Co-infections with Babesia microti and Plasmodium parasites along the China-Myanmar border

Zhou, Xiao‐Nong; Li, Shengguo; Chen, Shen-Bo; Wang, Jiazhi; Xu, Bin; Zhou, He-Jun; Ge, Hongxiang; Chen, Jun-Hu; Hu, Wei

doi:10.1186/2049-9957-2-24

Cited by 64 publications

(66 citation statements)

References 33 publications

(29 reference statements)

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“…China [31]. So, the co-prevalence of Babesia in malaria-endemic regions is possible and sometimes babesiosis has been diagnosed as malaria due to the similarities of symptoms and morphology.…”

Section: Resultsmentioning

confidence: 99%

A molecular survey of febrile cases in malaria-endemic areas along China-Myanmar border in Yunnan province, People’s Republic of China

Zhou¹,

Huang²,

Njuabe³

et al. 2014

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Background: Imported malaria is a major threat to neighboring malaria-eliminating countries such as P.R. China and is difficult to monitor. A molecular survey of febrile patients with a history of traveling abroad along the Myanmar-China endemic border areas from January 2008 to August 2012 was carried out. The rates of infection with species of Plasmodium and compliance of microscopy diagnosis with nested PCR (Polymerase Chain Reaction) results were calculated. Results: Plasmodium genus-specific nested PCR confirmed that 384 cases were positive. Further species-specific nested PCR showed that the rate of Plasmodium vivax infection was 55% (213/384); that of Plasmodium falciparum was 21% (81/384) and 17% (67/384) of cases were co-infection cases of P. vivax and P. falciparum; the remaining 6% (23/384) of cases were caused by other species, such as Plasmodium ovale, P. malaria, P. knowlesi or mixed infections of Plasmodium. In total there was 13% (50/384) false microscopy diagnosis including 6% (22/384) error in species diagnosis and 7% (28/384) undiagnosed cases in co-infection or low parasitemia malaria cases. Conclusions: This study indicates that there are considerable numbers of malaria cases in the China-Myanmar endemic border areas that remain undiagnosed or misdiagnosed by microscopy, especially in low-level and/or complex co-infection cases. It is urgent to develop accurate rapid diagnostic tests and apply PCR confirmation for efficient surveillance.

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Section: Resultsmentioning

confidence: 99%

A molecular survey of febrile cases in malaria-endemic areas along China-Myanmar border in Yunnan province, People’s Republic of China

Zhou¹,

Huang²,

Njuabe³

et al. 2014

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“…Additionally, reports of tick-borne cases within new geographical regions, such as in the Pacific Northwest of the United States (7)(8)(9)(10), through Eastern Europe (11)(12)(13), and into China (14)(15)(16)(17), are also on the rise. Further, new Babesia spp.…”

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Identification and Characterization of the Rhoptry Neck Protein 2 in Babesia divergens and B. microti

