scholarly journals G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Kay Thwe Han ◽  
Zay Yar Han ◽  
Kyin Hla Aye ◽  
Khin Thet Wai ◽  
Aung Thi ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Malaria Elimination ◽  
G6pd Deficiency ◽  
Control Program ◽  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Radical Cure ◽  
Readiness Assessment ◽  
Cross Sectional

Abstract Background Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies. Methods A cross-sectional study in one township each with high malaria burden from two states in the western part of Myanmar, was conducted during 2016-2018, and 320 participants (164 Rakhine and 156 Chin National groups) were recruited. We used RDT and ultrasensitive polymerase chain reaction (us PCR) method to confirm malaria infection, and a G6PD RDT(CareStart) to detect G6PDd and PCR/restriction fragment length polymorphism (RFLP) method to confirm the variant of G6PDd for genotyping. G6PD enzyme activity was measured by G6PD Biosensor (CareStart). Results Malaria positivity rates detected by RDT were lower than those detected by us PCR in the combined samples [13% (42/320) vs. 21% (67/320)] as well as in the Rakhine samples [17% (28/164) vs. 25% (41/164)] and in Chin samples [9% (14/156) vs. 17% (26/156)]. G6PD deficiency rates were approximately 10% in both the combined samples and specific national groups. For G6PD enzyme activity in the combined samples, G6PDd (defined as < 30% of adjusted male median) was 10% (31/320) and severe G6PDd (< 10% of AMM) was 3% (9/320). Among malaria-infected patients with positive by both RDT and usPCR, G6PDd was less than 20% in each national group. G6PD genotyping showed that the G6PD Mahidol (G487A) was the major variant. Conclusions The varying degree of G6PDd detected among malaria-infected national groups by advanced diagnostic tools, strongly support the recommend G6PD testing by the National Malaria Control Program and the subsequent safe treatment of P. vivax by primaquine for radical cure. Establishing a field monitoring system to achieve timely malaria elimination is mandatory to observe the safety of patients after PQ treatment.

scholarly journals Situation of Asymptomatic Malaria among Iranian Native and Af-ghan and Pakistani Immigrants in a Malarious Area under the Na-tional Malaria Elimination Program of Iran

2020 ◽  
Author(s):  
Setareh ASKARI ◽  
Mehdi NATEGHPOUR ◽  
Afsaneh MOTEVALLI HAGHI ◽  
Leila FARIVAR ◽  
Ahmad RAEISI ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Rapid Diagnostic Tests ◽  
Asymptomatic Malaria ◽  
Sectional Study ◽  
Cross Sectional ◽  
Microscopical Method ◽  
Pakistani Immigrants ◽  
Pcr Techniques

Background: This study was designed to detect, if there are asymptomatic malaria infections amongst native and immigrant population from Afghanistan and Pakistan countries in Sistan & Baluchistan Province of Iran, where is under the national malaria elimination program. Methods: This cross-sectional study was performed among native individuals and resident immigrants in the southeastern province of Sistan & Baluchistan from May 2016 to Jul 2017. A total of 271 individuals were considered in this cross- sectional study based on microscopical method, Rapid Diagnostic Tests (RDTs) and PCR techniques. Out of 271 native and immigrant participants 140 (52%) and 131 (48%) were male and female, respectively. Results: None of the prepared samples was diagnosed as malaria positive case when was considered via above mentioned three techniques. Conclusion: Neither native nor immigrant individuals had asymptomatic malaria, hinting that national malaria elimination program is performed according to planned schedule in the studied areas

scholarly journals G6PD DEFICIENCY

2015 ◽  
Vol 22 (07) ◽  
pp. 881-886
Author(s):  
Zahra Rashid Khan ◽  
Shumaila Najeeb ◽  
Alina Amjad
Keyword(s):  
G6pd Deficiency ◽  
Cross Sectional Study ◽  
World Health ◽  
Military Hospital ◽  
Radical Cure ◽  
Cross Sectional ◽  
Medical College ◽  
Health Organization ◽  
Enzyme Deficient ◽  
Glucose 6 Phosphate Dehydrogenase

