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Ribeiro BC, Garcia CGR, Lima LJP, Guerreiro JF, Póvoa MM, Cunha MG. Malaria in a vulnerable population living in quilombo remnant communities in the Brazilian Amazon: a cross-sectional study from 2005-2020. Rev Inst Med Trop Sao Paulo 2024; 66:e25. [PMID: 38656041 PMCID: PMC11027486 DOI: 10.1590/s1678-9946202466025] [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: 09/23/2023] [Accepted: 02/26/2024] [Indexed: 04/26/2024] Open
Abstract
Quilombo remnant communities are areas officially recognized by the Brazilian government as historical communities founded by formerly enslaved individuals. These communities are mostly located in the endemic areas of malaria in the Brazilian Amazon. We retrospectively described the prevalence of malaria among individuals living in 32 recognized quilombo remnant communities in the Baiao and Oriximina municipalities located in the Para State. The number of malaria cases and the Annual Parasitic Incidence (API) recorded by the Brazilian malaria surveillance system (SIVEP-Malaria) from January 2005 to December 2020 were analyzed. We found that all communities registered at least one case over the 16-year period, the most frequent parasitic species being Plasmodium vivax (76.1%). During this period, 0.44% (4,470/1,008,714) of the malaria cases registered in Para State were reported in these quilombo remnant communities, with frequencies of 10.9% (856/7,859) in Baiao municipality and 39.1% (3,614/9,238) in Oriximina municipality, showing that individuals living in these rural communities are exposed to malaria. These data indicate that effective surveillance requires improved measures to identify malaria transmission among vulnerable populations living in quilombo remnant communities in the Brazilian Amazon.
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Affiliation(s)
- Beatriz Costa Ribeiro
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Microbiologia e Imunologia, Belém, Pará, Brazil
| | - Carla Gisele R Garcia
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Microbiologia e Imunologia, Belém, Pará, Brazil
- Secretaria de Saúde do Estado do Pará, Belém, Pará, Brazil
| | - Lilian Jéssica Passos Lima
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Microbiologia e Imunologia, Belém, Pará, Brazil
| | - João F. Guerreiro
- Universidade Federal do Pará, Laboratório de Genética Humana e Médica, Belém, Pará, Brazil
| | | | - Maristela G. Cunha
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Microbiologia e Imunologia, Belém, Pará, Brazil
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Ancestry, diversity, and genetics of health-related traits in African-derived communities (quilombos) from Brazil. Funct Integr Genomics 2023; 23:74. [PMID: 36867305 PMCID: PMC9982798 DOI: 10.1007/s10142-023-00999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023]
Abstract
Brazilian quilombos are communities formed by enslaved Africans and their descendants all over the country during slavery and shortly after its abolition. Quilombos harbor a great fraction of the largely unknown genetic diversity of the African diaspora in Brazil. Thus, genetic studies in quilombos have the potential to provide important insights not only into the African roots of the Brazilian population but also into the genetic bases of complex traits and human adaptation to diverse environments. This review summarizes the main results of genetic studies performed on quilombos so far. Here, we analyzed the patterns of African, Amerindian, European, and subcontinental ancestry (within Africa) of quilombos from the five different geographic regions of Brazil. In addition, uniparental markers (from the mtDNA and the Y chromosome) studies are analyzed together to reveal demographic processes and sex-biased admixture that occurred during the formation of these unique populations. Lastly, the prevalence of known malaria-adaptive African mutations and other African-specific variants discovered in quilombos, as well as the genetic bases of health-related traits, are discussed here, together with their implication for the health of populations of African descent.
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Nortey LN, Anning AS, Nakotey GK, Ussif AM, Opoku YK, Osei SA, Aboagye B, Ghartey-Kwansah G. Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions. Cell Biosci 2022; 12:91. [PMID: 35715862 PMCID: PMC9204375 DOI: 10.1186/s13578-022-00830-6] [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: 01/27/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cerebral malaria (CM) is a preeminent cause of severe disease and premature deaths in Sub-Saharan Africa, where an estimated 90% of cases occur. The key features of CM are a deep, unarousable coma that persists for longer than 1 h in patients with peripheral Plasmodium falciparum and no other explanation for encephalopathy. Significant research efforts on CM in the last few decades have focused on unravelling the molecular underpinnings of the disease pathogenesis and the identification of potential targets for therapeutic or pharmacologic intervention. These efforts have been greatly aided by the generation and study of mouse models of CM, which have provided great insights into key events of CM pathogenesis, revealed an interesting interplay of host versus parasite factors that determine the progression of malaria to severe disease and exposed possible targets for therapeutic intervention in severe disease.
