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Ahmad SS, Verma R, Commons RJ, Nitika, Singh-Phulgenda S, Chhajed R, Bharti PK, Behera B, Naser SM, Pal SK, Ranjit PH, Baharia RK, Solanki B, Upadhyay KJ, Guerin PJ, Sharma A, Price RN, Rahi M, Thriemer K. A randomised controlled trial to compare the efficacy, safety, and tolerability of low dose, short course primaquine in adults with uncomplicated P. vivax malaria in two hospitals in India. Trials 2024; 25:154. [PMID: 38424577 PMCID: PMC10905854 DOI: 10.1186/s13063-024-07987-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Plasmodium vivax remains a major challenge for malaria control and elimination due to its ability to cause relapsing illness. To prevent relapses the Indian National Center for Vector Borne Diseases Control (NCVBDC) recommends treatment with primaquine at a dose of 0.25 mg/kg/day provided over 14 days. Shorter treatment courses may improve adherence and treatment effectiveness. METHODS This is a hospital-based, randomised, controlled, open-label trial in two centres in India. Patients above the age of 16 years, with uncomplicated vivax malaria, G6PD activity of ≥ 30% of the adjusted male median (AMM) and haemoglobin levels ≥ 8 g/dL will be recruited into the study and randomised in a 1:1 ratio to receive standard schizonticidal treatment plus 7-day primaquine at 0.50 mg/kg/day or standard care with schizonticidal treatment plus 14-day primaquine at 0.25 mg/kg/day. Patients will be followed up for 6 months. The primary endpoint is the incidence risk of any P. vivax parasitaemia at 6 months. Safety outcomes include the incidence risk of severe anaemia (haemoglobin < 8 g/dL), the risk of blood transfusion, a > 25% fall in haemoglobin and an acute drop in haemoglobin of > 5 g/dL during primaquine treatment. DISCUSSION This study will evaluate the efficacy and safety of a 7-day primaquine regimen compared to the standard 14-day regimen in India. Results from this trial are likely to directly inform national treatment guidelines. TRIAL REGISTRATION Trial is registered on CTRI portal, Registration No: CTRI/2022/12/048283.
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Affiliation(s)
| | - Reena Verma
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Robert J Commons
- WorldWide Antimalarial Resistance Network, Asia-Pacific Regional Hub, Melbourne, Australia
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- General and Subspecialty Medicine, Grampians Health, Ballarat, Australia
| | - Nitika
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Sauman Singh-Phulgenda
- Infectious Diseases Data Observatory - IDDO, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG, UK
| | - Rutuja Chhajed
- Infectious Diseases Data Observatory - IDDO, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG, UK
| | | | - Beauty Behera
- Delhi Skill and Entrepreneurship University, New Delhi, India
| | | | - Salil Kumar Pal
- Calcutta National Medical College, Kolkata, West Bengal, India
| | | | - Rajendra Kumar Baharia
- NIMR Field Unit, Academy of Scientific and Innovative Research, Ghaziabad, Gujarat, India
| | - Bhavin Solanki
- Ahmedabad Municipal Corporation, Ahmedabad, Gujarat, India
| | | | - Philippe J Guerin
- Infectious Diseases Data Observatory - IDDO, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG, UK
| | - Amit Sharma
- International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Ric N Price
- WorldWide Antimalarial Resistance Network, Asia-Pacific Regional Hub, Melbourne, Australia
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Manju Rahi
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
- Indian Council of Medical Research, New Delhi, India.
| | - Kamala Thriemer
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
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2
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Moore BR, Salman S, Tobe R, Benjamin J, Yadi G, Kasian B, Laman M, Robinson LJ, Page-Sharp M, Betuela I, Batty KT, Manning L, Mueller I, Davis TME. Short-course, high-dose primaquine regimens for the treatment of liver-stage vivax malaria in children. Int J Infect Dis 2023; 134:114-122. [PMID: 37269941 DOI: 10.1016/j.ijid.2023.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES To assess the pharmacokinetics, safety, and tolerability of two high-dose, short-course primaquine (PQ) regimens compared with standard care in children with Plasmodium vivax infections. METHODS We performed an open-label pediatric dose-escalation study in Madang, Papua New Guinea (Clinicaltrials.gov NCT02364583). Children aged 5-10 years with confirmed blood-stage vivax malaria and normal glucose-6-phosphate dehydrogenase activity were allocated to one of three PQ treatment regimens in a stepwise design (group A: 0.5 mg/kg once daily for 14 days, group B: 1 mg/kg once daily for 7 days, and group C: 1 mg/kg twice daily for 3.5-days). The study assessments were completed at each treatment time point and fortnightly for 2 months after PQ administration. RESULTS Between August 2013 and May 2018, 707 children were screened and 73 met the eligibility criteria (15, 40, and 16 allocated to groups A, B, and C, respectively). All children completed the study procedures. The three regimens were safe and generally well tolerated. The pharmacokinetic analysis indicated that an additional weight adjustment of the conventionally recommended milligram per kilogram PQ doses is not necessary to ensure the therapeutic plasma concentrations in pediatric patients. CONCLUSIONS A novel, ultra-short 3.5-day PQ regimen has potential benefits for improving the treatment outcomes in children with vivax malaria that warrants further investigation in a large-scale clinical trial.
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Affiliation(s)
- Brioni R Moore
- Curtin Medical School, Curtin University, Perth, Australia; Curtin Health Innovation Research Institute, Curtin University, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia.
| | - Sam Salman
- Medical School, The University of Western Australia, Perth, Australia; Clinical Pharmacology and Toxicology Unit, PathWest, Perth, Australia
| | - Roselyn Tobe
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - John Benjamin
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Gumul Yadi
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Bernadine Kasian
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Moses Laman
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Leanne J Robinson
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Department of Medical Biology, University of Melbourne, Melbourne, Australia; Burnet Institute, Melbourne, Australia
| | | | - Inoni Betuela
- Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Kevin T Batty
- Curtin Medical School, Curtin University, Perth, Australia; Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | - Laurens Manning
- Medical School, The University of Western Australia, Perth, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Ivo Mueller
- Department of Medical Biology, University of Melbourne, Melbourne, Australia; Burnet Institute, Melbourne, Australia
| | - Timothy M E Davis
- Medical School, The University of Western Australia, Perth, Australia
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3
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Ding H, Dong Y, Deng Y, Xu Y, Liu Y, Wu J, Chen M, Zhang C, Zheng W. Characteristics of molecular markers associated with chloroquine resistance in Plasmodium vivax strains from vivax malaria cases in Yunnan Province, China. Malar J 2023; 22:181. [PMID: 37303047 DOI: 10.1186/s12936-023-04616-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Chloroquine (CQ) has been the preferred clinical treatment for vivax malaria in Yunnan Province since 1958, with over 300,000 patients. This study aimed to help make trend predictions regarding variations the in anti-malarial drug susceptibility of Plasmodium vivax distributed in Yunnan Province and effectively implement monitoring measures on the efficacy of anti-malarial drugs for vivax malaria. METHODS Blood samples collected from patients with mono-P. vivax infections were employed in this study based on the principle of cluster sampling. The whole gene of P. vivax multidrug resistance 1 protein gene (pvmdr1) was amplified by nested-PCR techniques and the PCR amplification produce were sequenced by Sanger bidirectional sequencing. The mutant loci and haplotypes of coding DNA sequence (CDS) were identified by comparison with the reference sequence (NC_009915.1) of the P. vivax Sal I isolate. Parameters such as Ka/Ks ratio were calculated using MEGA 5.04 software. RESULTS A total of 753 blood samples from patients infected with mono-P. vivax were collected, of which 624 blood samples yielded the full gene sequence (4392 bp) of the pvmdr1 gene, with 283, 140, 119, and 82 sequences from 2014, 2020, 2021 and 2022, respectively. A total of 52 single nucleotide polymorphic (SNP) loci were detected for the 624 CDSs, of which 92.3% (48/52), 34.6% (18/52), 42.3% (22/52), and 36.5% (19/52) SNPs were detected in 2014, 2020, 2021 and 2022, respectively. All of 624 CDSs were defined for a total of 105 mutant haplotypes, with CDSs of 2014, 2020, 2021, and 2022 containing 88, 15, 21, and 13 haplotypes, respectively. Of the 105 haplotypes, the threefold mutant haplotype (Hap_87) was the starting point for stepwise evolution, and the most drastic tenfold mutations were Hap_14 and Hap_78, and the fivefold, sixfold, sevenfold, and eightfold mutations. CONCLUSIONS In the majority of vivax malaria cases in Yunnan Province, most of them were infected with strains carrying demonstrating highly mutated in pvmdr1 genes. However, the dominant mutation strains types varied from year to year, which warrants further exploration in order to confirm the correlation between with phenotypic changes in P. vivax strains and their susceptibility to anti-malarial drugs such as chloroquine.