et al. 2016

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bApicomplexan parasites include those of the genera Plasmodium, Cryptosporidium, and Toxoplasma and those of the relatively understudied zoonotic genus Babesia. In humans, babesiosis, particularly transfusion-transmitted babesiosis, has been emerging as a major threat to public health. Like malaria, the disease pathology is a consequence of the parasitemia which develops through cyclical replication of Babesia parasites in host erythrocytes. However, there are no exoerythrocytic stages in Babesia, so targeting of the blood stage and associated proteins to directly prevent parasite invasion is the most desirable option for effective disease control. Especially promising among such molecules are the rhoptry neck proteins (RONs), whose homologs have been identified in many apicomplexan parasites. RONs are involved in the formation of the moving junction, along with AMA1, but no RON has been identified and characterized in any Babesia spp. Here we identify the RON2 proteins of Babesia divergens (BdRON2) and B. microti (BmRON2) and show that they are localized apically and that anti-BdRON2 antibodies are significant inhibitors of parasite invasion in vitro. Neither protein is immunodominant, as both proteins react only marginally with sera from infected animals. Further characterization of the direct role of both BdRON2 and BmRON2 in parasite invasion is required, but knowledge of the level of conformity of RON2 proteins within the apicomplexan phylum, particularly that of the AMA1-RON2 complex at the moving junction, along with the availability of an animal model for B. microti studies, provides a key to target this complex with a goal of preventing the erythrocytic invasion of these parasites and to further our understanding of the role of these conserved ligands in invasion.H uman babesiosis is a zoonotic disease caused by protozoan parasites of the Babesia genus, primarily the bovine pathogen Babesia divergens in Europe (1, 2) and the rodent-borne parasite B. microti in the United States (3, 4). Parasites are transmitted by the bite of the ixodid tick when the insect takes a blood meal, and the current understanding of human babesiosis epidemiology is that B. divergens causes acute illness, usually in immunocompromised patients, whereas B. microti can also infect normosplenic immunocompetent individuals, resulting in infections that range from being asymptomatic to chronic. While many infections remain asymptomatic, especially in younger and immunocompetent individuals, the burden of severe pathology is in newborn infants and older or immunocompromised individuals, and fatality rates average 30% to 45% in these susceptible hosts (5). Transfusiontransmitted babesiosis is an emerging threat to public health, as asymptomatic carriers donate blood and there are no approved or regulated tests to screen blood products for this pathogen. As a consequence, since 2011, babesiosis has been a nationally notifiable disease in 18 states in the United States (6).Additionally, reports of tick-borne cases within new geographical...

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“…However it is clear that in recent years, there has be a steady and significant increase of new tick borne infections with the People’s Republic of China, and the incidence rate of these infection is rising with certain regions [58]. I. persulcatus is considered the main vector throughout PR China, and the historical cases of babesiosis have been attributed to either B. microti or B. divergens but have been sporadic [17, 59-61]. Yet two recent reports demonstrate the seriousness of this emerging zoonosis in this region.…”

Section: Introductionmentioning

confidence: 99%

Human Babesiosis: Pathogens, Prevalence, Diagnosis, and Treatment

Ord

Lobo

2015

Curr Clin Micro Rpt

110

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Human babesiosis is a zoonotic disease caused by protozoan parasites of the Babesia genus, primarily in the Northeastern and Midwest United States due to B. microti, and Western Europe due to B. divergens. Parasites are transmitted by the bite of the ixodid tick when the vector takes a blood meal from the vertebrate host, and the economic importance of bovine babesiosis is well understood. The pathology of human disease is a direct result of the parasite’s ability to invade host’s red blood cells. The current understanding of human babesiosis epidemiology is that many infections remain asymptomatic, especially in younger or immune competent individuals, and the burden of severe pathology resides within older or immunocompromised individuals. However, transfusion-transmitted babesiosis is an emerging threat to public health as asymptomatic carriers donate blood and there are as yet no licensed or regulated tests to screen blood products for this pathogen. Reports of tick-borne cases within new geographical regions such as the Pacific Northwest of the US, through Eastern Europe, and into China are also on the rise. Further, new Babesia spp. have been identified globally as agents of severe human babesiosis, suggesting that the epidemiology of this disease is rapidly changing, and it is clear that human babesiosis is a serious public health concern that requires close monitoring and effective intervention measure.

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Co-infections with Babesia microti and Plasmodium parasites along the China-Myanmar border

Cited by 64 publications

References 33 publications

A molecular survey of febrile cases in malaria-endemic areas along China-Myanmar border in Yunnan province, People’s Republic of China

A molecular survey of febrile cases in malaria-endemic areas along China-Myanmar border in Yunnan province, People’s Republic of China

Identification and Characterization of the Rhoptry Neck Protein 2 in Babesia divergens and B. microti

Human Babesiosis: Pathogens, Prevalence, Diagnosis, and Treatment

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