The hidden Plasmodium malariae in blood donors: a risk coming from areas of low transmission of malaria

Aschar, Mariana; Levi, José Eduardo; Farinas, M.; Montebello, Sandra C.; Mendrone‐Júnior, Alfredo; Santi, Sílvia Maria Di

doi:10.1590/s1678-9946202062100

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…With the current predominance of P. vivax and still a certain prevalence of P. falciparum , combined with low parasitaemia and all of the difficulties in diagnosing P. malariae , it is not surprising that P. malariae infections have been overlooked in this area. Though not as clinically relevant, it is becoming more appreciated that donors with asymptomatic P. malariae infection could be reservoirs of transfusion-transmitted malaria [ 48 ], and serological surveillance through the MBA offers a prime opportunity for a robust identification of regions where this parasite may be endemic. Alternatively, these PmMSP1 recombinant proteins could be useful to the species-specific diagnosis of P. malariae in routine malaria diagnosis by rapid diagnostic tests (RDTs), which currently target P. falciparum , and other Plasmodium species are identified as “pan-species” [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Antibody Profile Comparison against MSP1 Antigens of Multiple Plasmodium Species in Human Serum Samples from Two Different Brazilian Populations Using a Multiplex Serological Assay

et al. 2021

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Plasmodium malariae has a wide geographic distribution, but mainly at very low parasitemias and in co-infections, leading to an underestimated prevalence of this species. Studies for the detection of antibodies against Plasmodium recombinant proteins are increasingly used to map geographical distributions, seroprevalence and transmission intensities of malaria infection. However, no seroepidemiological survey using recombinant P. malariae proteins has been conducted in Brazil. This work evaluated the antibody response in serum samples of individuals from endemic regions of Brazil (the Amazon region and Atlantic Forest) against five recombinant proteins of P. malariae merozoite surface protein 1 (MSP1), and the MSP1 C-terminal portions of P. vivax and P. falciparum, in a multiplex assay. The positivity was 69.5% of samples recognizing at least one MSP1 recombinant protein. The mean of the Reactivity Index for the C-terminal portion of the P. falciparum was significantly higher compared to the other recombinant proteins, followed by the C-terminal of P. vivax and the N-terminal of P. malariae. Among the recombinant P. malariae proteins, the N-terminal of P. malariae showed the highest Reactivity Index alone. This study validates the use of the multiplex assay to measure naturally acquired IgG antibodies against Plasmodium MSP1 proteins and demonstrate that these proteins are important tools for seroepidemiological surveys and could be used in malaria surveillance.

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Section: Discussionmentioning

confidence: 99%

Antibody Profile Comparison against MSP1 Antigens of Multiple Plasmodium Species in Human Serum Samples from Two Different Brazilian Populations Using a Multiplex Serological Assay

et al. 2021

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“…Plasmodium falciparum was responsible for the majority of infections (70.5%), followed by Plasmodium vivax (10.0%), Plasmodium ovale (5.5%) and Plasmodium malariae (2.6%) [7]. In Brazil, about 99.6% of cases were identifi ed in the Amazon region, which is considered an endemic area [8].…”

Section: Abstract Malaria's Epidemiologymentioning

confidence: 99%

“…A limitation of this methodology is that it cannot detect low levels of Plasmodium clones in the transfused blood. Therefore, the association of diff erent approaches needs to be established to ensure the safety of blood transfusions through a screening with a diagnostic strategy that is sensitive enough to detect low levels of parasitemia, taking into account availability and costs [8].…”

Section: Laboratory Screening For the Prevention Of Transfusion-transmitted Malariamentioning

confidence: 99%

Malaria Transfusional Transmission: Epidemiological Review, Screening Protocols and Prevention Mechanisms