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Affiliation(s)
- Hongyun Ding
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Ying Dong
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China.
| | - Yan Deng
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Yanchun Xu
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Yan Liu
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Jing Wu
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Mengni Chen
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Canglin Zhang
- Yunnan Institute of Parasitic Diseases Control, Yunnan Provincial Key Laboratory, Yunnan Centre of Malaria Research, Pu'er, 665000, China
| | - Weibin Zheng
- Center for Disease Control and Prevention, Baoshan, 678000, China.
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4
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Adhikari B, Tripura R, Dysoley L, Callery JJ, Peto TJ, Heng C, Vanda T, Simvieng O, Cassidy-Seyoum S, Ley B, Thriemer K, Dondorp AM, von Seidlein L. Glucose 6 Phosphate Dehydrogenase (G6PD) quantitation using biosensors at the point of first contact: a mixed method study in Cambodia. Malar J 2022; 21:282. [PMID: 36195916 PMCID: PMC9531219 DOI: 10.1186/s12936-022-04300-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quantitative measurement of Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme activity is critical to decide on appropriate treatment and provision of radical cure regimens for vivax malaria. Biosensors are point-of-care semi-quantitative analysers that measure G6PD enzyme activity. The main objective of this study was to evaluate the operational aspects of biosensor deployment in the hands of village malaria workers (VMWs) in Cambodia over a year. METHODS Following initial orientation and training at Kravanh Referral Hospital, each VMW (n = 28) and laboratory technician (n = 5) was provided a biosensor (STANDARD SD Biosensor, Republic of Korea) with supplies for routine use. Over the next 12 months VMWs convened every month for refresher training, to collect supplies, and to recalibrate and test their biosensors. A quantitative self-administered questionnaire was used to assess the skills necessary to use the biosensor after the initial training. Subsequently, VMWs were visited at their location of work for field observation and evaluation using an observer-administered questionnaire. All quantitative questionnaire-based data were analysed descriptively. Semi-structured interviews (SSIs) were conducted among all participants to explore their experience and practicalities of using the biosensor in the field. SSIs were transcribed and translated into English and underwent thematic analysis. RESULTS A total of 33 participants completed the training and subsequently used the biosensor in the community. Quantitative assessments demonstrated progressive improvement in skills using the biosensor. VMWs expressed confidence and enthusiasm to use biosensors in their routine work. Providing G6PD testing at the point of first contact avoids a multitude of barriers patients have to overcome when travelling to health centres for G6PD testing and radical cure. Deploying biosensors in routine work of VMWs was also considered an opportunity to expand and strengthen the role of VMWs as health care providers in the community. VMWs reported practical concerns related to the use of biosensor such as difficulty in using two pipettes, difficulty in extracting the code chip from the machine, and the narrow base of buffer tube. CONCLUSIONS VMWs considered the biosensor a practical and beneficial tool in their routine work. Providing VMWs with biosensors can be considered when followed by appropriate training and regular supervision. Providing community management of vivax malaria at the point of first contact could be key for elimination.
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Affiliation(s)
- Bipin Adhikari
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
| | - Rupam Tripura
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Lek Dysoley
- C.N.M National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - James J Callery
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Thomas J Peto
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Chhoeun Heng
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thy Vanda
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ou Simvieng
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sarah Cassidy-Seyoum
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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5
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Abstract
PURPOSE OF REVIEW To discuss the neurological complications and pathophysiology of organ damage following malaria infection. RECENT FINDINGS The principal advancement made in malaria research has been a better understanding of the pathogenesis of cerebral malaria (CM), the most dreaded neurological complication generally caused by Plasmodium falciparum infection. However, no definitive treatment has yet been evolved other than the use of antimalarial drugs and supportive care. The development of severe cerebral edema in CM results from two distinct pathophysiologic mechanisms. First, the development of "sticky" red blood cells (RBCs) leads to cytoadherence, where red blood cells (RBCs) get stuck to the endothelial walls and between themselves, resulting in clogging of the brain microvasculature with resultant hypoxemia and cerebral edema. In addition, the P. falciparum-infected erythrocyte membrane protein 1 (PfEMP1) molecules protrude from the raised knob structures on the RBCs walls and are in themselves made of a combination of human and parasite proteins in a tight complex. Antibodies to surfins, rifins, and stevors from the parasite are also located in the RBC membrane. On the human microvascular side, a range of molecules involved in host-parasite interactions, including CD36 and intracellular adhesion molecule 1, is activated during interaction with other molecules such as endothelial protein C receptor and thrombospondin. As a result, an inflammatory response occurs with the dysregulated release of cytokines (TNF, interleukins 1 and 10) which damage the blood-brain barrier (BBB), causing plasma leakage and brain edema. This second mechanism of CNS injury often involves multiple organs in adult patients in endemic areas but remains localized only to the central nervous system (CNS) among African children. Neurological sequelae may follow both P. falciparum and P. vivax infections. The major brain pathology of CM is brain edema with diffuse brain swelling resulting from the combined effects of reduced perfusion and hypoxemia of cerebral neurons due to blockage of the microvasculature by parasitized RBCs as well as the neurotoxic effect of released cytokines from a hyper-acute immune host reaction. A plethora of additional neurological manifestations have been associated with malaria, including posterior reversible encephalopathy syndrome (PRES), reversible cerebral vasoconstriction syndrome (RCVS), malarial retinopathy, post-malarial neurological syndrome (PMNS), acute disseminated encephalomyelitis (ADEM), Guillain-Barré syndrome (GBS), and cerebellar ataxia. Lastly, the impact of the COVID-19 pandemic on worldwide malaria control programs and the possible threat from co-infections is briefly discussed.
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Affiliation(s)
- Sweety Trivedi
- Department of Neurology, Sanjay Gandhi Post-graduate Institute of Medical Science, Lucknow, India
| | - Ambar Chakravarty
- Department of Neurology, Vivekananda Institute of Medical Science, Kolkata, India.
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6
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Nascimento JR, Brito-Sousa JD, Almeida ACG, Melo MM, Costa MRF, Barbosa LRA, Ramos RN, Silva-Neto AV, Balieiro PCDS, Figueiredo EFG, Silva EL, Baia-da-Silva DC, Bassat Q, Romero G, Melo GC, Sampaio VS, Lacerda M, Monteiro W. Prevalence of glucose 6-phosphate dehydrogenase deficiency in highly malaria-endemic municipalities in the Brazilian Amazon: A region-wide screening study. Lancet Reg Health Am 2022; 12:100273. [PMID: 36776424 PMCID: PMC9903920 DOI: 10.1016/j.lana.2022.100273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Difficulties associated with the assessment of glucose-6-phosphate dehydrogenase deficiency (G6PDd), particularly in remote areas, hinders the safe use of 8-aminoquinolines such as primaquine (PQ) and tafenoquine against Plasmodium vivax malaria due to the risk of haemolysis. Methods This cross-sectional study was conducted in 41 malaria-endemic municipalities of six states in the Brazilian Amazon, between 2014 and 2018. Male individuals were screened for G6PDd using the qualitative Fluorescent Spot Test using fingerpick-collected whole blood samples. Point and interval estimates of the G6PDd prevalence were calculated for each state. Deficient samples were genotyped for the most prevalent variants in the Amazon. Frequencies of P. vivax malaria recurrences were estimated for G6PDd and non-G6PDd patients. Interpretation This is one of the largest surveys ever conducted in Latin America, covering the entire malaria endemic area in the Brazilian Amazon. These results indicate that an important proportion of the population is at risk of hemolysis if exposed to PQ and its congener drug tafenoquine. The adoption of G6PDd screening protocols is essential to ensure the safety of individuals treated with those drugs and should also be considered when implementing malaria elimination strategies. Findings A total of 14,847 individuals were included, of which 5.6% presented G6PDd. The state of Acre had the highest G6PDd prevalence (8.3%), followed by Amapá (5.8%), Pará (5.7%), Rondônia (5.4%), Roraima (4.2%) and Amazonas (4.0%). From 828 genotyped samples, African A+ (6.2%), African A- (39.3%) and wild-type (non-African non-Mediterranean; 54.2%) variants were found. A greater proportion of malaria recurrences was found among G6PD deficient individuals [16.7% vs 4.1%, Risk ratio 3.52 (2.16-5.74) p < 0.01]. Funding Brazilian Ministry of Health; Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM).
