Of 52,242 notified cases of malaria, 6.04% (3157) were caused by P. ovale spp. and 1.61% (841) by P. malariae; mortality was 0.03% (1) and 0.12% (1), respectively. Almost all travellers acquired infection in West or East Africa. Infection rate per travel episode fell fivefold during the study period. The median latency of P. malariae and P. ovale spp. was 18 and 76 days, respectively; delayed presentation occurred with both species. The latency of P. ovale spp. infection imported from West Africa was significantly shorter in those arriving in the UK during the West African peak malarial season compared to those arriving outside it (44 days vs 94 days, p < 0.0001), implying that relapse synchronises with the period of high malarial transmission. This trend was not seen in P. ovale spp. imported from East Africa nor in P. malariae. CONCLUSION In West Africa, where malaria transmission is highly seasonal, P. ovale spp. may have evolved to relapse during the malarial high transmission season. This has public health implications. Deaths are very rare, supporting current guidelines emphasising outpatient treatment. However, late presentations do occur.
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Affiliation(s)
- Laura E B Nabarro
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Debbie Nolder
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Claire Broderick
- The Hospital for Tropical Diseases, Mortimer Market Capper Street, London, WC1E 6JD, UK
| | - Behzad Nadjm
- The Hospital for Tropical Diseases, Mortimer Market Capper Street, London, WC1E 6JD, UK.,Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Valerie Smith
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Marie Blaze
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Anna M Checkley
- The Hospital for Tropical Diseases, Mortimer Market Capper Street, London, WC1E 6JD, UK
| | - Peter L Chiodini
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,The Hospital for Tropical Diseases, Mortimer Market Capper Street, London, WC1E 6JD, UK
| | - Colin J Sutherland
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Christopher J M Whitty
- Public Health England Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,The Hospital for Tropical Diseases, Mortimer Market Capper Street, London, WC1E 6JD, UK
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12
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Yavne Y, Leshem E, Paran Y, Nadir E, Weinberger M, Stein M, Petersiel N, Yahav D, Grossman T, Schwartz E. Plasmodium malariae in Israeli Travelers: A Nationwide Study. Clin Infect Dis 2018; 65:1516-1522. [PMID: 29020345 DOI: 10.1093/cid/cix560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/18/2017] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about Plasmodium malariae, a relatively rare cause of malaria in returned travelers. Recently, polymerase chain reaction (PCR) use for malaria diagnosis has enhanced specificity of P. malariae detection. The study objective was to describe the unique aspects of P. malariae diagnosis and clinical course in travelers. Methods Malaria is a reportable disease in Israel. All PCR-proven P. malariae monoinfections in Israeli travelers between January 2008 and January 2017 were retrieved from the Ministry of Health Reference Parasitology Laboratory. Data regarding method and timing of diagnosis, clinical characteristics, and laboratory testing were collected from patient charts. Results Eighteen patients with P. malariae were included. All cases were acquired in Africa. During the study period, the relative proportion of P. malariae increased (2%-10% of all malaria cases). Malaria was identified by blood smear in 10 of 18 patients (56%) on admission, and by rapid antigen test in 5 of 18 (29%) patients only, while P. malariae speciation was correctly identified by smear in 2 of 18 (11%) patients. Though all patients reported fever, only 4 of 18 (22%) described a quartan fever course. In 7 of 18 (39%) patients, malaria was contracted despite prophylactic treatment. Five patients had prolonged prepatent periods (median, 55 days), all of whom received prior prophylaxis. Conclusions The relative proportion of P. malariae is on the rise. Diagnosis in routine clinical settings is inadequate due to the low sensitivity and specificity of blood smears. PCR should be considered when clinical suspicion is high. Prophylaxis failure, which caused delayed clinical presentation, was documented.
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Affiliation(s)
- Yarden Yavne
- Sackler Faculty of Medicine, Tel-Aviv University
| | - Eyal Leshem
- Sackler Faculty of Medicine, Tel-Aviv University.,Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer
| | - Yael Paran
- Sackler Faculty of Medicine, Tel-Aviv University.,Infectious Diseases Unit, Sourasky Medical Center, Tel Aviv
| | - Eyal Nadir
- Infectious Diseases Unit, Kaplan Medical Center, Rehovot, affiliated to the School of Medicine, Hebrew University and Hadassah, Jerusalem
| | - Miriam Weinberger
- Sackler Faculty of Medicine, Tel-Aviv University.,Infectious Diseases Unit, Assaf Harofeh Medical Center
| | - Michal Stein
- Infectious Diseases Unit, Hillel Yaffe Medical Center, Hadera
| | - Neta Petersiel
- Unit of Infectious Diseases and Internal Medicine B, Rambam Medical Center and Bruce Rappaport Faculty of Medicine, Technion, Haifa
| | - Dafna Yahav
- Unit of Infectious Diseases, Rabin Medical Center, Beilinson Hospital, Petah-Tikva
| | - Tamar Grossman
- Reference Parasitology Laboratory, Central Laboratories, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Eli Schwartz
- Sackler Faculty of Medicine, Tel-Aviv University.,Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer
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13
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Betson M, Clifford S, Stanton M, Kabatereine NB, Stothard JR. Emergence of Nonfalciparum Plasmodium Infection Despite Regular Artemisinin Combination Therapy in an 18-Month Longitudinal Study of Ugandan Children and Their Mothers. J Infect Dis 2018; 217:1099-1109. [PMID: 29325068 PMCID: PMC5939692 DOI: 10.1093/infdis/jix686] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/05/2018] [Indexed: 12/04/2022] Open
Abstract
As part of a longitudinal cohort investigation of intestinal schistosomiasis and malaria in Ugandan children and their mothers on the shorelines of Lakes Victoria and Albert, we documented risk factors and morbidity associated with nonfalciparum Plasmodium infections and the longitudinal dynamics of Plasmodium species in children. Host age, household location, and Plasmodium falciparum infection were strongly associated with nonfalciparum Plasmodium infections, and Plasmodium malariae infection was associated with splenomegaly. Despite regular artemisinin combination therapy treatment, there was a 3-fold rise in P. malariae prevalence, which was not accountable for by increasing age of the child. Worryingly, our findings reveal the consistent emergence of nonfalciparum infections in children, highlighting the complex dynamics underlying multispecies infections here. Given the growing body of evidence that nonfalciparum malaria infections cause significant morbidity, we encourage better surveillance for nonfalciparum Plasmodium infections, particularly in children, with more sensitive DNA detection methods and improved field-based diagnostics.
