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Abagero BR, Rama R, Obeid A, Tolosa T, Lukas B, Teka T, Tesfaye D, Lo E, Yewhalaw D. Detection of Duffy blood group genotypes and submicroscopic Plasmodium infections using molecular diagnostic assays in febrile malaria patients. Malar J 2024; 23:194. [PMID: 38902674 PMCID: PMC11191254 DOI: 10.1186/s12936-024-04875-5] [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: 10/10/2023] [Accepted: 02/09/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Malaria remains a severe parasitic disease, posing a significant threat to public health and hindering economic development in sub-Saharan Africa. Ethiopia, a malaria endemic country, is facing a resurgence of the disease with a steadily rising incidence. Conventional diagnostic methods, such as microscopy, have become less effective due to low parasite density, particularly among Duffy-negative human populations in Africa. To develop comprehensive control strategies, it is crucial to generate data on the distribution and clinical occurrence of Plasmodium vivax and Plasmodium falciparum infections in regions where the disease is prevalent. This study assessed Plasmodium infections and Duffy antigen genotypes in febrile patients in Ethiopia. METHODS Three hundred febrile patients visiting four health facilities in Jimma town of southwestern Ethiopia were randomly selected during the malaria transmission season (Apr-Oct). Sociodemographic information was collected, and microscopic examination was performed for all study participants. Plasmodium species and parasitaemia as well as the Duffy genotype were assessed by quantitative polymerase chain reaction (qPCR) for all samples. Data were analysed using Fisher's exact test and kappa statistics. RESULTS The Plasmodium infection rate by qPCR was 16% (48/300) among febrile patients, of which 19 (39.6%) were P. vivax, 25 (52.1%) were P. falciparum, and 4 (8.3%) were mixed (P. vivax and P. falciparum) infections. Among the 48 qPCR-positive samples, 39 (13%) were negative by microscopy. The results of bivariate logistic regression analysis showed that agriculture-related occupation, relapse and recurrence were significantly associated with Plasmodium infection (P < 0.001). Of the 300 febrile patients, 85 (28.3%) were Duffy negative, of whom two had P. vivax, six had P. falciparum, and one had mixed infections. Except for one patient with P. falciparum infection, Plasmodium infections in Duffy-negative individuals were all submicroscopic with low parasitaemia. CONCLUSIONS The present study revealed a high prevalence of submicroscopic malaria infections. Plasmodium vivax infections in Duffy-negative individuals were not detected due to low parasitaemia. In this study, an improved molecular diagnostic tool was used to detect and characterize Plasmodium infections, with the goal of quantifying P. vivax infection in Duffy-negative individuals. Advanced molecular diagnostic techniques, such as multiplex real-time PCR, loop-mediated isothermal amplification (LAMP), and CRISPR-based diagnostic methods. These techniques offer increased sensitivity, specificity, and the ability to detect low-parasite-density infections compared to the employed methodologies.
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Affiliation(s)
- Beka R Abagero
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Rei Rama
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Abdulghani Obeid
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Tirusew Tolosa
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Biniyam Lukas
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Taye Teka
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Daniel Tesfaye
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia
| | - Eugenia Lo
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, USA.
- Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Centre, Jimma University, Jimma, Ethiopia.
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Abagero BR, Rama R, Obeid A, Tolossa T, Legese F, Lo E, Yewhalaw D. Detection of Duffy Blood Group Genotypes and Submicroscopic Plasmodium Infections Using Molecular Diagnostic Assays in Febrile Malaria Patients. RESEARCH SQUARE 2023:rs.3.rs-3706814. [PMID: 38105972 PMCID: PMC10723540 DOI: 10.21203/rs.3.rs-3706814/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Malaria remains a severe parasitic disease, posing a significant threat to public health and hindering economic development in sub-Saharan Africa. Ethiopia, a malaria endemic country, is facing a resurgence of the disease with a steadily rising incidence. Conventional diagnostic methods, such asmicroscopy, have become less effective due to low parasite density, particularly among Duffy-negative human populations in Africa. To develop comprehensive control strategies, it is crucial to generate data on the distribution and clinical occurrence of Plasmodium vivax and P. falciparum infections in regions where the disease is prevalent. This study assessed Plasmodium infections and Duffy antigen genotypes in febrile patients in Ethiopia. Methods Three hundred febrile patients visiting four health facilities in Jimma town of southwestern Ethiopia were randomly selected during the malaria transmission season (Apr-Oct). Sociodemographic information was collected, and microscopic examination was performed for all study participants. Plasmodiumspecies and parasitemia as well as the Duffy genotype were assessed by quantitative polymerase chain reaction (qPCR) for all samples. Data were analyzed using Fisher's exact test and kappa statistics. Results The Plasmodium infection rate by qPCR was 16% (48/300) among febrile patients, of which 19 (39.6%) were P. vivax, 25 (52.1%) were P. falciparum, and 4 (8.3%) were mixed (P. vivax and P. falciparum) infections. Among the 48 qPCR-positive samples, 39 (13%) were negative by microscopy. The results of bivariate logistic regression analysis showed that agriculture-related occupation, relapse and recurrence were significantly associated withPlasmodium infection (P<0.001). Of the 300 febrile patients, 85 (28.3%) were Duffy negative, of whom two had P. vivax, six had P. falciparum, and one had mixed infections.Except for one patient with P. falciparum infection, Plasmodium infections in Duffy-negative individuals were all submicroscopic with low parasitemia. Conclusions The present study revealed a high prevalence of submicroscopic malaria infections. Plasmodium vivax infections in Duffy-negative individuals were not detected due to low parasitemia. Here, we recommend an improved molecular diagnostic tool to detect and characterize plasmodium infections, with the goal of quantifyingP. vivax infection in Duffy-negative individuals.