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Affiliation(s)
- Joabi Rocha Nascimento
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Jose Diego Brito-Sousa
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Anne Cristine Gomes Almeida
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
| | - Marly M Melo
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Monica Regina Farias Costa
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
| | - Laila Rowena Albuquerque Barbosa
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Reinaldo Nery Ramos
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
| | - Alexandre Vilhena Silva-Neto
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Patricia Carvalho da Silva Balieiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Erick Frota Gomes Figueiredo
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Emanuelle Lira Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Djane Clarys Baia-da-Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Instituto de Pesquisas Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Brazil
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, Barcelona 08010, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gustavo Romero
- Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, Brazil
| | - Gisely Cardoso Melo
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Vanderson Souza Sampaio
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Marcus Lacerda
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Instituto de Pesquisas Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Brazil
| | - Wuelton Monteiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
- Corresponding author at: Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Av. Pedro Teixeira 25 , Manaus, Amazonas CEP 69040-000, Brazil.
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7
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Thriemer K, Degaga TS, Christian M, Alam MS, Ley B, Hossain MS, Kibria MG, Tego TT, Abate DT, Weston S, Karahalios A, Rajasekhar M, Simpson JA, Rumaseb A, Mnjala H, Lee G, Anose RT, Kidane FG, Woyessa A, Baird K, Sutanto I, Hailu A, Price RN. Reducing the risk of Plasmodium vivax after falciparum infections in co-endemic areas-a randomized controlled trial (PRIMA). Trials 2022; 23:416. [PMID: 35585641 PMCID: PMC9116071 DOI: 10.1186/s13063-022-06364-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/26/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Plasmodium vivax forms dormant liver stages that can reactivate weeks or months following an acute infection. Recurrent infections are often associated with a febrile illness and can cause a cumulative risk of severe anaemia, direct and indirect mortality, and onward transmission of the parasite. There is an increased risk of P. vivax parasitaemia following falciparum malaria suggesting a rationale for universal use of radically curative treatment in patients with P. falciparum malaria even in the absence of detectable P. vivax parasitaemia in areas that are co-endemic for both species. METHODS This is a multicentre, health care facility-based, randomized, controlled, open-label trial in Bangladesh, Indonesia and Ethiopia. Patients with uncomplicated falciparum malaria, G6PD activity of ≥70% of the adjusted male median (AMM) and haemoglobin levels ≥8g/dl are recruited into the study and randomized to either receive standard schizonticidal treatment plus 7-day high dose primaquine (total dose 7mg/kg) or standard care in a 1:1 ratio. Patients are followed up weekly until day 63. The primary endpoint is the incidence risk of any P. vivax parasitemia on day 63. Secondary endpoints include incidence risk on day 63 of symptomatic P. vivax malaria and the risk of any P. falciparum parasitaemia. Secondary safety outcomes include the proportion of adverse events and serious adverse events, the incidence risk of severe anaemia (Hb<5g/dl and <7g/dl) and/or the risk for blood transfusion, the incidence risk of ≥ 25% fall in haemoglobin with and without haemoglobinuria, and the incidence risk of ≥ 25% fall in haemoglobin to under 7g/dl with and without haemoglobinuria. DISCUSSION This study evaluates the potential benefit of a universal radical cure for both P. vivax and P. falciparum in different endemic locations. If found safe and effective universal radical cure could represent a cost-effective approach to clear otherwise unrecognised P. vivax infections and hence accelerate P. vivax elimination. TRIAL REGISTRATION NCT03916003 . Registered on 12 April 2019.
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Affiliation(s)
- Kamala Thriemer
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Tamiru Shibru Degaga
- grid.442844.a0000 0000 9126 7261College of Medicine & Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Michael Christian
- grid.418754.b0000 0004 1795 0993Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - Mohammad Shafiul Alam
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Benedikt Ley
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Mohammad Sharif Hossain
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammad Golam Kibria
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Dagimawie Tadesse Abate
- grid.442844.a0000 0000 9126 7261College of Medicine & Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sophie Weston
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Amalia Karahalios
- grid.1008.90000 0001 2179 088XCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
| | - Megha Rajasekhar
- grid.1008.90000 0001 2179 088XCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
| | - Julie A. Simpson
- grid.1008.90000 0001 2179 088XCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
| | - Angela Rumaseb
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Hellen Mnjala
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Grant Lee
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Rodas Temesgen Anose
- grid.442844.a0000 0000 9126 7261College of Medicine & Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Fitsum Getahun Kidane
- grid.442844.a0000 0000 9126 7261College of Medicine & Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Adugna Woyessa
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kevin Baird
- grid.418754.b0000 0004 1795 0993Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Inge Sutanto
- grid.9581.50000000120191471Department of Parasitology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Asrat Hailu
- grid.7123.70000 0001 1250 5688College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ric N. Price
- grid.271089.50000 0000 8523 7955Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK ,grid.10223.320000 0004 1937 0490Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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8
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Bahk YY, Cho SH, Na BK, Hong SJ, Lee SK, Kim TS. Awareness and Opinions of Inhabitants on Vivax Malaria in Two Endemic Areas, Gyeonggi-do, Korea. Korean J Parasitol 2021; 59:513-518. [PMID: 34724772 PMCID: PMC8561045 DOI: 10.3347/kjp.2021.59.5.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 12/04/2022]
Abstract
The incidence of vivax malaria in Korea was reduced to a low plateau. For successful elimination of vivax malaria, socio-behavioral changes in the communities are essential. This study aimed to figure out awareness of the inhabitants on the vivax malaria endemicity. The 407 participants including vivax malaria patients and uninfected inhabitants in Gimpo- and Paju-si, Gyeonggi-do, known as high-risk areas in Korea. We used a community-based study design and non-probability sampling method using primary data. Except for the perception about the public health facilities’ capability to cope with anti-malaria programs, the 2 groups of participants shared the same level of awareness about public promotional and educational measures and opinions for malaria elimination from the community. Thus, our future goals for malaria prevention and elimination are to develop more active and well-organized community-based education and evaluation programs collaborating with the community healthcare authorities and local governments.
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Affiliation(s)
- Young Yil Bahk
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju 27478, Korea
| | | | - Byoung-Kuk Na
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Korea, and Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Korea
| | - Sung Jong Hong
- Convergence Research Center for Insect Vectors, Incheon National University, Incheon 22012, Korea
| | - Sung-Keun Lee
- Department of Pharmacology, Inha University School of Medicine, Incheon 22212, Korea
| | - Tong-Soo Kim
- Convergence Research Center for Insect Vectors, Incheon National University, Incheon 22012, Korea.,Department of Tropical Medicine, Inha University School of Medicine, Incheon 22212, Korea
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Harrington WE, Moore KA, Min AM, Gilder ME, Tun NW, Paw MK, Wiladphaingern J, Proux S, Chotivanich K, Rijken MJ, White NJ, Nosten F, McGready R. Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester. BMC Med 2021; 19:98. [PMID: 33902567 PMCID: PMC8077872 DOI: 10.1186/s12916-021-01960-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/16/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking. METHODS We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity. RESULTS There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP. CONCLUSIONS Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.
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Affiliation(s)
- Whitney E Harrington
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Kerryn A Moore
- London School of Hygiene and Tropical Medicine, London, UK
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Aung Myat Min
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Mary Ellen Gilder
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Nay Win Tun
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Moo Kho Paw
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Jacher Wiladphaingern
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Stephane Proux
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | - Marcus J Rijken
- Utrecht University Medical Centre, Utrecht, the Netherlands
- Julius Centre Global Health, Utrecht, the Netherlands
| | - Nicholas J White
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK.