Ferreira-Silva¹,

Carlos²,

Resende³

2021

J Biomed Res Environ Sci

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Malaria is a neglected tropical disease, whose main form of transmission occurs through the bite of the female Anopheles mosquito infected by the parasite Plasmodium sp. Its clinical symptoms range from asymptomatic cases to more severe and fatal conditions. Added to this natural transmission mechanism, many studies report that Malaria is one of the main infectious diseases transmitted by transfusion. There are reports of prevalence among blood donors in the five continents, with the highest number of cases in Africa, Asia and South America, regions of high endemicity. Factors such as the high prevalence rate of asymptomatic malaria carriers, as well as deficient regulation in the screening of blood donors and an ineffective hemovigilance policy make the risk of Transfusion-Transmitted Malaria (TTM) worse, exposing millions of people possible contamination by transfusion, especially in underdeveloped countries. Patients with underlying diseases or immunosuppressed who require polytransfusions are the most susceptible to TTM. After an eventual transfusion of bags contaminated by Plasmodium sp, these patients can develop the most severe form of the disease, presenting high-risk clinical complications that can culminate in fatal outcomes. In view of the facts and aiming at greater transfusion safety, it is observed that stricter regulatory policies aimed at preventing TTM are needed; such policies will be more comprehensive if coordinated by the World Health Organization (WHO) and more effective if they are adequate to the reality of endemic and non-endemic countries. In blood banks, control measures should focus mainly on broad serological coverage with high performance tests, in addition to active hemovigilance programs and encouragement of research and implementation of methods of inactivation of pathogens in blood component bags. Given the above, this study was carried out with the aim of providing knowledge of the current panorama of the prevalence of malaria among blood donors and of documented cases of TTM around the world, as well as demonstrating the disease tracking methodologies in use in different countries, and present possibilities for adopting mechanisms that allow better control of the transfusional transmission of malaria in blood banks.

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“…While more compelling evidences are required to document chloroquine-resistance in P. malariae , the blood stage infection of this Plasmodium species may persist for an unusually long period and can recrudesce after many years of dormancy 9 – 11 . Like other human malaria parasites, P. malariae has been incriminated in transfusion-transmitted malaria in which the prevalence seems to vary across endemic areas 12 , 13 . Meanwhile, the low parasite density of P. malariae among infected individuals has hampered efficient detection by conventional microscopy, especially when it co-infects with other malaria species 14 – 16 .…”

Section: Introductionmentioning

confidence: 99%

Structural organization and sequence diversity of the complete nucleotide sequence encoding the Plasmodium malariae merozoite surface protein-1

Putaporntip

Kuamsab

Rojrung

et al. 2022

Sci Rep

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The merozoite surface protein-1 (MSP1) is a prime candidate for an asexual blood stage vaccine against malaria. However, polymorphism in this antigen could compromise the vaccine’s efficacy. Although the extent of sequence variation in MSP1 has been analyzed from various Plasmodium species, little is known about structural organization and diversity of this locus in Plasmodium malariae ( PmMSP1 ). Herein, we have shown that PmMSP1 contained five conserved and four variable blocks based on analysis of the complete coding sequences. Variable blocks were characterized by short insertion and deletion variants (block II), polymorphic nonrepeat sequences (block IV), complex repeat structure with size variation (block VI) and degenerate octapeptide repeats (block VIII). Like other malarial MSP1 s, evidences of intragenic recombination have been found in PmMSP1 . The rate of nonsynonymous nucleotide substitutions significantly exceeded that of synonymous nucleotide substitutions in block IV, suggesting positive selection in this region. Codon-based analysis of deviation from neutrality has identified a codon under purifying selection located in close proximity to the homologous region of the 38 kDa/42 kDa cleavage site of P. falciparum MSP1 . A number of predicted linear B-cell epitopes were identified across both conserved and variable blocks of the protein. However, polymorphism in repeat-containing blocks resulted in alteration of the predicted linear B-cell epitope scores across variants. Although a number of predicted HLA-class II-binding peptides were identified in PmMSP1, all variants of block IV seemed not to be recognized by common HLA-class II alleles among Thai population, suggesting that diversity in this positive selection region could probably affect host immune recognition. The data on structural diversity in PmMSP1 could be useful for further studies such as vaccine development and strain characterization of this neglected malaria parasite.

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The hidden Plasmodium malariae in blood donors: a risk coming from areas of low transmission of malaria

Cited by 6 publications

References 13 publications

Antibody Profile Comparison against MSP1 Antigens of Multiple Plasmodium Species in Human Serum Samples from Two Different Brazilian Populations Using a Multiplex Serological Assay

Antibody Profile Comparison against MSP1 Antigens of Multiple Plasmodium Species in Human Serum Samples from Two Different Brazilian Populations Using a Multiplex Serological Assay

Malaria Transfusional Transmission: Epidemiological Review, Screening Protocols and Prevention Mechanisms

Structural organization and sequence diversity of the complete nucleotide sequence encoding the Plasmodium malariae merozoite surface protein-1

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