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Affiliation(s)
- Beka Raya Abagero
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA
| | - Rei Rama
- University of North Carolina at Charlotte
| | | | | | | | - Eugenia Lo
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA
| | - Delenasaw Yewhalaw
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
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Picón-Jaimes YA, Lozada-Martinez ID, Orozco-Chinome JE, Molina-Franky J, Acevedo-Lopez D, Acevedo-Lopez N, Bolaño-Romero MP, Visconti-Lopez FJ, Bonilla-Aldana DK, Rodriguez-Morales AJ. Relationship between Duffy Genotype/Phenotype and Prevalence of Plasmodium vivax Infection: A Systematic Review. Trop Med Infect Dis 2023; 8:463. [PMID: 37888591 PMCID: PMC10610806 DOI: 10.3390/tropicalmed8100463] [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: 07/24/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023] Open
Abstract
The Duffy protein, a transmembrane molecule, functions as a receptor for various chemokines and facilitates attachment between the reticulocyte and the Plasmodium Duffy antigen-binding protein. Duffy expression correlates with the Duffy receptor gene for the chemokine, located on chromosome 1, and exhibits geographical variability worldwide. Traditionally, researchers have described the Duffy negative genotype as a protective factor against Plasmodium vivax infection. However, recent studies suggest that this microorganism's evolution could potentially diminish this protective effect. Nevertheless, there is currently insufficient global data to demonstrate this phenomenon. This study aimed to evaluate the relationship between the Duffy genotype/phenotype and the prevalence of P. vivax infection. The protocol for the systematic review was registered in PROSPERO as CRD42022353427 and involved reviewing published studies from 2012 to 2022. The Medline/PubMed, Web of Science, Scopus, and SciELO databases were consulted. Assessments of study quality were conducted using the STROBE and GRADE tools. A total of 34 studies were included, with Africa accounting for the majority of recorded studies. The results varied significantly regarding the relationship between the Duffy genotype/phenotype and P. vivax invasion. Some studies predominantly featured the negative Duffy genotype yet reported no malaria cases. Other studies identified minor percentages of infections. Conversely, certain studies observed a higher prevalence (99%) of Duffy-negative individuals infected with P. vivax. In conclusion, this systematic review found that the homozygous Duffy genotype positive for the A allele (FY*A/*A) is associated with a higher incidence of P. vivax infection. Furthermore, the negative Duffy genotype does not confer protection against vivax malaria.
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Affiliation(s)
| | - Ivan David Lozada-Martinez
- Epidemiology Program, Department of Graduate Studies in Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga 44005, Colombia;
| | - Javier Esteban Orozco-Chinome
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá 10002, Colombia; (J.E.O.-C.); (N.A.-L.); (M.P.B.-R.)
| | - Jessica Molina-Franky
- Department of Inmunology and Theranostics, Arthur Riggs Diabetes and Metabolism Research Institute, Beckman Research Institute of the City of Hope, Duarte, CA 91007, USA;
- Molecular Biology and Inmunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 10001, Colombia
| | - Domenica Acevedo-Lopez
- School of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira 660003, Colombia;
| | - Nicole Acevedo-Lopez
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá 10002, Colombia; (J.E.O.-C.); (N.A.-L.); (M.P.B.-R.)
| | - Maria Paz Bolaño-Romero
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá 10002, Colombia; (J.E.O.-C.); (N.A.-L.); (M.P.B.-R.)
| | | | | | - Alfonso J. Rodriguez-Morales
- Clinical Epidemiology and Biostatistics Master Program, Universidad Cientifica del Sur, Lima 15067, Peru;
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut P.O. Box 36, Lebanon
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Picón-Jaimes YA, Lozada-Martinez ID, Forero Buelvas MC, Ardila Sarmiento AF, Serrano Baez GA, Nazareno Erazo DY, Cuastumal Martínez JD, Ruiz-Gutierrez FK, Carreño Barrera VD. Evolution of Plasmodium vivax and resistance patterns for infection based on Duffy genotype and phenotype. LE INFEZIONI IN MEDICINA 2023; 31:350-358. [PMID: 37701383 PMCID: PMC10495050 DOI: 10.53854/liim-3103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/04/2023] [Indexed: 09/14/2023]
Abstract
The Duffy protein, a transmembrane molecule, acts as a receptor for various chemokines and facilitates binding between reticulocytes and the Plasmodium Duffy antigen binding protein. Duffy expression is associated with the Duffy chemokine receptor antigen genotype on chromosome 1 and exhibits variation across different geographic regions. Traditionally, the Duffy negative genotype and phenotype have been described to confer a certain level of protection against infection and symptom development. However, recent data suggest a shift in this behavior, with significantly higher prevalence observed in individuals with Duffy negative genotype or phenotype. Given that malaria is an endemic vector-borne disease in regions of Asia, Africa, and Latin America, posing a substantial global burden of disease and prioritizing public and global health, identifying evolutionary changes in infection and resistance patterns holds great importance for the design of strategies and reevaluation of conventional interventions. Hence, the aim of this review was to analyze the evolution of Plasmodium vivax and infection resistance patterns based on Duffy genotype and phenotype. The distribution of genotypes, phenotypes, and polymorphisms of P. vivax ligands and erythrocyte receptors varies geographically, notably resistance patterns of this microorganism in individuals with Duffy negative genotype and phenotype have significantly changed compared to studies conducted 30 years ago. The prevalence of vivax malaria in individuals with a Duffy negative status can reach up to 100%. Consequently, prioritizing research on this topic is essential for public health.