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10
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Adhikari B, Awab GR, von Seidlein L. Rolling out the radical cure for vivax malaria in Asia: a qualitative study among policy makers and stakeholders. Malar J 2021; 20:164. [PMID: 33757538 PMCID: PMC7987122 DOI: 10.1186/s12936-021-03702-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Wide-spread implementation of treatment regimens for the radical cure of vivax malaria is hindered by a range of factors. This has resulted in an increase in the relative proportion of vivax malaria and is an important obstacle in the achievement of global malaria elimination by 2030. The main objective of this study was to explore the current policies guiding the treatment plans on vivax malaria, and the factors affecting the implementation of radical cure in South/South East Asian and Asian Pacific countries. METHODS This was a qualitative study among respondents who represented national malaria control programmes (NMCPs) or had a role and influence in the national malaria policies. 33 respondents from 17 countries in South/South East Asia and Asia Pacific participated in interviews between October 15 and December 15, 2020. Semi-structured interviews were conducted virtually except for two face to face interviews and audio-recorded. Transcribed audio-records underwent thematic analysis using QSR NVivo. RESULTS Policies against vivax malaria were underprioritized, compared with the focus on falciparum malaria and, in particular, drug resistant Plasmodium falciparum strains. Despite the familiarity with primaquine (PQ) as the essential treatment to achieve the radical cure, the respondents contested the need for G6PD testing. Optional G6PD testing was reported to have poor adherence. The fear of adverse events led health workers to hesitate prescribing PQ. In countries where G6PD was mandatory, respondents experienced frequent stockouts of G6PD rapid diagnostic kits in peripheral health facilities, which was compounded by a short shelf life of these tests. These challenges were echoed across participating countries to various degrees. Most respondents agreed that a shorter treatment regimen, such as single dose tafenoquine could resolve these problems but mandatory G6PD testing will be needed. The recommendation of shorter regimens including tafenoquine or high dose PQ requires operational evidence demonstrating the robust performance of point of care G6PD tests (biosensors). CONCLUSION There was sparse implementation and low adherence to the radical cure in South/South East Asian and Asian pacific countries. Shorter treatment regimens with appropriate point of care quantitative G6PD tests may resolve the current challenges. Operational evidence on point of care quantitative G6PD tests that includes the feasibility of integrating such tests into the radical cure regimen are critical to ensure its implementation.
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Affiliation(s)
- Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Ghulam Rhahim Awab
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Nangarhar Medical Faculty, Nangarhar University, Jalalabad, Afghanistan
- Ministry of Higher Education, Kabul, Afghanistan
| | - Lorenz von Seidlein
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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11
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Abstract
Severe complications have been observed and established for Plasmodium falciparum as well as P. vivax infections worldwide. Although P. vivax infection is not fully acknowledged as malignant malaria, recently life-threatening complications have been reported to occur in many studies. The recognition of biomarkers with excellent sensitivity and reliability plays a prime role in disease management. Acute inflammatory response and oxidative stress are observed in malaria due to the production of reactive oxygen species. Lipid and protein oxidative injuries are prospective biomarkers for disease severity owing to the damage caused by the parasite. We have tried to find out whether protein carbonylation (PC), lipid peroxidation (LPO) and superoxide dismutase (SOD) could suffice as a biomarker for severe vivax malaria or not. Blood samples were collected from the individuals attending Jawaharlal Nehru Medical College of Aligarh Muslim University during the wet season of malaria transmission. Microscopy and rapid diagnostic kits were used as a tool for malaria diagnosis. A total of 214 subjects were enrolled for the study: 30 febrile controls and 184 subjects with vivax malaria. Protein carbonylation and lipid peroxidation were found to be directly associated with parasite count and total antioxidant status (TAS). Increase in oxidative stress was also observed in severe vivax malaria patients. Levels of uric acid and bilirubin too were raised in complicated cases. Protein carbonylation was found to be a more reliable indicator of vivax malaria severity than lipid peroxidation.
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12
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Mehra S, McCaw JM, Flegg MB, Taylor PG, Flegg JA. Antibody Dynamics for Plasmodium vivax Malaria: A Mathematical Model. Bull Math Biol 2021; 83:6. [PMID: 33387082 DOI: 10.1007/s11538-020-00837-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Malaria is a mosquito-borne disease that, despite intensive control and mitigation initiatives, continues to pose an enormous public health burden. Plasmodium vivax is one of the principal causes of malaria in humans. Antibodies, which play a fundamental role in the host response to P. vivax, are acquired through exposure to the parasite. Here, we introduce a stochastic, within-host model of antibody responses to P. vivax for an individual in a general transmission setting. We begin by developing an epidemiological framework accounting for P. vivax infections resulting from new mosquito bites (primary infections), as well as the activation of dormant-liver stages known as hypnozoites (relapses). By constructing an infinite server queue, we obtain analytic results for the distribution of relapses in a general transmission setting. We then consider a simple model of antibody kinetics, whereby antibodies are boosted with each infection, but are subject to decay over time. By embedding this model for antibody kinetics in the epidemiological framework using a generalised shot noise process, we derive analytic expressions governing the distribution of antibody levels for a single individual in a general transmission setting. Our work provides a means to explore exposure-dependent antibody dynamics for P. vivax, with the potential to address key questions in the context of serological surveillance and acquired immunity.
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13
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Matlani M, Kojom LP, Mishra N, Dogra V, Singh V. Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India. Ann Clin Microbiol Antimicrob 2020; 19:49. [PMID: 33126884 PMCID: PMC7602347 DOI: 10.1186/s12941-020-00393-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background Plasmodium vivax, once considered benign species, is recently being recognised to be causing severe malaria like Plasmodium falciparum. In the present study, the authors report the trends in malaria severity in P. vivax among patients from a Delhi government hospital. The aim of the study was to understand the disease severity and the burden of severe vivax malaria. Methods A hospital based study was carried out from June 2017 to December 2018 at a tertiary care centre from Delhi, India. Patients were tested for malaria using peripheral blood smear (PBS) and/or rapid malaria antigen test (RMAT). The severe and non-severe vivax malaria categorization was done as per the WHO guidelines. Sociodemographic, clinic and paraclinical data were collected from patients and their medical records. Results Of the 205 patients, 177 (86.3%) had P. vivax infection, 22 (10.7%) had P. falciparum infection and six (2.9%) had mixed infection with both the species. Out of 177 P. vivax cases included in this study one or more manifestations of severe malaria was found in 58 cases (32.7%). Severe anaemia (56.9%), jaundice (15%) and significant bleeding (15%) were the most common complications reported in most of patients, along with thrombocytopenia. Conclusions In this study, it is evident that vivax malaria is emerging as the new severe disease in malaria patients, a significant shift in the paradigm of P. vivax pathogenesis. The spectrum of complications and alterations in the laboratory parameters in P. vivax clinical cases also indicate the recent shift in the disease severity.
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Affiliation(s)
- Monika Matlani
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Loick P Kojom
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Neelangi Mishra
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Vinita Dogra
- Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Vineeta Singh
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, New Delhi, India.
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Abstract
Vivax malaria which had been highly prevalent in Korea disappeared rapidly from the 1960s to 1984 when domestic occurrence of cases stopped. However, malaria reemerged in 1993 near the demilitarized zone (DMZ) bordering with North Korea. The number of patients thereafter increased exponentially year after year totaling 35,526 cases by the end of 2015. A small number of cases (1 - 53 patients annually) also occurred among the United States military personnel camping in Korea. However, after the 2010s the number of annual malaria cases has been decreasing slowly in Korea. Several reports on malaria situation in North Korea described high malaria prevalence after 1997 which peaked during 1999 - 2002 and has been decreasing thereafter. At the beginning of the reemergence, the majority of cases (60 - 90%) were soldiers aged 20 - 25 years camping around the northern parts of Gyeonggi-do and Gangwon-do (Province), Korea just facing the DMZ. However, as the outbreak continued more civilians were infected. The course of illness was relatively mild, and chemotherapy with chloroquine in combination with primaquine was successful in most of the patients. Mass chemoprophylaxis combined with mosquito control activities greatly contributed to the decline of malaria situation among Korean military soldiers.
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Affiliation(s)
- Jong Yil Chai
- Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul, Korea.
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15
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Mironova VA, Shartova NV, Beljaev AE, Varentsov MI, Korennoy FI, Grishchenko MY. Re-introduction of vivax malaria in a temperate area (Moscow region, Russia): a geographic investigation. Malar J 2020; 19:116. [PMID: 32188468 PMCID: PMC7081549 DOI: 10.1186/s12936-020-03187-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 03/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background Between 1999 and 2008 Russia experienced a flare-up of transmission of vivax malaria following its massive importation with more than 500 autochthonous cases in European Russia, the Moscow region being the most affected. The outbreak waned soon after a decrease in importation in mid-2000s and strengthening the control measures. Compared with other post-eradication epidemics in Europe this one was unprecedented by its extension and duration. Methods The aim of this study is to identify geographical determinants of transmission. The degree of favourability of climate for vivax malaria was assessed by measuring the sum of effective temperatures and duration of season of effective infectivity using data from 22 weather stations. For geospatial analysis, the locations of each of 405 autochthonous cases detected in Moscow region have been ascertained. A MaxEnt method was used for modelling the territorial differentiation of Moscow region according to the suitability of infection re-emergence based on the statistically valid relationships between the distribution of autochthonous cases and environmental and climatic factors. Results In 1999–2004, in the beginning of the outbreak, meteorological conditions were extremely favourable for malaria in 1999, 2001 and 2002, especially within the borders of the city of Moscow and its immediate surroundings. The greatest number of cases occurred at the northwestern periphery of the city and in the adjoining rural areas. A significant role was played by rural construction activities attracting migrant labour, vegetation density and landscape division. A cut-off altitude of 200 m was observed, though the factor of altitude did not play a significant role at lower altitudes. Most likely, the urban heat island additionally amplified malaria re-introduction. Conclusion The malariogenic potential in relation to vivax malaria was high in Moscow region, albeit heterogeneous. It is in Moscow that the most favourable conditions exist for vivax malaria re-introduction in the case of a renewed importation. This recent event of large-scale re-introduction of vivax malaria in a temperate area can serve as a case study for further research.
