Late Symptomatic Plasmodium malariae Relapse in the Territory of the Former Yugoslavia

Morović, Miro; Poljak, Ivica; Miletić, Bojan; Trošelj‐Vukić, Biserka; Seili-Bekafigo, Irene; Milotic, Irena

doi:10.2310/7060.2003.2599

Cited by 11 publications

(7 citation statements)

References 7 publications

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“…malariae for neurosyphilis in the 1930s [ 16 ]. Given the parasite’s ability to survive in the human host at low parasitemias for decades [ 17 ], chronic morbidity related to P . malariae infection is likely to occur.…”

Section: Introductionmentioning

confidence: 99%

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

et al. 2015

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Background Plasmodium malariae is a slow-growing parasite with a wide geographic distribution. Although generally regarded as a benign cause of malaria, it has been associated with nephrotic syndrome, particularly in young children, and can persist in the host for years. Morbidity associated with P. malariae infection has received relatively little attention, and the risk of P. malariae-associated nephrotic syndrome is unknown.Methodology/Principal FindingsWe used data from a very large hospital-based surveillance system incorporating information on clinical diagnoses, blood cell parameters and treatment to describe the demographic distribution, morbidity and mortality associated with P. malariae infection in southern Papua, Indonesia. Between April 2004 and December 2013 there were 1,054,674 patient presentations to Mitra Masyarakat Hospital of which 196,380 (18.6%) were associated with malaria and 5,097 were with P. malariae infection (constituting 2.6% of all malaria cases). The proportion of malaria cases attributable to P. malariae increased with age from 0.9% for patients under one year old to 3.1% for patients older than 15 years. Overall, 8.5% of patients with P. malariae infection required admission to hospital and the median length of stay for these patients was 2.5 days (Interquartile Range: 2.0–4.0 days). Patients with P. malariae infection had a lower mean hemoglobin concentration (9.0g/dL) than patients with P. falciparum (9.5g/dL), P. vivax (9.6g/dL) and mixed species infections (9.3g/dL). There were four cases of nephrotic syndrome recorded in patients with P. malariae infection, three of which were in children younger than 5 years old, giving a risk in this age group of 0.47% (95% Confidence Interval; 0.10% to 1.4%). Overall, 2.4% (n = 16) of patients hospitalized with P. malariae infection subsequently died in hospital, similar to the proportions for the other endemic Plasmodium species (range: 0% for P. ovale to 1.6% for P. falciparum).Conclusions/Significance Plasmodium malariae infection is relatively uncommon in Papua, Indonesia but is associated with significant morbidity from anemia and a similar risk of mortality to patients hospitalized with P. falciparum and P. vivax infection. In our large hospital database, one in 200 children under the age of 5 years with P. malariae infection were recorded as having nephrotic syndrome.

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Section: Introductionmentioning

confidence: 99%

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

et al. 2015

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“…The review of the literature confirms the importance of immunity in controlling long-term latency of P. malariae with a state of balanced parasitism which can be abruptly broken by stress events, such as surgery or removing the spleen or by treatment with immunosuppressive drugs, each one responsible for recrudescence of malaria [5–7, 15, 17, 19, 21]. However, the precipitating event in several other cases remain unexplained [12–14, 16, 18, 20, 22–31]. Also intriguing is the ability of P. malariae to escape drugs which are blood schizontocidal for P. falciparum despite the very low parasitaemia that the former parasite produces.…”

Section: Discussionmentioning

confidence: 88%

A case of Plasmodium malariae recurrence: recrudescence or reinfection?

Grande

Antinori

Meroni

et al. 2019

Malar J

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Background Plasmodium malariae is the most neglected of the six human malaria species and it is still unknown which is the mechanism underlying the long latency of this Plasmodium . Case presentation A case of PCR-confirmed P. malariae recurrence in a 52-year old Italian man was observed 5 months after a primary attack. In the interval between the two observed episodes of malaria the patient denied any further stay in endemic areas except for a visit to Libya, a country considered malaria-free. Genomic DNA of the P. malariae strain using five microsatellites (PM2, PM9, PM11, PM25, PM34) and the antigen marker of circumsporozoite ( csp ) was amplified and sequenced. Analysis of polymorphisms of the P. malariae csp central repeat region showed differences between the strains responsible of the first and second episode of malaria. A difference in the allele size was also observed for the sequence analysis of PM2 microsatellites. Conclusions Plasmodium malariae is a challenging human malaria parasite and even with the use of molecular techniques the pathogenesis of recurrent episodes cannot be precisely explained. Electronic supplementary material The online version of this article (10.1186/s12936-019-2806-y) contains supplementary material, which is available to authorized users.

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“…In 2017, Wyoming was the only state that did not report at least one case of malaria. States reporting one or more cases were categorized into quartiles ( Figure 2); the 13 jurisdictions in the upper quartile accounted for 73.1% of the 2,161 cases 67, and Ohio (59). Compared with 2016, a total of 10 jurisdictions reported an increase of five or more cases, and 32 reported no change or a decrease in cases.…”

Section: Region Of Acquisition and Diagnosismentioning

confidence: 99%

“…His medical chart was reviewed, and no additional information was found. Rarely, P. malariae parasitemia has been documented to persist for years after initial infection (59)(60)(61)(62)(63). Explanations for this illness include prolonged P. malariae persistence or nondisclosed travel.…”

Section: Cryptic Casesmentioning

confidence: 99%

Malaria Surveillance — United States, 2017

Mace

Lucchi

Tan

2021

MMWR Surveill. Summ.

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Problem/Condition: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, nosocomial exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate rapid transmission control measures if locally acquired cases are identified. Period Covered: This report summarizes confirmed malaria cases in persons with onset of illness in 2017 and trends in previous years. Description of System: Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments through electronic laboratory reports or by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all cases from NMSS and NNDSS, CDC reference laboratory reports, and CDC clinical consultations. Results: CDC received reports of 2,161 confirmed malaria cases with onset of symptoms in 2017, including two congenital cases, three cryptic cases, and two cases acquired through blood transfusion. The number of malaria cases diagnosed in the United States has been increasing since the mid-1970s; in 2017, the number of cases reported was the highest in 45 years, surpassing the previous peak of 2,078 confirmed cases reported in 2016. Of the cases in 2017, a total of 1,819 (86.1%) were imported cases that originated from Africa; 1,216 (66.9%) of these came from West Africa. The overall proportion of imported cases originating from West Africa was greater in 2017 (57.6%) than in 2016 (51.6%). Among all cases, P. falciparum accounted for the majority of infections (1,523 [70.5%]), followed by P. vivax (216 [10.0%]), P. ovale (119 [5.5%]), and P. malariae (55 [2.6%]). Infections by two or more species accounted for 22 cases (1.0%). The infecting species was not reported or was undetermined in 226 cases (10.5%). CDC provided diagnostic assistance for 9.5% of confirmed cases and tested 8.0% of specimens with P. falciparum infections for antimalarial resistance markers. Mos...

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Late Symptomatic Plasmodium malariae Relapse in the Territory of the Former Yugoslavia

Cited by 11 publications

References 7 publications

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study

A case of Plasmodium malariae recurrence: recrudescence or reinfection?

Malaria Surveillance — United States, 2017

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