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Affiliation(s)
| | - Ivan David Lozada-Martinez
- Epidemiology Program, Department of Graduate Studies in Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Abebe A, Bouyssou I, Mabilotte S, Dugassa S, Assefa A, Juliano JJ, Lo E, Menard D, Golassa L. Potential hidden Plasmodium vivax malaria reservoirs from low parasitemia Duffy-negative Ethiopians: Molecular evidence. PLoS Negl Trop Dis 2023; 17:e0011326. [PMID: 37399221 PMCID: PMC10348516 DOI: 10.1371/journal.pntd.0011326] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/14/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The interaction between the Plasmodium vivax Duffy-binding protein and the corresponding Duffy Antigen Receptor for Chemokines (DARC) is primarily responsible for the invasion of reticulocytes by P. vivax. The Duffy-negative host phenotype, highly prevalent in sub-Saharan Africa, is caused by a single point mutation in the GATA-1 transcription factor binding site of the DARC gene promoter. The aim of this study was to assess the Duffy status of patients with P. vivax infection from different study sites in Ethiopia. METHODS A cross-sectional study was conducted from February 2021 to September 2022 at five varying eco-epidemiological malaria endemic sites in Ethiopia. Outpatients who were diagnosed with P. vivax infection (pure and mixed P. vivax/P. falciparum) by microscopy and Rapid Diagnostic Test (RDT) were subjected to PCR genotyping at the DARC promoter. The associations between P. vivax infection, host genotypes and other factors were evaluated. RESULT In total, 361 patients with P. vivax infection were included in the study. Patients with pure P. vivax infections accounted for 89.8% (324/361), while the remaining 10.2% (37/361) had mixed P. vivax/P. falciparum infections. About 95.6% (345/361) of the participants were Duffy-positives (21.2% homozygous and 78.8%, heterozygous) and 4.4% (16/361) were Duffy-negatives. The mean asexual parasite density in homozygous and heterozygous Duffy-positives was 12,165 p/μl (IQR25-75: 1,640-24,234 p/μl) and11,655 p/μl (IQR25-75: 1,676-14,065 p/μl), respectively, significantly higher than that in Duffy-negatives (1,227p/μl; IQR25-75: 539-1,732p/μl). CONCLUSION This study confirms that Duffy-negativity does not provide complete protection against P. vivax infection. The development of P. vivax-specific elimination strategies, including alternative antimalarial vaccines should be facilitated by a better understanding of the epidemiological landscape of vivax malaria in Africa. More importantly, low parasitemia associated with P. vivax infections in Duffy-negative patients may represent hidden reservoirs of transmission in Ethiopia.
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Affiliation(s)
- Abnet Abebe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Isabelle Bouyssou
- Institut Pasteur, Université Paris Cité, Malaria Genetics and Resistance Unit, INSERM U1201, F-75015 Paris, France
- Sorbonne Université, Collège Doctoral ED 515 Complexité du Vivant, Paris, France
| | - Solenne Mabilotte
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Dynamics of Host-Pathogen Interactions, F-67000 Strasbourg, France
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jonathan J. Juliano
- Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eugenia Lo
- Department of Biological Sciences, Bioinformatics Research Center, University of North Carolina at Charlotte, United States of America
| | - Didier Menard
- Institut Pasteur, Université Paris Cité, Malaria Genetics and Resistance Unit, INSERM U1201, F-75015 Paris, France
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Dynamics of Host-Pathogen Interactions, F-67000 Strasbourg, France
- Institut Pasteur, Université Paris Cité, Malaria Parasite Biology and Vaccines Unit, Paris, France
- CHU Strasbourg, Laboratory of Parasitology and Medical Mycology, Strasbourg, France
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
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Boundenga L, Bignoumba M, Dibakou SE, Mombo LE, Moukagni-Mussadji CJ, Wora DM, Kassa-Kassa F, Bisseye C, Onanga R. Decrease on malaria clinical cases from 2017 to 2019 in Franceville, Southeast Gabon, Central Africa. J Public Health Afr 2023; 14:1865. [PMID: 37229438 PMCID: PMC10204601 DOI: 10.4081/jphia.2023.1865] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/05/2022] [Indexed: 05/27/2023] Open
Abstract
Background In Gabon, malaria remains a major public health problem. All malaria cases with axillary temperature ≥ 37.5°C with a parasites density ≥ 1200/μL are serious cases and must be treated as a medical emergency. Thus, early diagnosis is essential for successful treatment. Because of the impact of malaria on the population, the surveillance of malaria infections in hospitals is urgently needed. The aim of this study was to to assess of clinical cases of malaria in a private health structure in Franceville between 2017 and 2019. Methods For that, we conducted a retrospective study using data on malaria cases recorded in a private medical analysis laboratory in Franceville, southeast Gabon. Malaria was diagnosed in this laboratory using a Rapid Diagnostic Test and confirmed by microscopic analysis. Results Analysis of 2518 patient forms revealed an increase in malaria prevalence in Franceville between 2017-2019. The global clinical cases was 26.1% (658/2015). Children under 5 years (44.0%) and patients aged 5-14 years (40.1%) were more affected than patients aged ≥15 years (18.8%, P=0.0001). Malaria infection was also significantly dependent on season and gender. We observed at least three Plasmodium species and the predominant Plasmodium species was P. falciparum 80.0%, followed by P. ovale (19.5%) and P. malariae (17.8%). Conclusion Our study showed that malaria remains a public health priority for the population of Franceville and that the prevalence of clinical cases of malaria at the laboratory decrease between 2017 and 2019. Our results highlight the need for strategies to control malaria in Franceville, adapted to epidemiological contexts and environmental constraint.