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Affiliation(s)
- Varvara A Mironova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Natalia V Shartova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia.
| | | | - Mikhail I Varentsov
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia.,A.M, Obukhov Institute of Atmospheric Physics, 3 Pyzhyovskiy Pereulok, Moscow, 119017, Russia.,Research Computing Center, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Fedor I Korennoy
- FGBI Federal Center for Animal Health (FGBI ARRIAH), Vladimir, 600901, Russia
| | - Mikhail Y Grishchenko
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia.,Faculty of Geography and Geoinformatics, Higher School of Economics, Moscow, 101000, Russia
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Yoshii A, Sekihara M, Furusawa T, Hombhanje F, Tsukahara T. Factors associated with children's health facility visits for primaquine treatment in rural Papua New Guinea. Malar J 2019; 18:42. [PMID: 30786891 PMCID: PMC6383275 DOI: 10.1186/s12936-019-2675-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 02/14/2019] [Indexed: 12/20/2022] Open
Abstract
Background To control and eventually eliminate vivax malaria, radical treatment with primaquine (PQ) is essential after completion of blood-stage treatment. Although in many malaria-endemic countries, village health volunteers (VHVs) are engaged in diagnostic treatment of malaria in remote communities, they principally provide blood-stage treatment. In such a situation, access to PQ following blood-stage treatment can be a barrier to complete treatment. However, studies on access to PQ treatment have been scarce and limited in health facility-based settings. This study aimed to identify factors associated with access to PQ treatment in rural Papua New Guinea (PNG) from the community case management perspective. Methods A community-based, cross-sectional survey was conducted to collect sociodemographic information on children under 15 years of age, their households, and their caretakers in East Sepik Province, PNG. Data collection lasted from February to March, 2015. Information on the diagnoses of potential non-falciparum malaria and prescription of PQ in preceding year (January to December 2014) were obtained from child health-record books. Then, multilevel logistic regression model was used to determine the factors associated with formal health facility visits for PQ treatment among children with potential non-falciparum malaria. Results Of 420 episodes diagnosed as potential non-falciparum malaria, 46 (11%) were immediately given PQ. The rest were instructed to visit formal health facilities (HFs) for PQ, and the patients obtained PQ during the second visit to HFs was 44%. Consequently, the overall proportion of PQ prescription was 50%. Logistic regression analysis suggested that among the patients who were instructed to visit HFs for PQ treatment, the initial visit to VHV and higher transportation costs to HF were inversely associated with PQ prescription during the second visit to an HF. Conclusions Few children received PQ treatment during the second visit to HFs following diagnosis of potential non-falciparum malaria. These findings suggest a need to establish a policy to reduce structural and economic barriers and improve rural inhabitant access to PQ treatment. Electronic supplementary material The online version of this article (10.1186/s12936-019-2675-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Akiko Yoshii
- TWMU Career Development Center for Medical Professionals, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.,Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Makoto Sekihara
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.,Department of Tropical Medicine and Parasitology, Juntendo University School of Medicine, 6th Floor, Bldg. No.9, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takuro Furusawa
- Department of Ecology and Environment, Graduate School of Asian and African Area Studies, Kyoto University, Room#AA431, Research Bldg. No.2, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Francis Hombhanje
- Centre for Health Research and Diagnostics, Divine Word University-Rabaul Campus, Kokopo, Papua New Guinea
| | - Takahiro Tsukahara
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. .,School of Economics, Hosei University Graduate School, 2-15-2 Ichigaya Tamachi, Shinjuku-ku, Tokyo, 162-0843, Japan.
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17
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Thriemer K, Bobogare A, Ley B, Gudo CS, Alam MS, Anstey NM, Ashley E, Baird JK, Gryseels C, Jambert E, Lacerda M, Laihad F, Marfurt J, Pasaribu AP, Poespoprodjo JR, Sutanto I, Taylor WR, van den Boogaard C, Battle KE, Dysoley L, Ghimire P, Hawley B, Hwang J, Khan WA, Mudin RNB, Sumiwi ME, Ahmed R, Aktaruzzaman MM, Awasthi KR, Bardaji A, Bell D, Boaz L, Burdam FH, Chandramohan D, Cheng Q, Chindawongsa K, Culpepper J, Das S, Deray R, Desai M, Domingo G, Duoquan W, Duparc S, Floranita R, Gerth-Guyette E, Howes RE, Hugo C, Jagoe G, Sariwati E, Jhora ST, Jinwei W, Karunajeewa H, Kenangalem E, Lal BK, Landuwulang C, Le Perru E, Lee SE, Makita LS, McCarthy J, Mekuria A, Mishra N, Naket E, Nambanya S, Nausien J, Duc TN, Thi TN, Noviyanti R, Pfeffer D, Qi G, Rahmalia A, Rogerson S, Samad I, Sattabongkot J, Satyagraha A, Shanks D, Sharma SN, Sibley CH, Sungkar A, Syafruddin D, Talukdar A, Tarning J, ter Kuile F, Thapa S, Theodora M, Huy TT, Waramin E, Waramori G, Woyessa A, Wongsrichanalai C, Xa NX, Yeom JS, Hermawan L, Devine A, Nowak S, Jaya I, Supargiyono S, Grietens KP, Price RN. Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group. Malar J 2018; 17:241. [PMID: 29925430 PMCID: PMC6011582 DOI: 10.1186/s12936-018-2380-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 06/08/2018] [Indexed: 01/13/2023] Open
Abstract
The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness.
