Malaria Elimination: Time to Target All Species

Lover, Andrew A.; Baird, J. Kevin; Gosling, Roly; Price, Ric N.

doi:10.4269/ajtmh.17-0869

Cited by 70 publications

(55 citation statements)

References 84 publications

(85 reference statements)

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“…Plasmodium vivax and P. ovale both form dormant liver stages (hypnozoites) that can reactivate weeks to months following an initial infection, resulting in relapsing malaria [1]. The complete treatment of either species requires the use of drugs able to clear hypnozoites from the liver ('radical cure'), alongside standard blood-stage antimalarials.…”

Section: Introductionmentioning

confidence: 99%

Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis

et al. 2020

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“…infections with a LOD between 100 and 1000 parasites/µL which is significantly higher when compared to NATs [43]. In addition, there is currently no single RDT available that could distinguish all five malaria species infections posing a clear limitation to comprehensive malaria infection status monitoring [44, 45]. Infections with P. malariae [46], P. ovale [47] and P. vivax [48] are usually characterized by low parasitaemia levels, rendering these infections largely undetectable by using currently available RDT technologies [49].…”

Section: Discussionmentioning

confidence: 99%

Molecular monitoring of the diversity of human pathogenic malaria species in blood donations on Bioko Island, Equatorial Guinea

Schindler

Robaina

Sax

et al. 2019

Malar J

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BackgroundMalaria can be transmitted by blood transfusion from human to human and it is responsible for the majority of transfusion-transmitted infectious diseases worldwide. In sub-Saharan Africa, it had been estimated that almost a quarter of blood donations contain malaria parasites. Since rapid diagnostic tests and thick blood smear microscopy lack sensitivity for low density parasitaemia, particularly in asymptomatic adults, the most reliable method to assess the problem of transfusion-transmitted malaria are nucleic acid-based molecular approaches such as quantitative polymerase chain reaction. The study was undertaken to determine the prevalence of sub-microscopic malaria parasite infection among blood donors in Malabo, Equatorial Guinea.MethodsBetween July and August 2017, a total of 200 individual blood samples from blood donors at the Malabo Blood Bank were collected and screened by rapid diagnostic tests and thick blood smear microscopy. Retrospectively, the same samples were analysed for the presence of undetected, low-density malaria parasites using quantitative polymerase chain reaction.ResultsIn comparison to 6.5% (13/200) by rapid diagnostic test and 2.0% (4/200) by microscopy, the proportion of Plasmodium falciparum positive blood donations analysed by quantitative polymerase chain reaction was significantly higher (26%, 52/200). Densities of P. falciparum positive blood donations were ranging from 0.06 to 3707.0 parasites/µL with 79.6% below 100 parasites/µL and therefore not detectable by non-molecular malaria diagnostic tests. qPCR based species identification revealed that P. falciparum was the dominating species responsible for 88.1% (52/59) of positive blood donations, followed by Plasmodium malariae (15.3%, 9/59) and Plasmodium ovale (3.4%, 2/59).ConclusionsThis study confirms that in malaria endemic settings, sub-patent malaria infections among blood donors are prevalent. In blood collected from healthy donors living in Malabo, P. falciparum, P. malariae and P. ovale parasites were identified. Currently widely used malaria diagnostic tools have missed more than 75% of P. falciparum containing blood donations, demonstrating the value of quantitative polymerase chain reaction to reliably detect low density P. falciparum infections. Since the availability of molecular diagnostic methods in malaria endemic countries is still limited, the blood recipients living in malaria endemic countries should be treated following WHO recommendations.Electronic supplementary materialThe online version of this article (10.1186/s12936-019-2639-8) contains supplementary material, which is available to authorized users.

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“…In recent years, malaria vectors have been isolated in the hilly regions of Nepal, which previously were devoid of vectors for malaria [22, 33]. The control and elimination of malaria, therefore, needs to target species-specific interventions integrating the current elimination program [34]. For the complete elimination of malaria (including P. vivax ), a radical therapy using primaquine is essential.…”

Section: Discussionmentioning

confidence: 99%

Micro-stratification of malaria risk in Nepal: implications for malaria control and elimination

Rijal

Adhikari

et al. 2019

Trop Med Health

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Background A significant reduction in malaria cases over the recent years in Nepal has encouraged the government to adopt a goal of “malaria-free nation by 2025.” Nevertheless, to achieve this goal, it is critical to identify the epidemiological burden of malaria by specific regions and areas for an effective targeted intervention. The main objective of this study was to estimate the risk of malaria at Village Development Committee (VDC) level in Nepal based on disease, vector, parasite, and geography. Methods In 2012, the micro-stratification of malaria risk was carried out in 75 districts of Nepal. Instruments such as a questionnaire, case record forms, and guidelines for malaria micro-stratification were developed and pre-tested for necessary adaptations. Village Development Committee (VDC)-wise malaria data were analyzed using exploratory statistics and were stratified by geographical variables that contributed to the risk of malaria. To understand the transmission risk at VDC level, overlay analysis was done using ArcGIS 10. To ensure transparent, reproducible, and comprehensible risk assessment, standard scoring method was selected and utilized for data from 2009 to 2011. Thus identified, three major variables (key determinants) were given weights (wt.) accordingly to stratification of the malaria risk (disease burden, “0.3” wt.; ecology/vector transmission, “0.5” wt.; and vulnerability-population movement, “0.2” wt.). Malaria risk in a VDC was determined based on the overall scores and classified into four categories: no risk, low risk, moderate risk, and high risk. Results Analyzing the overall risk based on scoring of the total VDCs ( n = 3976), 54 (1.36%), 201 (5.06%), 999 (25.13%), and 2718 (68.36%) were identified as high-, moderate-, low-, and no-risk categories for malaria, respectively. Based on the population statistics, 3.62%, 9.79%, 34.52%, and 52.05% of the country’s total population live in high-risk, moderate-risk, low-risk, and no-risk VDCs for malaria, respectively. Our micro-stratification study estimates are 100,000 population at high risk. Regional distribution showed that the majority of the high-risk VDCs were identified in the Far- and Mid-western regions (19 and 18 VDCs) followed by Central and Western regions (10 and 7 VDCs) with no high-risk VDCs in the Eastern region. Similarly, 77, 59, 27, 24, and 14 VDCs of the Central, Mid-western, Western, Eastern, and Far-western regions, respectively, were found under moderate malaria risk. Of the low-risk VDCs, 353, 215, 191, 148, and 92 were respectively from the Central, Eastern, Western, Far-western, and Mid-western regions. Conclusions The current micro-stratification study provides insights on malaria risk up to the VDC level. This will help the malaria elimination program to target interventions at the local level thereby ensuring the best utilization of available resources to substantially narrowed-down ...

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Malaria Elimination: Time to Target All Species

Cited by 70 publications

References 84 publications

Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis

Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis

Molecular monitoring of the diversity of human pathogenic malaria species in blood donations on Bioko Island, Equatorial Guinea

Micro-stratification of malaria risk in Nepal: implications for malaria control and elimination

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