Context: Hyperbilirubinemia due to glucose 6 phosphate dehydrogenase(G6PD) deficiency can cause permanent neurological damage and death in neonates.Screening for the enzyme enables timely diagnosis and treatment in cases of G6PD relatedkernicterus. Knowledge of patient G6PD status is also important in treatment of malaria, adisease endemic in Pakistan. World Health Organization recommends mandatoryuse ofprimaquine for radical cure and eradication of malaria. Since, Primaquine, causes hemolysisin G6PD deficient cases, widespread adoption of the drug is viewed with caution. Aims: Thisstudy assessed frequency of G6PD deficiency in Pakistani noenates and examines the need forits screening based on local disease prevalence and malaria endemicity. Settings and Design:A cross sectional study was carried at Hematology Department, Army Medical College (NUST),in collaboration with Military Hospital, Rawalpindi, Pakistan.(January - August, 2011). Methodsand Material: The frequency of G6PD deficiency in newborn population was determined byquantitative (spectrophotometric) method. Cord blood (2.5 ml blood in K3EDTA bottle) sampleswere obtained from 240 newborns (male: female 1.2:1) after informed consent from parents.Statistical analysis used: Data obtained was analyzed using SPSS Windows version 17.Results: Frequency of G6PD deficient cases was 4.2%. Among the ten G6PD deficient patients,six had severe enzyme deficiency (<10% enzyme activity). Conclusions: The local prevalenceof G6PD deficiency and its potential complications qualify it as a disease that must be screenedfor. Also, prior knowledge of patient G6PD status enables the physician to revert to modifiedtreatment regimen for malaria only in enzyme deficient cases and not otherwise.

scholarly journals A Comprehensive Survey of Asymptomatic Malaria Cases in an Endemic Focus in Iran: A Successful Experience on the Road to Eliminate Malaria

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Habibollah Turki ◽  
Mohammad Shekari ◽  
Aboozar Soltani
Keyword(s):  
Malaria Elimination ◽  
Surveillance System ◽  
Protozoan Parasite ◽  
Cross Sectional Study ◽  
Molecular Techniques ◽  
Diagnostic Methods ◽  
Asymptomatic Malaria ◽  
Malaria Surveillance ◽  
Cross Sectional ◽  
On The Road

Background: Malaria is one of the important infectious blood diseases caused by the protozoan parasite of the genus Plasmodium and transmitted by female Anopheles mosquito bites. A malaria elimination plan is currently being followed in Hormozgan Province. The robust malaria surveillance system with appropriate active case findings, especially asymptomatic cases, plays an important role in the malaria elimination program. Objectives: The main objectives of this research were to determine the presence and prevalence of asymptomatic malaria cases and monitor asymptomatic parasitic reservoirs in Jask District, Hormozgan Province. Methods: This cross-sectional study aimed to evaluate and monitor asymptomatic cases in the Jask District. The purpose and stages of the study were explained to all participants/parents, and written informed consent was obtained. A total of 230 asymptomatic residents (124 females and 86 males) were randomly selected, and their blood samples (3 mL) were taken to assess Plasmodium infection using microscopic, RDT, and molecular (18ssrRNA) methods. Results: Of the 230 studied cases, 54.8% were females, and 454.2% were males. The age range was four to 65 years old, and the mean age was 24.5. None of the diagnostic methods, including the microscopic, serological, and molecular techniques, could find asymptomatic malaria cases in the study area. Conclusions: It can be concluded that Malaria Elimination Program is feasible in the Jask Region irrespective of asymptomatic parasitic reservoirs. The results also emphasize a robust and efficient malaria surveillance system to diagnose and treat positive cases and monitor treated cases successfully. Ongoing and continuous studies are recommended in the high-risk malarious area of Hormozgan Province to monitor asymptomatic cases of malaria.

Asymptomatic low-density Plasmodium infection during non-transmission season: a community-based cross-sectional study in two districts of North Eastern Region, India

2021 ◽  
Author(s):  
Hari Shankar ◽  
Sobhan Phookan ◽  
Mrigendra Pal Singh ◽  
Ram Suresh Bharti ◽  
Naseem Ahmed ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Eastern Region ◽  
Low Density ◽  
Plasmodium Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Agencies ◽  
North Eastern ◽  
Asymptomatic Infections