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Affiliation(s)
- Kamala Thriemer
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Albino Bobogare
- Ministry of Health and Medical Services, National Vector-Borne Disease Control Programme, Honiara, Solomon Islands
| | - Benedikt Ley
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | | | - Mohammad Shafiul Alam
- 0000 0004 0600 7174grid.414142.6International Center for Diarrheal Diseases (ICDDR,B), Dhaka, Bangladesh
| | - Nick M. Anstey
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Elizabeth Ashley
- Myanmar-Oxford Clinical Research Unit, Yangon, Myanmar ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - J. Kevin Baird
- 0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,0000 0004 1795 0993grid.418754.bEijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - Charlotte Gryseels
- 0000 0001 2153 5088grid.11505.30Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Elodie Jambert
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | - Marcus Lacerda
- Instituto Leônidas & Maria Deane (Fiocruz), Manaus, Amazonas Brazil ,0000 0004 0486 0972grid.418153.aFundação de Medicina Tropical Dr, Heitor Vieira Dourado, Manaus, Amazonas Brazil
| | - Ferdinand Laihad
- National Forum on Indonesia RBM/National Forum on Gebrak Malaria, Jakarta, Indonesia
| | - Jutta Marfurt
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | | | | | - Inge Sutanto
- 0000000120191471grid.9581.5University of Indonesia, Jakarta, Indonesia
| | - Walter R. Taylor
- 0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Christel van den Boogaard
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia
| | - Katherine E. Battle
- 0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | - Lek Dysoley
- grid.452707.3National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia ,grid.436334.5School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Prakash Ghimire
- 0000 0001 2114 6728grid.80817.36Microbiology Department, Tribhuvan University, Kathmandu, Nepal
| | - Bill Hawley
- 0000 0001 2163 0069grid.416738.fEntomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jimee Hwang
- 0000 0001 2163 0069grid.416738.fPresident’s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA ,0000 0001 2297 6811grid.266102.1Global Health Group, University of California San Francisco, San Francisco, USA
| | - Wasif Ali Khan
- 0000 0004 0600 7174grid.414142.6International Center for Diarrheal Diseases (ICDDR,B), Dhaka, Bangladesh
| | - Rose Nani Binti Mudin
- 0000 0001 0690 5255grid.415759.bDisease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Rukhsana Ahmed
- 0000 0004 1936 9764grid.48004.38Liverpool School of Tropical Medicine, Liverpool, UK
| | - M. M. Aktaruzzaman
- grid.466907.aDirectorate General of Health Services, Ministry of Health & Family Welfare Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | | | - Azucena Bardaji
- 0000 0000 9635 9413grid.410458.cISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - David Bell
- 0000 0004 0406 7608grid.471104.7Intellectual Ventures Global Good Fund, Bellevue, USA
| | - Leonard Boaz
- Ministry of Health and Medical Services, National Vector-Borne Disease Control Programme, Honiara, Solomon Islands
| | | | - Daniel Chandramohan
- 0000 0004 0425 469Xgrid.8991.9The London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Qin Cheng
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia
| | | | - Janice Culpepper
- 0000 0000 8990 8592grid.418309.7Bill & Melinda Gates Foundation, Seattle, USA
| | - Santasabuj Das
- 0000 0004 1767 225Xgrid.19096.37Indian Council of Medical Research, New Delhi, India
| | - Raffy Deray
- Department of Health, National Centre for Disease Control & Prevention, Manila, Philippines
| | - Meghna Desai
- 0000 0001 2163 0069grid.416738.fMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Wang Duoquan
- 0000 0000 8803 2373grid.198530.6National Institute of Parasitic Diseases, China CDC, Shanghai, China
| | - Stephan Duparc
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | | | | | - Rosalind E. Howes
- 0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | | | - George Jagoe
- 0000 0004 0432 5267grid.452605.0Medicines for Malaria Venture (MMV), Geneva, Switzerland
| | - Elvieda Sariwati
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Sanya Tahmina Jhora
- grid.466907.aDirectorate General of Health Services, Ministry of Health & Family Welfare Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Wu Jinwei
- Tengchong Center for Disease Control and Prevention, Tengchong, China
| | - Harin Karunajeewa
- grid.1042.7Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Enny Kenangalem
- Yayasan Pengembangan Kesehatan dan Masyarakat, Papua (YPKMP), Papua, Indonesia
| | - Bibek Kumar Lal
- Epidemiology & Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | - Sang-Eun Lee
- 0000 0004 1763 8617grid.418967.5Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Seoul, South Korea
| | - Leo Sora Makita
- Ministry of Health, National Malaria Control Programme, Port Mosby, Papua New Guinea
| | - James McCarthy
- 0000 0001 2294 1395grid.1049.cQIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Asrat Mekuria
- 0000 0001 1250 5688grid.7123.7School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Neelima Mishra
- 0000 0004 1767 225Xgrid.19096.37Indian Council of Medical Research, New Delhi, India
| | - Esau Naket
- Ministry of Health, Malaria and Other Vector-Borne Diseases Control Program (MOVBDCP), Port Vila, Vanuatu
| | - Simone Nambanya
- Center of Malariology, Parasitology and Entomology, Communicable Diseases Control, Vientiane, Lao PDR
| | - Johnny Nausien
- Ministry of Health, Malaria and Other Vector-Borne Diseases Control Program (MOVBDCP), Port Vila, Vanuatu
| | - Thang Ngo Duc
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Thuan Nguyen Thi
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Rinitis Noviyanti
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Daniel Pfeffer
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Malaria Atlas Project (MAP), Big Data Institute, University of Oxford, Oxford, UK
| | - Gao Qi
- grid.452515.2Jiangsu Institute of Parasitic Diseases, Wuxi, China ,WHO Collaborative Centre for Research and Training of Malaria Elimination, Wuxi, China
| | - Annisa Rahmalia
- 0000 0004 1796 1481grid.11553.33Tuberculosis-HIV Research Center Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia ,0000000122931605grid.5590.9Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Stephen Rogerson
- 0000 0001 2179 088Xgrid.1008.9Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Iriani Samad
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Jetsumon Sattabongkot
- 0000 0004 1937 0490grid.10223.32Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Bangok, Thailand
| | - Ari Satyagraha
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Dennis Shanks
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia
| | - Surender Nath Sharma
- grid.415820.aNational Vector Borne Disease Control Programme Directorate General of Health Services Ministry of Health & Family Welfare, New Delhi, India
| | - Carol Hopkins Sibley
- WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK ,0000000122986657grid.34477.33University of Washington, Seattle, WA USA
| | - Ali Sungkar
- 0000 0004 0470 8161grid.415709.eFamily Health Directorate, Ministry of Health, Jakarta, Indonesia
| | - Din Syafruddin
- 0000 0004 1795 0993grid.418754.bEijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Arunansu Talukdar
- 0000 0004 1768 2335grid.413204.0Medicine Department, Medical College Kolkata, Kolkata, India
| | - Joel Tarning
- Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Feiko ter Kuile
- 0000 0004 1936 9764grid.48004.38Liverpool School of Tropical Medicine, Liverpool, UK ,0000 0001 0155 5938grid.33058.3dKenya Medical Research Institute (KEMRI) Centre for Global Health Research, Kisumu, Kenya
| | | | - Minerva Theodora
- 0000 0004 0470 8161grid.415709.eMinistry of Health, National Malaria Control Program, Jakarta, Indonesia
| | - Tho Tran Huy
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Edward Waramin
- Family Health Services, Ministry of Health, Port Mosby, Papua New Guinea
| | | | - Adugna Woyessa
- grid.452387.fEthiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Nguyen Xuan Xa
- grid.452658.8National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Joon Sup Yeom
- 0000 0004 0470 5454grid.15444.30Yonsei University College of Medicine, Seoul, South Korea
| | - Lukas Hermawan
- 0000 0004 0470 8161grid.415709.eFamily Health Directorate, Ministry of Health, Jakarta, Indonesia
| | - Angela Devine
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK ,Mahidol Oxford Clinical Research Unit (MORU), Bangkok, Thailand
| | - Spike Nowak
- 0000 0000 8940 7771grid.415269.dPATH, Seattle, USA
| | - Indra Jaya
- Program and Information Department, Directorate General of Disease Prevention and Control, Jakarta, Indonesia
| | | | - Koen Peeters Grietens
- 0000 0001 2153 5088grid.11505.30Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Ric N. Price
- 0000 0000 8523 7955grid.271089.5Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Darwin, NT 0810 Australia ,0000 0004 1936 8948grid.4991.5Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
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18
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Thriemer K, Ley B, Bobogare A, Dysoley L, Alam MS, Pasaribu AP, Sattabongkot J, Jambert E, Domingo GJ, Commons R, Auburn S, Marfurt J, Devine A, Aktaruzzaman MM, Sohel N, Namgay R, Drukpa T, Sharma SN, Sarawati E, Samad I, Theodora M, Nambanya S, Ounekham S, Mudin RN, Da Thakur G, Makita LS, Deray R, Lee SE, Boaz L, Danansuriya MN, Mudiyanselage SD, Chinanonwait N, Kitchakarn S, Nausien J, Naket E, Duc TN, Do Manh H, Hong YS, Cheng Q, Richards JS, Kusriastuti R, Satyagraha A, Noviyanti R, Ding XC, Khan WA, Swe Phru C, Guoding Z, Qi G, Kaneko A, Miotto O, Nguitragool W, Roobsoong W, Battle K, Howes RE, Roca-Feltrer A, Duparc S, Bhowmick IP, Kenangalem E, Bibit JA, Barry A, Sintasath D, Abeyasinghe R, Sibley CH, McCarthy J, von Seidlein L, Baird JK, Price RN. Challenges for achieving safe and effective radical cure of Plasmodium vivax: a round table discussion of the APMEN Vivax Working Group. Malar J 2017; 16:141. [PMID: 28381261 DOI: 10.1186/s12936-017-1784-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 03/18/2017] [Indexed: 01/12/2023] Open
Abstract
The delivery of safe and effective radical cure for Plasmodium vivax is one of the greatest challenges for achieving malaria elimination from the Asia-Pacific by 2030. During the annual meeting of the Asia Pacific Malaria Elimination Network Vivax Working Group in October 2016, a round table discussion was held to discuss the programmatic issues hindering the widespread use of primaquine (PQ) radical cure. Participants included 73 representatives from 16 partner countries and 33 institutional partners and other research institutes. In this meeting report, the key discussion points are presented and grouped into five themes: (i) current barriers for glucose-6-phosphate deficiency (G6PD) testing prior to PQ radical cure, (ii) necessary properties of G6PD tests for wide scale deployment, (iii) the promotion of G6PD testing, (iv) improving adherence to PQ regimens and (v) the challenges for future tafenoquine (TQ) roll out. Robust point of care (PoC) G6PD tests are needed, which are suitable and cost-effective for clinical settings with limited infrastructure. An affordable and competitive test price is needed, accompanied by sustainable funding for the product with appropriate training of healthcare staff, and robust quality control and assurance processes. In the absence of quantitative PoC G6PD tests, G6PD status can be gauged with qualitative diagnostics, however none of the available tests is currently sensitive enough to guide TQ treatment. TQ introduction will require overcoming additional challenges including the management of severely and intermediately G6PD deficient individuals. Robust strategies are needed to ensure that effective treatment practices can be deployed widely, and these should ensure that the caveats are outweighed by the benefits of radical cure for both the patients and the community. Widespread access to quality controlled G6PD testing will be critical.