Main Body
This paper reviews our current understanding of the pathogenic and immunologic factors involved in CM. We present the current view of the roles of certain gene products e.g., the var gene, ABCA-1, ICAM-1, TNF-alpha, CD-36, PfEMP-1 and G6PD, in CM pathogenesis. We also present alterations in the blood–brain barrier as a consequence of disease proliferation as well as complicated host and parasite interactions, including the T-cell immune reaction, reduced deformation of erythrocytes and cytoadherence. We further looked at recent advances in cerebral malaria treatment interventions by emphasizing on biomarkers, new diagnostic tools and emerging therapeutic options.
Conclusion
Finally, we discuss how the current understanding of some of these pathogenic and immunologic factors could inform the development of novel therapeutic interventions to fight CM.
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Ferreira NS, Mathias JLS, Albuquerque SRL, Almeida ACG, Dantas AC, Anselmo FC, Lima ES, Lacerda MVG, Nogueira PA, Ramasawmy R, Gonçalves MS, Moura Neto JP. Duffy blood system and G6PD genetic variants in vivax malaria patients from Manaus, Amazonas, Brazil. Malar J 2022; 21:144. [PMID: 35527254 PMCID: PMC9080172 DOI: 10.1186/s12936-022-04165-y] [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: 07/31/2021] [Accepted: 04/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Over a third of the world’s population is at risk of Plasmodium vivax-induced malaria. The unique aspect of the parasite’s biology and interactions with the human host make it harder to control and eliminate the disease. Glucose-6-phosphate dehydrogenase (G6PD) deficiency and Duffy-negative blood groups are two red blood cell (RBC) variations that can confer protection against malaria. Methods Molecular genotyping of G6PD and Duffy variants was performed in 225 unrelated patients (97 with uncomplicated and 128 with severe vivax malaria) recruited at a Reference Centre for Infectious Diseases in Manaus. G6PD and Duffy variants characterizations were performed using Real Time PCR (qPCR) and PCR–RFLP, respectively. Results The Duffy blood group system showed a phenotypic distribution Fy(a + b−) of 70 (31.1%), Fy(a + b +) 96 (42.7%), Fy(a−b +) 56 (24.9%) and Fy(a−b−) 1 (0.44%.) The genotype FY*A/FY*B was predominant in both uncomplicated (45.3%) and severe malaria (39.2%). Only one Duffy phenotype Fy(a-b) was found and this involved uncomplicated vivax malaria. The G6PD c.202G > A variant was found in 11 (4.88%) females and 18 (8.0%) males, while c.376A > G was found in 20 females (8.88%) and 23 (10.22%) male patients. When combined GATA mutated and c.202G > A and c.376A > G mutated, was observed at a lower frequency in uncomplicated (3.7%) in comparison to severe malaria (37.9%). The phenotype Fy(a−b +) (p = 0.022) with FY*B/FY*B (p = 0.015) genotype correlated with higher parasitaemia. Conclusions A high prevalence of G6PD c202G > A and c.376A > G and Duffy variants is observed in Manaus, an endemic area for vivax malaria. In addition, this study reports for the first time the Duffy null phenotype Fy(a-b-) in the population of the Amazonas state. Moreover, it is understood that the relationship between G6PD and Duffy variants can modify clinical symptoms in malaria caused by P. vivax and this deserves to be further investigated and explored among this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04165-y.
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Grobusch MP, Rodríguez-Morales AJ, Schlagenhauf P. The Primaquine Problem-and the Solution? Point-of-care Diagnostics for Glucose 6-Phosphate Dehydrogenase Deficiency. Clin Infect Dis 2020; 69:1443-1445. [PMID: 30783651 DOI: 10.1093/cid/ciz124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/08/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - Alfonso J Rodríguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Risaralda, Colombia
| | - Patricia Schlagenhauf
- University of Zürich, World Health Organization Collaborating Centre for Travel Medicine, Travel Clinic and Department of Public Health, Epidemiology, Biostatistics and Prevention Institute, Switzerland
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Ferreira AIC, Brandão de Mattos CC, Frederico FB, Bernardo CR, de Almeida Junior GC, Siqueira RC, Meira-Strejevitch CS, Pereira-Chioccola VL, de Mattos LC. Duffy blood group system and ocular toxoplasmosis. INFECTION GENETICS AND EVOLUTION 2020; 85:104430. [PMID: 32565360 DOI: 10.1016/j.meegid.2020.104430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
Duffy blood group phenotypes [Fy(a + b-), Fy(a-b+), Fy(a + b+), Fy(a-b-)], characterized by the expression of Fya, and Fyb antigens, are present in red blood cells. Therefore, we hypothesize that the non-hematopoietic expression of these antigens might influence cell invasion by T. gondii. 576 consecutive patients from both genders were enrolled. The presumed OT clinical diagnosis was performed. Duffy phenotyping was performed by hemagglutination in gel columns and for the correct molecular characterization Fy(a-b-) phenotype, using PCR-RFLP. Anti-T. gondii IgG antibodies were detected by ELISA. Chi-square, Fisher's exact tests were used to compare the proportions. OT was present in 22.9% (n = 132) and absent in 77.1% (n = 444) of patients. The frequencies of anti-T. gondii IgG antibodies were higher in OT (127/132, 96.2%) than those without this disease (321/444, 72.3%) (p < .0001). None of the Duffy antigens or phenotypes were associated with T. gondii infection (χ2: 2.222, GL: 3, p = .5276) as well as the risk of OT (χ2: 0.771, GL: 3, p = .8566). Duffy blood group system phenotypes and their antigens do not constitute risk factors for infection by T. gondii infection and the development of OT.