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Affiliation(s)
- Larson Boundenga
- International Centre of Medical Research of Franceville (CIRMF), Franceville, Gabon
- Department of Anthropology, University of Durham, UK
| | - Michelle Bignoumba
- International Centre of Medical Research of Franceville (CIRMF), Franceville, Gabon
| | - Serge-Ely Dibakou
- International Centre of Medical Research of Franceville (CIRMF), Franceville, Gabon
| | - Landry Erik Mombo
- Cellular Biology (LABMC), Masuku University of Science and Technology, Franceville, Gabon
| | | | | | - Fabrice Kassa-Kassa
- International Centre of Medical Research of Franceville (CIRMF), Franceville, Gabon
| | - Cyrille Bisseye
- Cellular Biology (LABMC), Masuku University of Science and Technology, Franceville, Gabon
| | - Richard Onanga
- International Centre of Medical Research of Franceville (CIRMF), Franceville, Gabon
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Molina-Franky J, Reyes C, Picón Jaimes YA, Kalkum M, Patarroyo MA. The Black Box of Cellular and Molecular Events of Plasmodium vivax Merozoite Invasion into Reticulocytes. Int J Mol Sci 2022; 23:ijms232314528. [PMID: 36498854 PMCID: PMC9739029 DOI: 10.3390/ijms232314528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Plasmodium vivax is the most widely distributed malaria parasite affecting humans worldwide, causing ~5 million cases yearly. Despite the disease's extensive burden, there are gaps in the knowledge of the pathophysiological mechanisms by which P. vivax invades reticulocytes. In contrast, this crucial step is better understood for P. falciparum, the less widely distributed but more often fatal malaria parasite. This discrepancy is due to the difficulty of studying P. vivax's exclusive invasion of reticulocytes, which represent 1-2% of circulating cells. Its accurate targeting mechanism has not yet been clarified, hindering the establishment of long-term continuous in vitro culture systems. So far, only three reticulocyte invasion pathways have been characterised based on parasite interactions with DARC, TfR1 and CD98 host proteins. However, exposing the parasite's alternative invasion mechanisms is currently being considered, opening up a large field for exploring the entry receptors used by P. vivax for invading host cells. New methods must be developed to ensure better understanding of the parasite to control malarial transmission and to eradicate the disease. Here, we review the current state of knowledge on cellular and molecular mechanisms of P. vivax's merozoite invasion to contribute to a better understanding of the parasite's biology, pathogenesis and epidemiology.
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Affiliation(s)
- Jessica Molina-Franky
- Department of Immunology and Theranostics, Arthur Riggs Diabetes and Metabolism Research Institute, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 112111, Colombia
- Biotechnology, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, Colombia
| | - César Reyes
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 112111, Colombia
- Biotechnology, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, Colombia
- Animal Sciences Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá 111166, Colombia
| | | | - Markus Kalkum
- Department of Immunology and Theranostics, Arthur Riggs Diabetes and Metabolism Research Institute, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA
- Correspondence: (M.K.); (M.A.P.)
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 112111, Colombia
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia
- Correspondence: (M.K.); (M.A.P.)
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Abate A, Bouyssou I, Mabilotte S, Doderer-Lang C, Dembele L, Menard D, Golassa L. Vivax malaria in Duffy-negative patients shows invariably low asexual parasitaemia: implication towards malaria control in Ethiopia. Malar J 2022; 21:230. [PMID: 35915453 PMCID: PMC9341100 DOI: 10.1186/s12936-022-04250-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The increase in detections of Plasmodium vivax infection in Duffy-negative individuals in Africa has challenged the dogma establishing the unique P. vivax Duffy Binding Protein-Duffy antigen receptor for chemokines (PvDBP-DARC) pathway used by P. vivax merozoites to invade reticulocytes. Information on the impact of Duffy antigen polymorphisms on the epidemiology of P. vivax malaria remains elusive. The objective of this study was to determine the distribution of asexual parasitaemia of P. vivax according to the Duffy antigen polymorphisms in Ethiopia. METHODS DNA was extracted from dried blood spots (DBS) collected from prospectively recruited 138 P. vivax-infected patients from health centres. The identification and estimation of P. vivax asexual parasitaemia were performed by microscopic examination and quantitative real-time polymerase chain reaction (PCR). Duffy genotyping was conducted by DNA sequencing in a total of 138 P.vivax infected samples. RESULTS The proportion of Duffy-negatives (FY*BES/FY*BES) in P. vivax infected patients was 2.9% (4/138). Duffy genotype FY*B/FY*BES (48.6%) was the most common, followed by FY*A/FY*BES genotype (25.4%). In one patient, the FY*02 W.01/FY*02 N.01 genotype conferring a weak expression of the Fyb antigen was observed. All P.vivax infected Duffy-negative patients showed low asexual parasitaemia (≤ 110 parasites/µL). The median P. vivax parasitaemia in Duffy-negative patients (53 parasites/µL) was significantly lower than those found in homozygous and heterozygous individuals (P < 0.0001). CONCLUSION Plasmodium vivax in Duffy-negative patients shows invariably low asexual parasitaemia. This finding suggests that the pathway used by P. vivax to invade Duffy-negative reticulocytes is much less efficient than that used in Duffy-positives. Moreover, the low asexual parasitaemia observed in Duffy-negative individuals could constitute an 'undetected silent reservoir', thus likely delaying the elimination of vivax malaria in Ethiopia.
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Affiliation(s)
- Andargie Abate
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Isabelle Bouyssou
- Malaria Genetics and Resistance Unit, Institut Pasteur, INSERM U1201, Paris, France
- ED515 Complexité du Vivant, Sorbonne Université, Paris, France
| | - Solenne Mabilotte
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Cecile Doderer-Lang
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Laurent Dembele
- Malaria Research and Training Centre (MRTC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Didier Menard
- Malaria Genetics and Resistance Unit, Institut Pasteur, INSERM U1201, Paris, France
- Institute of Parasitology and Tropical Diseases, UR7292 Dynamics of Host-Pathogen Interactions, Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
- Laboratory of Parasitology and Medical Mycology, Strasbourg University Hospital, Strasbourg, France
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Nundu SS, Culleton R, Simpson SV, Arima H, Muyembe JJ, Mita T, Ahuka S, Yamamoto T. Malaria parasite species composition of Plasmodium infections among asymptomatic and symptomatic school-age children in rural and urban areas of Kinshasa, Democratic Republic of Congo. Malar J 2021; 20:389. [PMID: 34600558 PMCID: PMC8487491 DOI: 10.1186/s12936-021-03919-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Malaria remains a major public health concern in the Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC. METHODS A total of 634 (427 asymptomatic and 207 symptomatic) blood samples collected from school-age children aged 6 to 14 years were analysed by microscopy, RDT and Nested-PCR. RESULTS The overall prevalence of Plasmodium spp. by microscopy, RDT and PCR was 33%, 42% and 62% among asymptomatic children and 59%, 64% and 95% in symptomatic children, respectively. The prevalence of Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale spp. by PCR was 58%, 20% and 11% among asymptomatic and 93%, 13% and 16% in symptomatic children, respectively. Among P. ovale spp., P. ovale curtisi, P. ovale wallikeri and mixed P. ovale curtisi + P. ovale wallikeri accounted for 75%, 24% and 1% of infections, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p < 0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p < 0.001). Amongst asymptomatic malaria parasite carriers, 43% and 16% of children harboured mixed Plasmodium with P. falciparum infections in the rural and the urban areas, respectively, whereas in symptomatic malaria infections, it was 22% and 26%, respectively. Few children carried single infections of P. malariae (2.2%) and P. ovale spp. (1.9%). CONCLUSION School-age children are at significant risk from both asymptomatic and symptomatic malaria infections. Continuous systematic screening and treatment of school-age children in high-transmission settings is needed.
