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

Gunawardena, Sharmini; Daniels, Rachel F.; Yahathugoda, Thishan C.; Weerasooriya, Mirani V.; Durfee, Katelyn; Volkman, Sarah K.; Wirth, Dyann F.; Karunaweera, Nadira D.

doi:10.1186/s12879-017-2411-z

Cited by 4 publications

(7 citation statements)

References 26 publications

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“…Both P. ovale spp. have been infrequently reported from Bangladesh [16]; Bioko Island [17], the Comoros Islands [18], Congo-Brazzaville [17], Ethiopia [19, 20], Ghana [21], India [22], the Ivory Coast [16], Kenya [23], Senegal [24, 25], and Uganda [17]. Plasmodium o. wallikeri is also prevalent in Malaysia [26], while P. o. curtisi infections have recently been reported from Sri Lanka [27].…”

Section: Introductionmentioning

confidence: 99%

A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Frickmann

Wegner

Ruben

et al. 2019

Malar J

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Background: To assess the occurrence of Plasmodium ovale wallikeri and Plasmodium ovale curtisi species in travellers returning to Germany, two real-time PCR protocols for the detection and differentiation of the two P. ovale species were compared. Results of parasite differentiation were correlated with patient data. Methods: Residual nucleic acid extractions from EDTA blood samples of patients with P. ovale spp. malaria, collected between 2010 and 2019 at the National Reference Centre for Tropical Pathogens in Germany, were subjected to further parasite discrimination in a retrospective assessment. All samples had been analysed by microscopy and by P. ovale spp.-specific real-time PCR without discrimination on species level. Two different real-time PCR protocols for species discrimination of P. o. curtisi and P. o. wallikeri were carried out. Results were correlated with patient data on gender, age, travel destination, thrombocyte count, and duration of parasite latency. Results: Samples from 77 P. ovale spp. malaria patients were assessed, with a male:female ratio of about 2:1 and a median age of 30 years. Parasitaemia was low, ranging from few visible parasites up to 1% infected erythrocytes. Discriminative real-time PCRs revealed 41 cases of P. o. curtisi and 36 cases of P. o. wallikeri infections. Concordance of results by the two PCR approaches was 100%. Assessment of travel destinations confirmed coexistence of P. o. curtisi and P. o. wallikeri over a wide range of countries in sub-Saharan Africa. Latency periods for the two P. ovale species were similar, with median values of 56.0 days for P. o. curtisi and 58.0 days for P. o. wallikeri; likewise, there was no statistically significant difference in thrombocyte count with median values of 138.5/µL for patients with P. o. curtisi and 152.0/µL for P. o. wallikeri-infected patients. Conclusions: Two different real-time PCR protocols were found to be suitable for the discrimination of P. o. curtisi and P. o. wallikeri with only minor differences in sensitivity. Due to the overall low parasitaemia and the lack of differences in severity-related aspects like parasite latency periods or thrombocyte counts, this study supports the use of P. ovale spp. PCR without discrimination on species level to confirm the diagnosis and to inform clinical management of malaria in these patients.

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Section: Introductionmentioning

confidence: 99%

A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Frickmann

Wegner

Ruben

et al. 2019

Malar J

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“…Though mortality and morbidity are not typically associated with P. ovale, this disease can be fatal as evidenced by a few cases [7,10,22].The recurrence of parasites dormant in the liver further complicates the difficulty of diagnosing this disease [19,20]. In 2010, two sub-species of P.ovale, Plasmodium ovalecurtisi and Plasmodium ovalewallikeri, were discovered, and discrepancies between the two is still being researched [17].…”

Section: Discussionmentioning

confidence: 99%

“…While malaria was never endemic to America, it did experience a spike in reported cases following World War II, around 1947-1950 [10,16]. Swift government action in the 1950s significantly reduced transmission, and small outbreaks that continued were controlled.…”

