An Indigenous Case of Plasmodium ovale Infection in Sri Lanka

Wickremasinghe, Renu; Galapaththy, Gawrie N. L.; Fernando, Wahyu; Monbrison, Frédérique de; Wijesinghe, Rushika; Mendis, Kamini; Picot, Stéphane; Ringwald, Pascal; Wickremasinghe, Ananda R.

doi:10.4269/ajtmh.2008.78.206

Cited by 9 publications

(12 citation statements)

References 8 publications

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“…Although the distribution of P. ovale is concentrated in sub-Saharan Africa [6], P. ovale infections have also been intermittently reported in other parts of the world such as India [15-18], Papua New Guinea [19], Korea [20], Thailand [21], Spain [22] and Sri Lanka [23]. In Southeast Asia, prevalence of P. ovale infections ranged from 2.0% to 9.4%, with records from southern Vietnam, Thai-Myanmar border, Lao PDR and Indonesia [24-26].…”

Section: Discussionmentioning

confidence: 99%

“…While most P. ovale infections in Asia were imported cases, there were at least two reports which indicated indigenous cases such as the one in India [18] and the other in Sri Lanka [23]. Since in both cases, patients involved had no travel history or receipt of blood transfusion or any blood products, P. ovale infection was postulated as locally acquired through infected mosquito bites [18,23].…”

Section: Discussionmentioning

confidence: 99%

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Plasmodium ovale infection in Malaysia: first imported case

Lim

Mahmud

Chew

et al. 2010

Malar J

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BackgroundPlasmodium ovale infection is rarely reported in Malaysia. This is the first imported case of P. ovale infection in Malaysia which was initially misdiagnosed as Plasmodium vivax.MethodsPeripheral blood sample was first examined by Giemsa-stained microscopy examination and further confirmed using a patented in-house multiplex PCR followed by sequencing.Results and DiscussionInitial results from peripheral blood smear examination diagnosed P. vivax infection. However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale. Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.ConclusionsThe current finding should serve as an alert to epidemiologists, clinicians and laboratory technicians in the possibility of finding P. ovale in Malaysia. P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale. It is also timely that conventional diagnosis of malaria via microscopy should be coupled with more advanced molecular tools for effective diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Plasmodium ovale infection in Malaysia: first imported case

Lim

Mahmud

Chew

et al. 2010

Malar J

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“…and Papua New Guinea, but using the availability of polymerase chain reaction (PCR)-based techniques for the diagnosis of malaria, this parasite has recently also been reported from a number of countries in South and Southeast Asia. [12][13][14][15][16] So far, infections with P. ovale have not been reported from Bangladesh.…”

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confidence: 99%

Indigenous Plasmodium ovale Malaria in Bangladesh

Fuehrer

Starzengrüber²,

Swoboda³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. In spite of the high prevalence of malaria in Southeastern Bangladesh, there remains a significant shortage of information regarding the presence of three of five human malaria parasites: Plasmodium ovale , P. malariae , and P. knowlesi . The presence of P. ovale and P. knowlesi has previously never been reported from Bangladesh. We used a genusand species-specific nested polymerase chain reaction, targeting highly conserved regions of the small subunit ribosomal RNA (SSU rRNA) gene, to investigate the presence of malaria parasites in a total number of 379 patient samples in a survey of patients with febrile illnesses in the Chittagong Hill Tracts in Southeastern Bangladesh. We identified the first cases of P. ovale in Bangladesh. They were confirmed by sequence analysis; 189 of 379 samples (49.9%; 95% confidence interval = 44.9-54.9%) were positive for Plasmodium sp. by PCR. P. falciparum monoinfections accounted for 68.3% (61.3-74.5%), followed by P. vivax (15.3%; 10.9-21.2%), P. malariae (1.6%; 0.5-4.6%), P. ovale (1.6%; 0.5-4.6%), and mixed infections (13.2%; 9.1-18.8%). We found no evidence of P. knowlesi in this region.

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“…An indigenous case of P. ovale was reported from Sri Lanka in 2008 [5]. The patient had given a history of repeated attacks of P. vivax malaria, the last of which had occurred only two weeks prior to the episode of admission.…”

Section: Introductionmentioning

confidence: 99%

“…He had been treated as a case of treatment failure until molecular testing confirmed it as a P. ovale infection. This was considered an indigenous infection as the patient neither gave a history of travel overseas nor received any transfusion of blood or blood products [5]. …”

Section: Introductionmentioning

confidence: 99%

Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status

et al. 2017

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BackgroundFollowing its recent certification as malaria-free, imported infections now pose the greatest threat for maintaining this status in Sri Lanka. Imported infections may also introduce species that are uncommon or not previously endemic to these areas. We highlight in this case report the increasing importance of less common malaria species such as Plasmodium ovale in elimination settings and discuss its relevance for the risk of malaria resurgence in the country.Case presentationA 41-year-old patient from southern Sri Lanka was diagnosed with malaria after 8 days of fever. Microscopy of blood smears revealed parasites morphologically similar to P. vivax and the rapid diagnostic test was indicative of non-P. falciparum malaria. He was treated with chloroquine over 3 days and primaquine for 14 days. He was negative for malaria at a one-year follow-up. Molecular testing performed subsequently confirmed that infection was caused by P. ovale curtisi. The patient gave a history of P. vivax malaria treated with chloroquine and primaquine. He also provided a history of travel to malaria endemic regions, including residing in Liberia from May 2012 to November 2013, throughout which he was on weekly malaria prophylaxis with mefloquine. He had also visited India on an eight-day Buddhist pilgrimage tour in September 2014 without malaria prophylaxis.ConclusionsIt is crucial that every case of malaria is investigated thoroughly and necessary measures taken to prevent re-introduction of malaria. Accurate molecular diagnostic techniques need to be established in Sri Lanka for the screening and diagnosis of all species of human malaria infections, especially those that may occur with low parasitemia and are likely to be undetected using the standard techniques currently in use. In addition, ascertaining whether an infection occurred through local transmission or by importation is critical in the implementation of an effective plan of action in the country. This new era emphasizes the global nature of regional malaria elimination. Increasing global surveillance and tool development are necessary in order to “fingerprint” parasites and identify their origin.

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An Indigenous Case of Plasmodium ovale Infection in Sri Lanka

Cited by 9 publications

References 8 publications

Plasmodium ovale infection in Malaysia: first imported case

Plasmodium ovale infection in Malaysia: first imported case

Indigenous Plasmodium ovale Malaria in Bangladesh

Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status

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