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Affiliation(s)
- Sabin S Nundu
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Ehime, Japan.
| | - Shirley V Simpson
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Jean-Jacques Muyembe
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Toshihiro Mita
- Department of Tropical Medicine and Parasitology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Steve Ahuka
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Nagasaki University, Nagasaki, Japan
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10
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Abstract
J. Kevin Baird and colleagues, examine and discuss the estimated global burden of vivax malaria and it's biological, clinical, and public health complexity.
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Affiliation(s)
- Katherine E. Battle
- Institute for Disease Modeling, Seattle, Washington, United States of America
| | - J. Kevin Baird
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute of Molecular Biology, Jakarta, Indonesia
- Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail:
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11
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The epidemiology of Plasmodium vivax among adults in the Democratic Republic of the Congo. Nat Commun 2021; 12:4169. [PMID: 34234124 PMCID: PMC8263614 DOI: 10.1038/s41467-021-24216-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/01/2021] [Indexed: 11/08/2022] Open
Abstract
Reports of P. vivax infections among Duffy-negative hosts have accumulated throughout sub-Saharan Africa. Despite this growing body of evidence, no nationally representative epidemiological surveys of P. vivax in sub-Saharan Africa have been performed. To overcome this gap in knowledge, we screened over 17,000 adults in the Democratic Republic of the Congo (DRC) for P. vivax using samples from the 2013-2014 Demographic Health Survey. Overall, we found a 2.97% (95% CI: 2.28%, 3.65%) prevalence of P. vivax infections across the DRC. Infections were associated with few risk-factors and demonstrated a relatively flat distribution of prevalence across space with focal regions of relatively higher prevalence in the north and northeast. Mitochondrial genomes suggested that DRC P. vivax were distinct from circulating non-human ape strains and an ancestral European P. vivax strain, and instead may be part of a separate contemporary clade. Our findings suggest P. vivax is diffusely spread across the DRC at a low prevalence, which may be associated with long-term carriage of low parasitemia, frequent relapses, or a general pool of infections with limited forward propagation.
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12
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The Pan African Vivax and Ovale Network (PAVON): Refocusing on Plasmodium vivax, ovale and asymptomatic malaria in sub-Saharan Africa. Parasitol Int 2021; 84:102415. [PMID: 34216801 DOI: 10.1016/j.parint.2021.102415] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/20/2022]
Abstract
The recent World Malaria report shows that progress in malaria elimination has stalled. Current data acquisition by NMCPs depend on passive case detection and clinical reports focused mainly on Plasmodium falciparum (Pf). In recent times, several countries in sub-Saharan Africa have reported cases of Plasmodium vivax (Pv) with a considerable number being Duffy negative. The burden of Pv and Plasmodium ovale (Po) appear to be more than acknowledged. Similarly, the contribution of asymptomatic malaria in transmission is hardly considered by NMCPs in Africa. Inclusion of these as targets in malaria elimination agenda is necessary to achieve elimination goal, as these harbor hypnozoites. The Pan African Vivax and Ovale Network (PAVON) is a new consortium of African Scientists working in Africa on the transmission profile of Pv and Po. The group collaborates with African NMCPs to train in Plasmodium molecular diagnostics, microscopy, and interpretation of molecular data from active surveys to translate into policy. Details of the mission, rational and modus operandi of the group are outlined.
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13
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Liu P, Shen L, Wang S, Qin P, Si Y, Pan M, Zeng W, Qin Y, Chen X, Zhang Y, Li C, Xiang Z, Menezes L, Huang Y, Cui L, Yang Z. Increasing proportions of relapsing parasite species among imported malaria in China's Guangxi Province from Western and Central Africa. Travel Med Infect Dis 2021; 43:102130. [PMID: 34166802 DOI: 10.1016/j.tmaid.2021.102130] [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] [Received: 05/17/2020] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Travel-related malaria in non-endemic areas returning from endemic areas presents important challenges to diagnosis and treatment. Imported malaria to newly malaria-free countries poses further threats of malaria re-introduction and potential resurgence. For those traveling to places with high Plasmodium falciparum prevalence, prophylaxis against this parasite is recommended, whereas causal prophylaxis against relapsing malaria is often overlooked. METHODS We analyzed a cluster of imported malaria among febrile patients in Shanglin County, Guangxi Province, China, who had recent travel histories to Western and Central Africa. Malaria was diagnosed by microscopy and subsequently confirmed by species- and subspecies-specific PCR. Plasmodium vivax was genotyped using a barcode consisting of 42 single nucleotide polymorphisms. RESULTS Investigations of 344 PCR-confirmed malaria cases revealed that in addition to Plasmodium falciparum being the major parasite species, the relapsing parasites Plasmodium ovale and P. vivax accounted for ~40% of these imported cases. Of the 114 P. ovale infections, 65.8% and 34.2% were P. ovale curtisi and P. ovale wallikeri, respectively, with the two subspecies having a ~2:1 ratio in both Western and Central Africa. Phylogenetic analysis of 14 P. vivax isolates using a genetic barcode demonstrated that 11 formed a distinct clade from P. vivax populations from Eastern Africa. CONCLUSION This study provides support for active P. vivax transmission in areas with the predominant Duffy-negative blood group. With relapsing malaria making a substantial proportion of the imported malaria, causal prophylaxis should be advocated to travelers with a travel destination to Western and Central Africa.
