Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar

Zaw, Moe; Thant, Myo; Hlaing, Tin Maung; Aung, Naing Zin; Thu, Min; Phumchuea, Kanit; Phusri, K.; Saeseu, Teerawat; Yorsaeng, Ritthideach; Nguitragool, Wang; Felger, Ingrid; Kaewkungwal, Jaranit; Cui, Liwang; Sattabongkot, Jetsumon

doi:10.1186/s12936-017-1789-9

Cited by 49 publications

(60 citation statements)

References 30 publications

(32 reference statements)

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“…However, this figure is lower than previous studies in Kenya 12.6% (28) and Tanzania 8% (29). Lower findings than the current study were reported in Malo, Southwest Ethiopia with no case (17), Myanmar 1.4% (30), and Haiti with 2.8% (24). This difference might be due to parasitemia level, variation in transmission setting, and skills of laboratory personnel.…”

Section: Discussioncontrasting

confidence: 94%

“…The polymerase chain reaction (PCR) detected and identified 12% of asymptomatic Plasmodium spp infection. This was higher than previous studies in Ethiopia; with 8.12% (17,18), Myanmar with 2.3% (30), Zambia with 8% (31). However, it was lower than findings in Southeast Asia with 20% 22 Moreover, the present study revealed that PCR invariably detected higher proportion of asymptomatic infection with about 2.7 and 2.3 folds higher than RDT and microscopy, respectively.…”

Section: Discussioncontrasting

confidence: 71%

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Reactive Case Detection of Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

Melese¹,

ma²,

Yimer³

et al. 2019

Preprint

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Background Malaria is the leading vector borne parasitic disease causing enormously high morbidity and mortality worldwide. There have been huge efforts so far to control and eliminate malaria in the world. However, high prevalence of asymptomatic carriage poses a threat on malaria control and elimination programs. Since asymptomatic infections present no overt sign and symptoms, they do not get clinical attention. Moreover, asymptomatic cases are a potential source of infection in high and low transmission settings. Despite the presence of some pocket data, the prevalence of asymptomatic carriage has not yet been known nationally and the current study area as well. Therefore, we aimed to assess the prevalence of asymptomatic malaria cases and associated factors in households and neighbors of laboratory confirmed cases in Raya Kobo district, Northeast Ethiopia. Methods: A community based cross-sectional study was conducted from February to April, 2019 among 270 study participants selected by convenient sampling technique at the community where laboratory confirmed cases were found. A structured questionnaire was used to collect data on socio-demographic characteristics, individual and household level factors. The data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20. Variables with P<0.25 in the bivariable analysis were taken to the multivariable analysis to control potential confounders, and p< 0.05 was considered statistically significant. Results: The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2% and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). Majority of the infections (73.7%) were identified from index households. PCR detected asymptomatic infections about 2.7 and 2.3 folds higher than RDT and microscope, respectively. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of Plasmodium spp infection.Conclusion: Reactive case detection had identified considerably higher asymptomatic malaria cases at the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities. Diagnostic tests involving the PCR should be implemented in the surveillance of asymptomatic malaria. Active malaria cases should also be treated.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussioncontrasting

confidence: 71%

Reactive Case Detection of Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

Melese¹,

ma²,

Yimer³

et al. 2019

Preprint

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“…The prevalence of asymptomatic Plasmodium infection was higher using microscopy than RDT which disagrees with a report from the rural surroundings of Arbaminch Town, South Ethiopia [6]. However, the finding was consistent with the study findings reported from Tanzania and Myanmar [16,17]. There was statistically significant association between ITN usage habit and plasmodium infection in pregnant women.…”

Section: Discussioncontrasting

confidence: 55%

Asymptomatic malaria infection among pregnant women attending antenatal care in malaria endemic areas of North-Shoa, Ethiopia: a cross-sectional study

