First report of detection and molecular confirmation of <i><scp>P</scp>lasmodium ovale</i> from severe malaria cases in central <scp>I</scp>ndia

Singh, Rajkumar; Jain, Vidhan; Singh, Puspendra P.; Bharti, Praveen K.; Thomas, Trilok; Basak, Sanjay; Singh, Neeru

doi:10.1111/tmi.12184

Cited by 22 publications

(12 citation statements)

References 11 publications

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“…It was also impossible to separate the burden of P. vivax from P.malariae and P. ovale . Although most studies in the area demonstrate the presence of only P.falciparum and P.vivax; P.ovale was also recently isolated in the Chhattisgarh area and its burden is not yet known [47]. …”

Section: Discussionmentioning

confidence: 99%

High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India

Corrêa

Das²,

Kovelamudi³

et al. 2017

Confl Health

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BackgroundWith more than 200 million cases a year, malaria is an important global health concern, especially among pregnant women. The forested tribal areas of Andhra Pradesh, Telangana and Chhattisgarh in India are affected by malaria and by an on-going chronic conflict which seriously limits access to health care. The burden of malaria and anemia among pregnant women in these areas is unknown; moreover there are no specific recommendations for pregnant women in the Indian national malaria policy. The aim of this study is to measure the burden of malaria and anemia among pregnant women presenting in mobile clinics for antenatal care in a conflict-affected corridor in India.MethodsThis is a descriptive study of routine programme data of women presenting at first visit for antenatal care in Médecins sans Frontières mobile clinics during 1 year (2015). Burden of malaria and anemia were estimated using rapid diagnostic tests (SD BIOLINE® and HemoCue® respectively).ResultsAmong 575 pregnant women (median age: 26 years, interquartile range: 25-30) 29% and 22% were in their first and second pregnancies respectively. Mid-Upper Arm Circumference (MUAC) was below 230 mm in 74% of them. The prevalence of anemia was 92.4% (95% Confidence Intervals (CI): 89.9–94.3), while severe anemia was identified in 6.9% of the patients. The prevalence of malaria was 29.3% (95%CI: 25.7–33.2) with 64% caused by isolated P. falciparum, 35% by either P. falciparum or mixed malaria and 1% by either P. vivax, or P.malariae or P. ovale. Malaria test was positive in 20.8% of asymptomatic cases. Malaria was associated with severe anemia (prevalence ratio: 2.56, 95%CI: 1.40–4.66, p < 0.01).ConclusionsSystematic screening for malaria and anemia should be integrated into maternal and child health services for conflict affected populations in highly endemic tribal areas. Interventions should include the use of rapid diagnostic test for all pregnant women at every visit, regardless of symptoms. Further studies should evaluate the impact of this intervention alone or in combination with intermittent malaria preventive treatment.

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Section: Discussionmentioning

confidence: 99%

High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India

Corrêa

Das²,

Kovelamudi³

et al. 2017

Confl Health

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“…Thus, a P. ovale infection acquired while residing in Liberia could have relapsed several years later. Sporadic cases of P. ovale malaria have also been reported from various parts of India [31, 32]. Since transmission of P. ovale in India is not widespread, it seems likely that this patient acquired his infection from Liberia where P. ovale is known to be endemic [12, 13].…”

Section: Discussionmentioning

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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“…Supernatant was aspirated and stored at −20°C for PCR amplification. Species-specific nested PCR was carried out for the detection of P. falciparum (Pf), P. vivax (Pv), P. malariae (Pm) and P. ovale (Po) using the 18s rRNA gene [9] , [20] . Species-specific nested PCR for P. knowlesi was also carried out [21] .…”

Section: Methodsmentioning

confidence: 99%

“…All four species of malaria parasites are found in CG i.e. P. vivax , P. falciparum , P. ovale and P. malariae [9] . This prospective study was undertaken with the objective to understand the clinical epidemiology of CM and SM.…”

Section: Introductionmentioning

confidence: 99%

Burden of Complicated Malaria in a Densely Forested Bastar Region of Chhattisgarh State (Central India)

Jain

Basak²,

Bhandari

et al. 2014

PLoS ONE

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BackgroundA prospective study on severe and complicated malaria was undertaken in the tribal dominated area of Bastar division, Chhattisgarh (CG), Central India, with an objective to understand the clinical epidemiology of complicated malaria in patients attending at a referral hospital.MethodsBlood smears, collected from the general medicine and pediatric wards of a government tertiary health care facility located in Jagdalpur, CG, were microscopically examined for malaria parasite from July 2010 to December 2013. The Plasmodium falciparum positive malaria cases who met enrollment criteria and provided written informed consent were enrolled under different malaria categories following WHO guidelines. PCR was performed to reconfirm the presence of P.falciparum mono infection among enrolled cases. Univariate and multivariate logistic regression analysis was done to identify different risk factors using STATA 11.0.ResultsA total of 40,924 cases were screened for malaria. The prevalence of malaria and P.falciparum associated complicated malaria (severe and cerebral both) in the hospital was 6% and 0.81%, respectively. P.falciparum malaria prevalence, severity and associated mortality in this region peaked at the age of>4–5 years and declined with increasing age. P.falciparum malaria was significantly more prevalent in children than adults (P<0.00001). Among adults, males had significantly more P.falciparum malaria than females (P<0.00001). Case fatality rate due to cerebral malaria and severe malaria was, respectively, 32% and 9% among PCR confirmed mono P.falciparum cases. Coma was the only independent predictor of mortality in multivariate regression analysis. Mortality was significantly associated with multi-organ complication score (P = 0.0003).ConclusionThis study has revealed that the pattern of morbidity and mortality in this part of India is very different from earlier reported studies from India. We find that the peak morbidity and mortality in younger children regardless of seasonality. This suggests that this age group needs special care for control and clinical management.

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First report of detection and molecular confirmation of Plasmodium ovale from severe malaria cases in central India

Cited by 22 publications

References 11 publications

High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India

High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India

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

Burden of Complicated Malaria in a Densely Forested Bastar Region of Chhattisgarh State (Central India)

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