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Affiliation(s)
- Penglu Liu
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Lijie Shen
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Siqi Wang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Pien Qin
- Shanglin County People's Hospital, Shanglin, Guangxi, 530500, China
| | - Yu Si
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Maohua Pan
- Shanglin County People's Hospital, Shanglin, Guangxi, 530500, China
| | - Weilin Zeng
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Yucheng Qin
- Shanglin County People's Hospital, Shanglin, Guangxi, 530500, China
| | - Xi Chen
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Yanmei Zhang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Cuiying Li
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Zheng Xiang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China
| | - Lynette Menezes
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 3720 Spectrum Boulevard, Suite 304, MDC84, Tampa, FL, 33612, USA
| | - Yaming Huang
- Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, 530021, China
| | - Liwang Cui
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 3720 Spectrum Boulevard, Suite 304, MDC84, Tampa, FL, 33612, USA.
| | - Zhaoqing Yang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, 650500, China.
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14
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Lo E, Russo G, Pestana K, Kepple D, Abagero BR, Dongho GBD, Gunalan K, Miller LH, Hamid MMA, Yewhalaw D, Paganotti GM. Contrasting epidemiology and genetic variation of Plasmodium vivax infecting Duffy-negative individuals across Africa. Int J Infect Dis 2021; 108:63-71. [PMID: 33991680 DOI: 10.1016/j.ijid.2021.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Plasmodium vivax malaria was thought to be rare in Africans who lack the Duffy blood group antigen expression. However, recent studies indicate that P. vivax can infect Duffy-negative individuals and has spread into areas of high Duffy negativity across Africa. Our study compared epidemiological and genetic features of P. vivax between African regions. METHODS A standardized approach was used to identify and quantify P. vivax from Botswana, Ethiopia, and Sudan, where Duffy-positive and Duffy-negative individuals coexist. The study involved sequencing the Duffy binding protein (DBP) gene and inferring genetic relationships among P. vivax populations across Africa. RESULTS Among 1215 febrile patients, the proportions of Duffy negativity ranged from 20-36% in East Africa to 84% in southern Africa. Average P. vivax prevalence among Duffy-negative populations ranged from 9.2% in Sudan to 86% in Botswana. Parasite density in Duffy-negative infections was significantly lower than in Duffy-positive infections. P. vivax in Duffy-negative populations were not monophyletic, with P. vivax in Duffy-negative and Duffy-positive populations sharing similar DBP haplotypes and occurring in multiple, well-supported clades. CONCLUSIONS Duffy-negative Africans are not resistant to P. vivax, and the public health significance of this should not be neglected. Our study highlights the need for a standardized approach and more resources/training directed towards the diagnosis of vivax malaria in Africa.
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Affiliation(s)
- Eugenia Lo
- Biological Sciences, University of North Carolina at Charlotte, USA.
| | - Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
| | - Kareen Pestana
- Biological Sciences, University of North Carolina at Charlotte, USA
| | - Daniel Kepple
- Biological Sciences, University of North Carolina at Charlotte, USA
| | - Beka Raya Abagero
- Tropical Infectious Disease Research Center, Jimma University, Jimma, Ethiopia
| | - Ghyslaine Bruna Djeunang Dongho
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; Evangelical University of Cameroon, Bandjoun, Cameroon
| | | | - Louis H Miller
- Laboratory of Malaria and Vector Research, NIAID/NIH, Bethesda, USA
| | - Muzamil Mahdi Abdel Hamid
- Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Delenasaw Yewhalaw
- Tropical Infectious Disease Research Center, Jimma University, Jimma, Ethiopia
| | - Giacomo Maria Paganotti
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana; Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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15
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Djeunang Dongho GB, Gunalan K, L'Episcopia M, Paganotti GM, Menegon M, Sangong RE, Georges BM, Fondop J, Severini C, Sobze MS, Miller LH, Russo G. Plasmodium vivax Infections Detected in a Large Number of Febrile Duffy-Negative Africans in Dschang, Cameroon. Am J Trop Med Hyg 2021; 104:987-992. [PMID: 33534776 DOI: 10.4269/ajtmh.20-1255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/15/2020] [Indexed: 01/09/2023] Open
Abstract
The Duffy blood group is a critical receptor for Plasmodium vivax (Pv) invasion of red blood cells, and consequently, Pv infections were considered rare in sub-Saharan Africa where the prevalence of Duffy-negativity is high. However, recently, Pv infections have been found in Duffy-negative Africans throughout the malaria transmission area of sub-Saharan Africa, raising important questions concerning the molecular composition of these Pv clones and the red blood cell receptors that facilitate their invasion. Here, we describe an unusually high number of Pv infections in febrile Duffy-negative Africans in Dschang, Cameroon (177 of 500 outpatients), as compared with Santchou (two of 400 outpatients) and Kye'-Ossi (two of 101 outpatients), other areas in Cameroon. In the discussion, we speculate on the possible reasons why Dschang might account for the unusually large numbers of Pv infections in Duffy-negative individuals living there.
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Affiliation(s)
- Ghyslaine Bruna Djeunang Dongho
- 1Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,2Evangelical University of Cameroon, Bandjoun, Cameroon
| | - Karthigayan Gunalan
- 3Laboratory of Malaria and Vector Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | | | - Giacomo Maria Paganotti
- 5Botswana-University of Pennsylvania Partnership, Gaborone, Botswana.,6Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,7Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Michela Menegon
- 4Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Joseph Fondop
- 9Dschang District Hospital, Dschang, Cameroon.,10Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Carlo Severini
- 4Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Martin Sanou Sobze
- 10Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Louis H Miller
- 3Laboratory of Malaria and Vector Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Gianluca Russo
- 1Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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16
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Kepple D, Pestana K, Tomida J, Abebe A, Golassa L, Lo E. Alternative Invasion Mechanisms and Host Immune Response to Plasmodium vivax Malaria: Trends and Future Directions. Microorganisms 2020; 9:E15. [PMID: 33374596 PMCID: PMC7822457 DOI: 10.3390/microorganisms9010015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/21/2022] Open
Abstract
Plasmodium vivax malaria is a neglected tropical disease, despite being more geographically widespread than any other form of malaria. The documentation of P. vivax infections in different parts of Africa where Duffy-negative individuals are predominant suggested that there are alternative pathways for P. vivax to invade human erythrocytes. Duffy-negative individuals may be just as fit as Duffy-positive individuals and are no longer resistant to P.vivax malaria. In this review, we describe the complexity of P. vivax malaria, characterize pathogenesis and candidate invasion genes of P. vivax, and host immune responses to P. vivax infections. We provide a comprehensive review on parasite ligands in several Plasmodium species that further justify candidate genes in P. vivax. We also summarize previous genomic and transcriptomic studies related to the identification of ligand and receptor proteins in P. vivax erythrocyte invasion. Finally, we identify topics that remain unclear and propose future studies that will greatly contribute to our knowledge of P. vivax.