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Affiliation(s)
- Martha Betson
- School of Veterinary Medicine, University of Surrey, Guildford
| | - Sarah Clifford
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Michelle Stanton
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Tan L, Li Y, Yang X, Ke Q, Lei W, Mughal MN, Fang R, Zhou Y, Shen B, Zhao J. Genetic diversity and drug sensitivity studies on Eimeria tenella field isolates from Hubei Province of China. Parasit Vectors 2017; 10:137. [PMID: 28274278 PMCID: PMC5343410 DOI: 10.1186/s13071-017-2067-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/27/2017] [Indexed: 11/28/2022] Open
Abstract
Background Avian coccidiosis is an intracellular intestinal parasitic disease, caused by intracellular intestinal parasites from the genus Eimeria, among which Eimeria tenella is one of the most pathogenic species and causes great economic losses. Frequent applications of anticoccidial drugs have resulted in the development of drug-resistance in E. tenella. In the present study, we sought to determine the genetic diversity of E. tenella isolates prevalent in chicken farms in Hubei Province of China and examine their sensitivity to three anticoccidial drugs. The results provide useful information for the prevention and control of coccidiosis in this region. Methods Eimeria tenella oocysts were isolated from faecal samples collected from different commercial broiler production farms in Hubei Province, China. After oocyst sporulation and animal inoculation for expansion of the field isolates, DNA and RNA were extracted from excysted sporozoites for molecular characterization. Species identification of field isolates were performed by polymerase chain reaction (PCR) amplification of the internal transcribed spacer 1 (ITS1) region of ribosomal DNA. Random amplified polymorphic DNA (RAPD) was used for population genetic analysis. Subsequently, sequences of the major sporozoite surface antigen (SAG), micronemal protein 2 (MIC-2) and cytochrome b (cytb) genes from genomic DNA, and the Eimeria tenella cation-transport ATPase (EtCat ATPase) gene from cDNA were obtained for genotyping using multi-sequence alignments. Finally, sensitivity of the field isolates to three commonly used anticoccidial drugs (diclazuril, decoquinate and maduramycin) were tested to assess the prevalence of drug resistance in E. tenella in Hubei Province of China. Results Analysis of the ITS1 sequences indicated that all the isolates were E. tenella. RAPD analysis and multi-sequence alignments of the SAG, MIC-2, EtCat ATPase and cytb showed genetic diversity among these isolates. Finally, drug sensitivity tests demonstrated that all field isolates were sensitive to diclazuril but resistant to decoquinate (except for the isolates from eastern Hubei) and maduramicin. Conclusions Population genetic analysis indicated that genetic polymorphisms among field isolates were closely related with their regional distributions. Drug sensitivity testing demonstrated that E. tenella isolates in Hubei Province were sensitive to diclazuril, but resistant to maduramycin and decoquinate. The results presented here provide important information for the control and preventions of coccidiosis in the Hubei Province of China. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2067-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Li Tan
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Yalin Li
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Xin Yang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Qiyun Ke
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Weiqiang Lei
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Mudassar Niaz Mughal
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Rui Fang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China.
| | - Yanqin Zhou
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Bang Shen
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China
| | - Junlong Zhao
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, Hubei, People's Republic of China.
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Sutherland CJ. Persistent Parasitism: The Adaptive Biology of Malariae and Ovale Malaria. Trends Parasitol 2016; 32:808-819. [PMID: 27480365 DOI: 10.1016/j.pt.2016.07.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/17/2016] [Accepted: 07/12/2016] [Indexed: 12/29/2022]
Abstract
Plasmodium malariae causes malaria in humans throughout the tropics and subtropics. Plasmodium ovale curtisi and Plasmodium ovale wallikeri are sympatric sibling species common in sub-Saharan Africa and also found in Oceania and Asia. Although rarely identified as the cause of malaria cases in endemic countries, PCR detection has confirmed all three parasite species to be more prevalent, and persistent, than previously thought. Chronic, low-density, multispecies asymptomatic infection is a successful biological adaptation by these Plasmodium spp., a pattern also observed among malaria parasites of wild primates. Current whole-genome analyses are illuminating the species barrier separating the ovale parasite species and reveal substantial expansion of subtelomeric gene families. The evidence for and against a quiescent pre-erythrocytic form of P. malariae is reviewed.
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Affiliation(s)
- Colin J Sutherland
- Department of Immunology and Infection and Public Health England Malaria Reference Laboratory, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Department of Clinical Parasitology, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, Mortimer Market Centre, Capper Street, London WC1E 6JB, UK.
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Mouse-Based Research on Quiescent Primate Malaria Parasites. Trends Parasitol 2016; 32:271-273. [DOI: 10.1016/j.pt.2016.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/04/2016] [Accepted: 02/11/2016] [Indexed: 11/19/2022]
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