Feleke

Adamu

Gebreweld

et al. 2020

Malar J

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Background: The effort to reduce the burden of malaria should target transmission in the community by accurate identification of asymptomatic infections. In malaria-endemic areas, asymptomatic malaria infection is still associated with complications. Malaria during pregnancy is characterized by anaemia and placental malaria, leading to low birth weight and perinatal morbidity and mortality. This study aimed to provide reliable data on the burden of asymptomatic malaria among pregnant women in malaria endemic areas of North-Shoa, Ethiopia. Methods: Cross-sectional study was carried out to assess the prevalence and predictors of asymptomatic malaria in pregnant women from November 2018 to January 2019. Multistage sampling technique was employed to include 263 study participants. Data were analysed using SPSS version 20.0 statistical software. In all comparisons, p-values ≤ 0.05 was considered as statistically significant. Results: The prevalence of asymptomatic malaria infection was 5.7% (15/263) and 3.4% (9/263) by using microscopy and RDTs, respectively. Plasmodium falciparum was a dominant species 9 (3.4%) and Plasmodium vivax accounted for 6 (2.3%) of Plasmodium infections as detected by microscopy. Multivariate analysis showed that ITN usage and haemoglobin level had a statistically significant association with Plasmodium infection after adjusting other possible factors. Compared to those who were using ITN always, the odds of Plasmodium infection was 18.16 times higher (95% CI 1.84-179.07) in pregnant women who were not using ITN, and 5.19 times higher (95% CI 0.55-49.21) in pregnant women who were using ITN sometimes. Asymptomatic malaria infected pregnant women were 3.78 times (95% CI 0.98-14.58) more likely to be anaemic compared to non-infected pregnant women. Conclusion: The present study showed asymptomatic malaria is prevalent in pregnant women and it has statistically significance association with the haemoglobin level of pregnant women. This indicates pregnant women have to be screened for asymptomatic malaria to avoid health consequences of malaria infection during pregnancy for the mother and fetus.

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“…Depending on the RDT used and study setting and design, RDT may 26,27 or may not 28,29 perform better than microscopy in detecting SMI. Such infections, if undetectable by the current generation of RDTs, may compromise the current focus on malaria elimination in PNG.…”

Section: Discussionmentioning

confidence: 99%

Plasmodium falciparum Histidine-Rich Protein 2 Gene Variation in a Malaria-Endemic Area of Papua New Guinea

Willie

Zimmerman

Mehlotra

2018

The American Journal of Tropical Medicine and Hygiene

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Histidine-rich protein 2 of (PfHRP2) forms the basis of many current malaria rapid diagnostic tests (RDTs). It is concerning that there are parasites that lack part or all of the gene, and thus do not express the PfHRP2 protein; such parasites are not identifiable by PfHRP2-detecting RDTs. Very limited information is available regarding genetic variation in Papua New Guinea (PNG). In the present study, this gene variation was evaluated using 169 samples previously collected from the Wosera area in East Sepik Province of PNG. Molecular diagnosis of these samples showed that 81% were infected, and was present in 91% of those infected samples. One hundred and twenty samples were amplified for exon-2, from which 12 randomly selected amplicons were sequenced, yielding 18 sequences, all of which were unique. Baker repeat type 2 × type 7 numbers ranged from 0 to 108. Epitope mapping analysis revealed that three major epitopes, DAHHAHHA, AHHAADAHHA, and AHHAADAHH, were present in high prevalence and frequencies. These major epitopes have been shown to be recognized by the monoclonal antibodies 3A4 and PTL-3 (DAHHAHHA), C1-13 (AHHAADAHHA), and S2-5 and C2-3 (AHHAADAHH). This study provides further information on the high genetic variation of and its unclear relationship with prediction of RDT detection sensitivity, and identifies major epitopes in this gene from PNG. These results could be relevant and useful to understand the genetic diversity of this gene and the performance of current and future RDTs in this malarious region of the world.

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Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar

Cited by 49 publications

References 30 publications

Reactive Case Detection of Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

Reactive Case Detection of Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

Asymptomatic malaria infection among pregnant women attending antenatal care in malaria endemic areas of North-Shoa, Ethiopia: a cross-sectional study

Plasmodium falciparum Histidine-Rich Protein 2 Gene Variation in a Malaria-Endemic Area of Papua New Guinea

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