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Affiliation(s)
- Daniel Kepple
- Biological Sciences, University of North Carolina, Charlotte, NC 28223, USA; (K.P.); (J.T.)
| | - Kareen Pestana
- Biological Sciences, University of North Carolina, Charlotte, NC 28223, USA; (K.P.); (J.T.)
| | - Junya Tomida
- Biological Sciences, University of North Carolina, Charlotte, NC 28223, USA; (K.P.); (J.T.)
| | - Abnet Abebe
- Ethiopian Public Health Institute, Addis Ababa 1000, Ethiopia;
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa 1000, Ethiopia;
| | - Eugenia Lo
- Biological Sciences, University of North Carolina, Charlotte, NC 28223, USA; (K.P.); (J.T.)
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17
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Podgorski RM, Goff KA, Penney TP, Maness NJ, Keating J, Yukich JO, Marx PA. DNA analysis reveals non-falciparum malaria in the Democratic Republic of the Congo. Acta Trop 2020; 212:105557. [PMID: 32479838 DOI: 10.1016/j.actatropica.2020.105557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The World Health Organization (WHO) attributes the entirety of malaria infection and transmission in the Democratic Republic of the Congo (DRC) to Plasmodium falciparum, one of the several species of malaria known to infect humans. Recent studies have put forth some evidence that transmission of Plasmodium vivax may also be occurring in the DRC. As interventions and treatments differ between malaria species, it is crucial to maintain the most accurate understanding of malaria species diversity in each region. METHODS Blood samples were taken from aymptomatic children 0-5 years old living in three regions of the DRC in 2014. For this study, samples were taken from a larger pool of samples, collected as part of a population-based survey in three regions. Plasmodium infection was screened for using nested polymerase chain reaction (PCR) assays and species were confirmed by cloning and DNA sequencing. RESULTS Of 336 samples screened by PCR, 62.2% (n=209) initially tested positive for P. falciparum and 14.6% (n=49) initially tested positive for P. vivax. Sanger sequencing was performed on PCR-positive Plasmodium samples to confirm identity of Plasmodium species. Sequencing showed Plasmodium malariae in one blood sample and Plasmodium ovale in another sample. Plasmodium vivax was detected in 12/65 cases (18.5%). Overall, 14/65 sequenced cases (21.5%) were infected with a non-falciparum malaria. 330bp 18s P. vivax DNA sequences were obtained. CONCLUSIONS This study reveals Plasmodium vivax and other non-falciparum malaria across several regions of the DRC, and enforces the importance of further testing and more precise diagnostics when testing for and treating malaria in the DRC. Here, we find a higher proportion of cases of P. vivax malaria than found in previous studies. This is the most robust DNA sequencing of Plasmodium vivax in the DRC to date.
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18
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Woldearegai TG, Lalremruata A, Nguyen TT, Gmeiner M, Veletzky L, Tazemda-Kuitsouc GB, Matsiegui PB, Mordmüller B, Held J. Characterization of Plasmodium infections among inhabitants of rural areas in Gabon. Sci Rep 2019; 9:9784. [PMID: 31278305 PMCID: PMC6611864 DOI: 10.1038/s41598-019-46194-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/25/2019] [Indexed: 12/18/2022] Open
Abstract
Plasmodium infections in endemic areas are often asymptomatic, can be caused by different species and contribute significantly to transmission. We performed a cross-sectional study in February/March 2016 including 840 individuals ≥ 1 year living in rural Gabon (Ngounié and Moyen-Ogooué). Plasmodium parasitemia was measured by high-sensitive, real-time quantitative PCR. In a randomly chosen subset of P. falciparum infections, gametocyte carriage and prevalence of chloroquine-resistant genotypes were analysed. 618/834 (74%) individuals were positive for Plasmodium 18S-rRNA gene amplification, of these 553 (66.3%) carried P. falciparum, 193 (23%) P. malariae, 74 (8.9%) P. ovale curtisi and 38 (4.6%) P.ovale wallikeri. Non-falciparum infections mostly presented as mixed infections. P. malariae monoinfected individuals were significantly older (median age: 60 years) than coinfected (20 years) or P. falciparum monoinfected individuals (23 years). P. falciparum gametocyte carriage was confirmed in 109/223 (48.9%) individuals, prevalence of chloroquine-resistant genotypes was high (298/336, 89%), including four infections with a new SVMNK genotype. In rural Gabon, Plasmodium infections with all endemic species are frequent, emphasizing that malaria control efforts shall cover asymptomatic infections also including non-falciparum infections when aiming for eradication.
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Affiliation(s)
- Tamirat Gebru Woldearegai
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Albert Lalremruata
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - The Trong Nguyen
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Vietnamese - German Center of Excellence in Medical Research, Hanoi, Vietnam
| | - Markus Gmeiner
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Luzia Veletzky
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Pierre Blaise Matsiegui
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Jana Held
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany. .,German Centre for Infection Research, partner site Tübingen, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.