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19
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Ubalee R, Kim HC, Schuster AL, McCardle PW, Phasomkusolsil S, Takhampunya R, Davidson SA, Lee WJ, Klein TA. Vector Competence of Anopheles kleini and Anopheles sinensis (Diptera: Culicidae) From the Republic of Korea to Vivax Malaria-Infected Blood From Patients From Thailand. J Med Entomol 2016; 53:1425-1432. [PMID: 27493248 DOI: 10.1093/jme/tjw109] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/03/2016] [Indexed: 06/06/2023]
Abstract
In total, 1,300 each of Anopheles kleini Rueda and Anopheles sinensis Wiedemann sensu stricto (s.s.) females (colonized from the Republic of Korea) and Anopheles dirus Peyton & Harrison (Thai strain) were allowed to feed on blood from Thai malaria patients naturally infected with Plasmodium vivax The overall oocyst infection rates for An. dirus, An. kleini, and An. sinensis s.s. were 77.4, 46.1, and 45.9%, respectively. The mean number of oocysts was significantly higher for An. dirus (82.7) compared with An. kleini (6.1) and An. sinensis s.s. (8.6), whereas the mean number of oocysts for An. kleini and An. sinensis s.s. was similar. The overall sporozoite infection rates for An. dirus, An. kleini, and An. sinensis s.s. dissected on days 14-15, 21, and 28 days post-feed were significantly higher for An. dirus (90.0%) than An. kleini (5.4%), whereas An. kleini sporozoite rates were significantly higher than An. sinensis s.s. (<0.1%). The overall sporozoite indices for positive females with +3 (100-1,000 sporozoites) and +4 (>1,000 sporozoites) salivary gland indices were significantly higher for An. dirus (85.7%), compared with An. kleini (47.1%). Only one An. sinensis s.s. had sporozoites (+2; >10-100 sporozoites). These results indicate that An. kleini is a competent vector of vivax malaria. Although An. sinensis s.s. develops relatively high numbers of oocysts, it is considered a very poor vector of vivax malaria due to a salivary gland barrier.
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Affiliation(s)
- Ratawan Ubalee
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
| | - Heung-Chul Kim
- 5th Medical Detachment, 168th Multifunctional Medical Battalion, 65th Medical Brigade, Unit 15247 APO AP 96205-5247
| | - Anthony L Schuster
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
- Current Address: Preventive Health Services Office, Fort Sam Houston, TX, 78234
| | - Patrick W McCardle
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
- Current Address: Walter Reed Army Institute of Research, Forest Glen, MD, 20910
| | - Siriporn Phasomkusolsil
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
| | - Ratree Takhampunya
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
| | - Silas A Davidson
- Department of Entomology, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi, Phayathai, Bangkok 10400, Thailand (; ; ; , ; )
| | - Won-Ja Lee
- Korea National Institute of Health, Cheongju-Si, Chungbuk Province, 28159, Republic of Korea
| | - Terry A Klein
- Medical Department Activity-Korea (MEDDAC-K)/65th Medical Brigade, Unit 15281, Box 754, AP, 96205
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20
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Alam MS, Zeeshan M, Rathore S, Sharma YD. Multiple Plasmodium vivax proteins of Pv-fam-a family interact with human erythrocyte receptor Band 3 and have a role in red cell invasion. Biochem Biophys Res Commun 2016; 478:1211-6. [PMID: 27545606 DOI: 10.1016/j.bbrc.2016.08.096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 08/17/2016] [Indexed: 01/16/2023]
Abstract
Elucidation of molecular mechanisms of receptor-ligand biology during host-parasite interaction helps in developing therapeutic targets. Several Pv-fam-a family proteins of Plasmodium vivax bind to host erythrocytes but their erythrocyte receptors remains to be explored. Here, we show that three merozoite proteins (PvTRAg36, PvATRAg74, and PvTRAg38) of this family interact with Band 3 on human erythrocytes through its three exofacial loops (loop 1, loop 3, and loop 6). These parasite proteins also interfered with the parasite growth in in-vitro, and the inhibition rate seems to be associated with their binding affinity to Band 3. This redundancy in receptor-ligand interaction could be one of the probable mechanism parasite utilizes to invade the host erythrocyte more efficiently.
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Affiliation(s)
- Mohd Shoeb Alam
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mohammad Zeeshan
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sumit Rathore
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Yagya D Sharma
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Alam MS, Zeeshan M, Mittra P, Choudhary V, Sharma YD. Receptor specific binding regions of Plasmodium vivax tryptophan rich antigens and parasite growth inhibition activity of PvTRAg35.2. Microbes Infect 2016; 18:550-8. [PMID: 27235199 DOI: 10.1016/j.micinf.2016.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/18/2016] [Accepted: 04/28/2016] [Indexed: 01/21/2023]
Abstract
Plasmodium tryptophan rich proteins play important role in host-parasite interaction. Earlier, we have described that one of the merozoite expressed Plasmodium vivax tryptophan-rich antigen PvTRAg35.2 binds to the host erythrocytes, have conserved sequences in parasite population, and generates humoral as well as cellular immune responses in humans during this parasitic infection. Here, we show that PvTRAg35.2 interferes with the parasite growth in a heterologous Plasmodium falciparum culture system. This probably suggests the recognition of the common erythrocyte receptor(s) by certain merozoite ligands of these two parasite species. We have mapped the erythrocyte binding activity of PvTRAg35.2 to its two different regions positioned at amino acid residues 155-190 and 263-283. Binding of these peptide domains to the erythrocytes was inhibited by anti-PvTRAg35.2 antibodies either raised in rabbit or produced by the P. vivax patients. The cross-competition between peptides of PvTRAg35.2 and PvTRAg33.5 or PvTRAg38 during erythrocyte binding assay suggested sharing of host cell receptors by these PvTRAgs. Further studies on these receptor-ligand interactions may lead to the development of therapeutic agents for P. vivax malaria.
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Affiliation(s)
- Mohd Shoeb Alam
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mohammad Zeeshan
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Pooja Mittra
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vandana Choudhary
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Yagya D Sharma
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Mirahmadi H, Fallahi S, Seyyed Tabaei SJ. Soluble recombinant merozoite surface antigen-142kDa of Plasmodium vivax: An improved diagnostic antigen for vivax malaria. J Microbiol Methods 2016; 123:44-50. [PMID: 26851675 DOI: 10.1016/j.mimet.2016.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
Abstract
Enzyme Linked Immunosorbent Assay (ELISA), as a serological test, can be a beneficial tool for epidemiological studies by screening blood donors and diagnosis of specific antibodies from Plasmodium vivax (P. vivax) infected cases. Since P. vivax cannot easily be acquired in vitro, ELISA assays using total or semi-purified antigens are seldom used. On the basis of this restriction, we examined whether recombinant protein 42 kDa related to C-terminal region of the merozoite surface antigen-1 of P. vivax (MSA-1(42)) could be suitable for serological detection of vivax malaria infection. Purified recombinant protein produced in Escherichia coli (E. coli) (GST-MSA-1(42)) was examined for its ability to bind to IgG antibodies of individuals with patent P. vivax infection. The method was tested with 262 serum samples collected from individuals living in the south and southeastern regions of Iran where malaria is endemic. Samples exposed to Plasmodium falciparum (P. falciparum) infection and patients with other infectious disease (toxoplasmosis, Leishmania infantum infection, echinococcosis and FUO (fever with unknown origin)) except for P. falciparum were residing in non- malaria endemic areas in Iran. Generally, the sensitivity of ELISA evaluated with sera from naturally infected individuals was 86.9%. The specificity value of the ELISA determined with sera from healthy individuals and from individuals with other infectious diseases was 94.05%. The positive predictive value (PPV), negative predictive value (NPV) provided, and the diagnostic efficiency of anti-rPvMSA-1(42) antibody using indirect ELISA were determined 93.58, 87.77 and 91.06% respectively. Our study demonstrated that, because MSA-1(42) kDa contains both the 33 and 19 kDa fragments in its structure, it can serve as the basis for the development of a sensitive serological test which can be used for epidemiological studies, screening blood donors and diagnosis of P. vivax malaria.