Section: Discussionmentioning

confidence: 99%

“…The first stage of the complex malaria plasmodium life cycle occurs when a healthy female Anopheles mosquito feeds on a malaria infected person allowing the mosquito's eggs to be nourished and parasites to reproduce [9]. Once the infected mosquito bites, mainly at dusk and dawn, it will transmit the parasite haploid form, known as sporozoites, from its saliva into the human blood stream [10][11][12]. These organisms then travel to the liver to complete the hepatocellular phase.…”

Section: Introductionmentioning

confidence: 99%

“…If available, diagnosis can be made by Rapid Detection Test, RDT. This immunochromgenic test can be conducted with a dipstick or cassette format, and results are available 2-15 minutes later [10]. A positive detection to plasmodium can be followed up with a PCR to confirm the species prior to treatment [18].…”

Section: Introductionmentioning

confidence: 99%

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Exotic infection presentation of Plasmodium ovale malaria in Morgan County, Alabama

Sujana¹,

Alexis²,

Monita³

2018

Int J Case Rep Images

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Malaria is commonly associated with the virulent form of parasite species known as P. falciparum. Another species that has the capability of causing severe disease is Plasmodium vivax; however, in contrast to these two species, Plasmodium ovale, discovered in 1922, is much rarer and have been known to cause a benign version of malaria. The case of an exotic infection was presented in the non-malaria-endemic North Alabama area imported from Sub-Saharan Africa. P. ovale was discovered in a 41-year-old woman complaining of fever and myalgia. First peripheral blood smear microscopic analysis was negative for malaria parasites. However, second blood smear confirmed the presence of P. ovale with a 1% parasitemia. Challenges in diagnosing this strain stem from the fact that P. ovale is not endemic to the United States and that the relapse phenomenon has not been adequately researched. It remains for a large part unexplained and warrant further investigation.

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Plasmodium ovale infection in Sri Lanka: distant exposure and incidental detection of hyperparasitemia: a case report

Kularatne,

Chulasiri,

Dharmapala

et al. 2023

J Med Case Reports

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Background Plasmodium ovale malaria, which was previously endemic to tropical Africa and the Southwest Pacific islands is now being reported from parts of Asia. In Sri Lanka, the indigenous transmission of malaria has not been documented since October 2012. Since then, there have been several imported cases of malaria, including P.ovale, which have been detected sporadically. The reporting case of P. ovale was imported and detected incidentally in 2021, with several atypical presentations. Case presentation A 40-year-old Sri Lankan medical doctor developed continuous fever with chills, rigors, and dysuria a day following removal of a large lipoma at the root of the neck under general anaesthesia. When the fever has been responding to antibiotics, on the 4th postoperative day a mild thrombocytopenia on complete blood count was detected. A blood smear which was done on the 5th postoperative day incidentally found a malaria parasite and confirmed as Plasmodium ovale with a density of 6535 parasites/microliter on the same day. He never had malaria in the past, but he had worked in South Sudan 1 year ago and visited India six months ago. On the 6th postoperative day, he was treated with chloroquine, and hyperparasitemia reduced rapidly by the next day. As the fever recurred with clinical deterioration, he was treated with different antibiotics. During the course of the illness, he did not develop pallor, or icterus except for a palpable soft spleen. The parasite count was zero on the 9th postoperative day and his fever subsided on the next day. Further, he was treated with primaquine to prevent future relapse and transmission. Conclusion A long incubation period, incidental detection of P ovale in a blood smear, and hyperparasitaemia are the atypical presentations of this case. Postoperative bacterial infection and stress may have reactivated the dormant malaria (hyponozoites) in this patient with an unusual picture. Coinfection of malaria with bacterial sepsis is a challenge in the management of the patient. As the Anopheles mosquito vector exists in Sri Lanka, the risk of indigenous transmission is high from such imported cases of P. ovale.

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

Cited by 4 publications

References 26 publications

A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Exotic infection presentation of Plasmodium ovale malaria in Morgan County, Alabama

Plasmodium ovale infection in Sri Lanka: distant exposure and incidental detection of hyperparasitemia: a case report

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