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Affiliation(s)
- Ana Iara Costa Ferreira
- Universidade Federal de Roraima. Brazil; Faculdade de Medicina de São Jose do Rio Preto, SP, Brazil
| | | | - Fábio Batista Frederico
- Ophthalmology Outpatient Clinic of Fundação Faculdade Regional de Medicina de São José do Rio Preto, SP, Brazil
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DePina AJ, Pires CM, Andrade AJB, Dia AK, Moreira AL, Ferreira MCM, Correia AJ, Faye O, Seck I, Niang EHA. The prevalence of glucose-6-phosphate dehydrogenase deficiency in the Cape Verdean population in the context of malaria elimination. PLoS One 2020; 15:e0229574. [PMID: 32176714 PMCID: PMC7075545 DOI: 10.1371/journal.pone.0229574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 02/10/2020] [Indexed: 11/19/2022] Open
Abstract
Cabo Verde aims to eliminate malaria by 2020. In the country, Plasmodium falciparum had been the main parasite responsible for indigenous cases and primaquine is the first line treatment of cases and for radical cure. However, the lack of knowledge of the national prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency may be one of the constraints to the malaria elimination process. Hence, this first study determines the prevalence of G6PD deficiency (G6PDd) in the archipelago. Blood samples were collected from patients who voluntarily agreed to participate in the study, in the health facilities of eight municipalities on four islands, tested with G6PD CareStart ™ deficiency Rapid Diagnosis Test (RDT). All subjects found to be G6PDd by RDT then underwent enzyme quantification by spectrophotometry. Descriptive statistics and inferences were done using SPSS 22.0 software. A total of 5.062 blood samples were collected, in majority from female patients (78.0%) and in Praia (35.6%). The RDT revealed the prevalence of G6PD deficiency in 2.5% (125/5062) of the general population, being higher in males (5.6%) than in females (1,6%). The highest G6PDd prevalence was recorded in São Filipe, Fogo, (5.4%), while in Boavista no case was detected. The G6PDd activity quantification shown a higher number of partially deficient and deficient males (respectively n = 26 and n = 22) compared to females (respectively n = 18 and n = 7), but more normal females (n = 35) than males (n = 11). According to the WHO classification, most of the G6PDd cases belongs to the class V (34.5%), while the Classes II and I were the less represented with respectively 5.8% and zero cases. This study in Cabo Verde determined the G6PDd prevalence in the population, relatively low compared to other African countries. Further studies are needed to characterize and genotyping the G6PD variants in the country.
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Affiliation(s)
- Adilson José DePina
- Programa Eliminação do Paludismo, CCS-SIDA, Ministério da Saúde e da Segurança Social, Praia, Cabo Verde
- Ecole Doctorale des Sciences de la Vie, de la Santé et de l´Environnement (ED-SEV), Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - Cecílio Mendes Pires
- Laboratório de Análises Clínicas, Hospital Regional de Santiago Norte, Assomada, Cabo Verde
| | | | - Abdoulaye Kane Dia
- Ecole Doctorale des Sciences de la Vie, de la Santé et de l´Environnement (ED-SEV), Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
- Laboratoire d’Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - António Lima Moreira
- Programa Nacional de Luta contra o Paludismo, Ministério da Saúde e da Segurança Social, Praia, Cabo Verde
| | | | | | - Ousmane Faye
- Laboratoire d’Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - Ibrahima Seck
- Institut de Santé et Développement, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - El Hadji Amadou Niang
- Laboratoire d’Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
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