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Affiliation(s)
- Hadi Mirahmadi
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shirzad Fallahi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Parasitology and Mycology, Facultyof Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyyed Javad Seyyed Tabaei
- Department of Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Zhang HW, Liu Y, Zhang SS, Xu BL, Li WD, Tang JH, Zhou SS, Huang F. Preparation of malaria resurgence in China: case study of vivax malaria re-emergence and outbreak in Huang-Huai Plain in 2006. Adv Parasitol 2015; 86:205-30. [PMID: 25476886 DOI: 10.1016/b978-0-12-800869-0.00008-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This chapter reviews the patterns of malaria re-emergence and outbreak that occurred in the Huang-Huai Plain of China in 2006, and the way of quick response to curtail the outbreak by mass drug administration and case management. The contribution of the each intervention in quick response is discussed. Particularly due to the special ecological characteristics in the Huang-Huai Plain, the intervention of vector control is not implemented. Finally, the challenges in the elimination of malaria in this region are highlighted.
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Affiliation(s)
- Hong-Wei Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Ying Liu
- Henan Center for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Shao-Sen Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Bian-Li Xu
- Henan Center for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Wei-Dong Li
- Anhui Center for Disease Control and Prevention, Hefei, People's Republic of China
| | - Ji-Hai Tang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
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Abstract
Malaria can present with various clinical symptoms and complications. While a tertian malaria form that is especially prevalent in Korea is characterized by mild clinical progression, occasional splenic complications are known to occur. A 26-year-old Korean male soldier without prior medical history visited The Armed Forces Capital Hospital with left upper quadrant abdominal pain one day ago. Hemostasis under laparoscopic approach was attempted. The operation was converted into laparotomy due to friable splenic tissue and consequently poor hemostasis. Splenectomy was performed. The patient was discharged at postoperative day 17 without complication. While numerous diseases can result in splenic complications, such as splenic rupture, malarial infection is known as the most common cause. The incidence of malarial infection in Korea is increasing annually, and there are occasional reports of splenic rupture due to the infection, which requires attention.
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Affiliation(s)
- Kwang Min Kim
- Department of Surgery, The Armed Forces Capital Hospital, Seongnam, Korea
| | - Byung Koo Bae
- Department of Surgery, The Armed Forces Capital Hospital, Seongnam, Korea
| | - Sung Bae Lee
- Department of Surgery, The Armed Forces Capital Hospital, Seongnam, Korea
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Maves RC, Dean K, Gadea N, Halsey ES, Graf PC, Lescano AG. False-positive rapid plasma reagin testing in patients with acute Plasmodium vivax malaria: a case control study. Travel Med Infect Dis 2014; 12:268-73. [PMID: 24201039 DOI: 10.1016/j.tmaid.2013.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 10/01/2013] [Accepted: 10/21/2013] [Indexed: 11/22/2022]
Abstract
Non-treponemal tests such as the rapid plasma reagin (RPR) assay are mainstays of syphilis diagnosis, but false-positive tests are common. We identified false-positive RPR titers in 8.2% of patients with malaria due to Plasmodium vivax in northern Peru. Similar rates were not detected in patients with other acute febrile illnesses.
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Singh R, Kumar S, Rana S, Thakur B, Singh S. A comparative study of clinical profiles of vivax and falciparum malaria in children at a tertiary care centre in uttarakhand. J Clin Diagn Res 2013; 7:2234-7. [PMID: 24298484 PMCID: PMC3843453 DOI: 10.7860/jcdr/2013/6914.3479] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/03/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Falciparum malaria has been constantly associated with high morbidity and mortality for a long time. Vivax malaria, which was once thought to be a relatively benign condition, is appearing in its more malignant form, with severity gradually becoming a serious concern. AIM This study is aimed to find out and compare the clinical and pathological manifestations of vivax and falciparum malaria in pediatric age group in Uttarakhand. SETTING AND DESIGN A prospective study was carried out at a tertiary care hospital of a medical college in Uttarakhand, India. MATERIAL AND METHODS This study was done for a period of 2 years, from December 2010 to November 2012. Patients of 18 years age or below from Uttarakhand and nearby regions, who were smear positive or antigen positive were included in the study. STATISTICAL ANALYSIS p value was calculated using Pearson Chi-square with Yates correction by DAG stat software. RESULT Eighty Five patients were found to be suffering from malaria. 61 (71.8%) had vivax malaria, while 24 (28.2%) patients suffered from falciparum. Larger majority of malaria patients in both the groups happened to be males. The detailed study of morbidity profile clearly establishes that the complication related severity, earlier attributed to only falciparum is equally seen in vivax. Thrombocytopenia was the commonest finding in both. Other complications seen in both groups were those of cerebral malaria, severe anemia, ARDS, renal failure, malarial hepatitis, leucocytopenia, pancytopenia, shock with multiorgan dysfunction and hemoglobinuria. Even the mortality in the two groups was of the same order as p value calculated for the difference between the two species was well above 0.05. CONCLUSION Vivax malaria is an important cause of mortality and morbidity. The severity of illness is almost similar in both vivax and falciparum malaria.
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Affiliation(s)
- Ragini Singh
- Associate Professor, Department of Pediatrics, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Shruti Kumar
- Assistant Professor, Department of Pediatrics, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - S.K. Rana
- Professor, Department of Pediatrics, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Brijesh Thakur
- Assistant Professor, Department of Pathology, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - S.P. Singh
- Professor, Department of Medicine, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
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Kwak YG, Lee HK, Kim M, Um TH, Cho CR. Clinical characteristics of vivax malaria and analysis of recurred patients. Infect Chemother 2013; 45:69-75. [PMID: 24265952 PMCID: PMC3780937 DOI: 10.3947/ic.2013.45.1.69] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 10/12/2012] [Accepted: 10/13/2012] [Indexed: 11/24/2022] Open
Abstract
Background Plasmodium vivax malaria is an acute debilitating illness characterized by recurrent paroxysmal fever and relapses from hypnozoites in the liver. Although a few studies reported clinical characteristics of vivax malaria in civilians after reemergence in the Republic of Korea, only a small group of patients was analyzed. Materials and Methods We retrospectively reviewed the medical records of patients who had been diagnosed with vivax malaria by peripheral blood smear in a university-affiliated hospital located in a malaria-endemic area between January 2005 and December 2009. Results During the study period, a total of 352 malarial cases from 341 patients were diagnosed. Vivax malaria was most commonly developed in July and August, 24.7% (87/352), and 21.9% (77/352), respectively. The mean (SD) age was 42.5 (14.7) years and the number of male patients was 243 (71.3%). Six patients had a previous history of vivax malaria from 6 months to 10 years before. A total of 337 patients (98.8%) had fever and the mean (SD) body temperature was 38.3 (1.4)℃. Common associated symptoms were chills (213/341, 62.5%), headache (115/341, 33.7%), and myalgia (85/341, 24.9%). Laboratory findings included thrombocytopenia (340/341, 99.7%), anemia (97/341, 28.5%), leukopenia (148/341, 43.4%), increase of aspartate transaminase (177/341, 51.9%), and increase of alanine transaminase (187/341, 54.8%). Hypotension (14/341, 4.1%), altered mentality (3/341, 0.9%), azotemia (3/341, 0.9%), spleen infarction (2/341, 0.6%), and spleen rupture (1/341, 0.3%) developed as complications. Chloroquine was administered to all patients and primaquine was administered with mean (SD) 3.39 (0.82) mg/kg to 320 patients. There were 11 recurrent infections during the study period. The median (range) time to recurrent infection was 100 (32-285) days. Platelet counts were higher (86,550 vs. 56,910/mm3) and time to treatment of malaria was shorter (5 vs. 7 days) in relapsed cases compared with first occurrence cases (P=0.046). Conclusions The overall recurrence rate of vivax malaria was 3.2% (11/341) in this study. In recurred cases, malaria was diagnosed earlier and thrombocytopenia was less severe. To evaluate the risk factors associated with recurrence and adequate dose of primaquine in Korean patients, further large-scale prospective studies will be needed.
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Affiliation(s)
- Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
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