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19
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Guerra RI, Ore M, Valdivia HO, Bishop DK, Ramos M, Mores CN, Campbell WR. A cluster of the first reported Plasmodium ovale spp. infections in Peru occuring among returning UN peace-keepers, a review of epidemiology, prevention and diagnostic challenges in nonendemic regions. Malar J 2019; 18:176. [PMID: 31113437 PMCID: PMC6530030 DOI: 10.1186/s12936-019-2809-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Plasmodium ovale curtisi and Plasmodium ovale wallikeri are regarded as less virulent forms of malaria with a geographic distribution including Southeast Asia, Central and West Africa, and is increasingly reported as an infection in returning travellers. A species of malaria that may have delayed or relapsing presentations similar to Plasmodium vivax, the clinical presentation of P. ovale spp. has been described to have prepatent periods of 2 weeks or slightly longer with reports of relapse following primary infection out to 8-9 months. This presentation may be obscured further in the setting of anti-malarial exposure, with report of delayed primary infection out to 4 years. Presented is a cluster of 4 imported P. ovale spp. cases in returning Peruvian military personnel assigned to United Nations peace-keeping operations in the Central African Republic. CASE PRESENTATION From January to December 2016, Peruvian peace-keepers were deployed in support of United Nations (UN) operations in the Central African Republic (CAR). While serving abroad, Navy, Army, and Air Force members experienced 223 episodes of Plasmodium falciparum malaria following interruption of prophylaxis with mefloquine. Diagnosis was made using rapid diagnostics tests (RDTs) and/or smear with no coinfections identified. Cases of malaria were treated with locally-procured artemether-lumefantrine. Returning to Peru in January 2017, 200 peace-keepers were screened via thick and thin smear while on weekly mefloquine prophylaxis with only 1 showing nucleic acid within red blood cells consistent with Plasmodium spp. and 11 reporting syndromes of ill-defined somatic complaints. Between a period of 5 days to 11 months post return, 4 cases of P. ovale spp. were diagnosed using smear and polymerase chain reaction (PCR) following febrile complaints. All cases were subsequently treated with chloroquine and primaquine, with cure of clinical disease and documented clearance of parasitaemia. CONCLUSION These patients represent the first imported cases in Peru of this species of malaria as well as highlight the challenges in implementing population level prophylaxis in a deployed environment, and the steps for timely diagnosis and management in a non-endemic region where risk of introduction for local transmission exists.
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Affiliation(s)
| | | | | | | | | | - Christopher N Mores
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Wesley R Campbell
- U.S. Naval Medical Research Unit No. 6, Lima, Peru. .,Division of Infectious Diseases, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD, USA.
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Transcriptome profiling of Plasmodium vivax in Saimiri monkeys identifies potential ligands for invasion. Proc Natl Acad Sci U S A 2019; 116:7053-7061. [PMID: 30872477 DOI: 10.1073/pnas.1818485116] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Unlike the case in Asia and Latin America, Plasmodium vivax infections are rare in sub-Saharan Africa due to the absence of the Duffy blood group antigen (Duffy antigen), the only known erythrocyte receptor for the P. vivax merozoite invasion ligand, Duffy binding protein 1 (DBP1). However, P. vivax infections have been documented in Duffy-negative individuals throughout Africa, suggesting that P. vivax may use ligands other than DBP1 to invade Duffy-negative erythrocytes through other receptors. To identify potential P. vivax ligands, we compared parasite gene expression in Saimiri and Aotus monkey erythrocytes infected with P. vivax Salvador I (Sal I). DBP1 binds Aotus but does not bind to Saimiri erythrocytes; thus, P. vivax Sal I must invade Saimiri erythrocytes independent of DBP1. Comparing RNA sequencing (RNAseq) data for late-stage infections in Saimiri and Aotus erythrocytes when invasion ligands are expressed, we identified genes that belong to tryptophan-rich antigen and merozoite surface protein 3 (MSP3) families that were more abundantly expressed in Saimiri infections compared with Aotus infections. These genes may encode potential ligands responsible for P. vivax infections of Duffy-negative Africans.
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Sibley CH. A Solid Beginning to Understanding Plasmodium vivax in Africa. J Infect Dis 2019; 220:1716-1718. [DOI: 10.1093/infdis/jiz019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
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Baird JK. Tafenoquine for travelers' malaria: evidence, rationale and recommendations. J Travel Med 2018; 25:5150129. [PMID: 30380095 PMCID: PMC6243017 DOI: 10.1093/jtm/tay110] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/17/2018] [Accepted: 10/30/2018] [Indexed: 01/01/2023]
Abstract
Background Endemic malaria occurring across much of the globe threatens millions of exposed travelers. While unknown numbers of them suffer acute attacks while traveling, each year thousands return from travel and become stricken in the weeks and months following exposure. This represents perhaps the most serious, prevalent and complex problem faced by providers of travel medicine services. Since before World War II, travel medicine practice has relied on synthetic suppressive blood schizontocidal drugs to prevent malaria during exposure, and has applied primaquine for presumptive anti-relapse therapy (post-travel or post-diagnosis of Plasmodium vivax) since 1952. In 2018, the US Food and Drug Administration approved the uses of a new hepatic schizontocidal and hypnozoitocidal 8-aminoquinoline called tafenoquine for the respective prevention of all malarias and for the treatment of those that relapse (P. vivax and Plasmodium ovale). Methods The evidence and rationale for tafenoquine for the prevention and treatment of malaria was gathered by means of a standard search of the medical literature along with the package inserts for the tafenoquine products Arakoda™ and Krintafel™ for the prevention of all malarias and the treatment of relapsing malarias, respectively. Results The development of tafenoquine-an endeavor of 40 years-at last brings two powerful advantages to travel medicine practice against the malaria threat: (i) a weekly regimen of causal prophylaxis; and (ii) a single-dose radical cure for patients infected by vivax or ovale malarias. Conclusions Although broad clinical experience remains to be gathered, tafenoquine appears to promise more practical and effective prevention and treatment of malaria. Tafenoquine thus applied includes important biological and clinical complexities explained in this review, with particular regard to the problem of hemolytic toxicity in G6PD-deficient patients.
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Affiliation(s)
- J Kevin Baird
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute of Molecular Biology, Jakarta 10430, Indonesia; and Nuffield Department of Medicine, the Centre for Tropical Medicine and Global Health, University of Oxford, UK
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