Abstract Background Malaria elimination requires targeting asymptomatic and low-density Plasmodium infections that largely remain undetected. Therefore we conducted a cross-sectional study to estimate the burden of asymptomatic and low-density Plasmodium infection using conventional and molecular diagnostics. Methods A total of 9118 participants, irrespective of age and sex, were screened for malaria using rapid diagnostic tests (RDTs), microscopy and polymerase chain reaction. Results Among the participants, 707 presented with symptoms and 8411 without symptoms, of which Plasmodium was present in 15.6% (110/707) and 8.1% (681/8411), respectively. Low-density infection was found in 5.1% (145/2818) of participants and 8327 of 9118 were Plasmodium negative. Endemicity was propotional to asymptomatic infections (high endemicity 11.1% [404/3633] vs low endemicity 5.8% [277/4778]; odds ratio [OR] 2.0 [95% confidence interval {CI} 1.7 to 2.4]) but inversely related to low-density infection (high endemicity 3.7% [57/1545] vs low endemicity 6.9% [88/1273]; OR 1.9 [95% CI 1.4 to 2.7]). The spleen rate in children 2–9 y of age was 17.9% (602/3368) and the enlarged spleen index was 1.6. Children between 8 and 14 y showed higher odds for asymptomatic (adjusted OR [aOR] 1.75 [95% CI 1.4 to 2.2]) and low-density infections (aOR 0.63 [95% CI 0.4 to 1.0)] than adults. Conclusions The prevalence of asymptomatic and low-density Plasmodium infection undermines the usefulness of standard diagnostic tools used by health agencies. This necessitates deploying molecular tools in areas where malaria microscopy/RDTs indicate a dearth of infection.

scholarly journals Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 838
Author(s):  
Berta Grau-Pujol ◽  
Inocencia Cuamba ◽  
Chenjerai Jairoce ◽  
Anelsio Cossa ◽  
Juliana Da Silva ◽  
...  
Keyword(s):  
Control Program ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Water And Sanitation ◽  
Real Time Quantitative Pcr ◽  
Protozoan Infection ◽  
Household Water ◽  
Protozoan Infections ◽  
Enteric Protozoa

Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01–6.65, p-value = 0.010; OR: 5.21, CI: 1.56–17.46, p-value = 0.010, respectively) compared to household piped water. A high proportion of children had enteric protozoan infections. Well consumable water displayed high risk for that.

scholarly journals The epidemiology and detectability of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in low, moderate and high transmission settings in Ethiopia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elifaged Hailemeskel ◽  
Surafel K Tebeje ◽  
Sinknesh W. Behaksra ◽  
Girma Shumie ◽  
Getasew Shitaye ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Plasmodium Vivax ◽  
Age Groups ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Rapid Diagnostics ◽  
Cross Sectional ◽  
Low Transmission ◽  
High Transmission ◽  
Study Sites

Abstract Background As countries move to malaria elimination, detecting and targeting asymptomatic malaria infections might be needed. Here, the epidemiology and detectability of asymptomatic Plasmodium falciparum and Plasmodium vivax infections were investigated in different transmission settings in Ethiopia. Method: A total of 1093 dried blood spot (DBS) samples were collected from afebrile and apparently healthy individuals across ten study sites in Ethiopia from 2016 to 2020. Of these, 862 were from community and 231 from school based cross-sectional surveys. Malaria infection status was determined by microscopy or rapid diagnostics tests (RDT) and 18S rRNA-based nested PCR (nPCR). The annual parasite index (API) was used to classify endemicity as low (API > 0 and < 5), moderate (API ≥ 5 and < 100) and high transmission (API ≥ 100) and detectability of infections was assessed in these settings. Results In community surveys, the overall prevalence of asymptomatic Plasmodium infections by microscopy/RDT, nPCR and all methods combined was 12.2% (105/860), 21.6% (183/846) and 24.1% (208/862), respectively. The proportion of nPCR positive infections that was detectable by microscopy/RDT was 48.7% (73/150) for P. falciparum and 4.6% (2/44) for P. vivax. Compared to low transmission settings, the likelihood of detecting infections by microscopy/RDT was increased in moderate (Adjusted odds ratio [AOR]: 3.4; 95% confidence interval [95% CI] 1.6–7.2, P = 0.002) and high endemic settings (AOR = 5.1; 95% CI 2.6–9.9, P < 0.001). After adjustment for site and correlation between observations from the same survey, the likelihood of detecting asymptomatic infections by microscopy/RDT (AOR per year increase = 0.95, 95% CI 0.9–1.0, P = 0.013) declined with age. Conclusions Conventional diagnostics missed nearly half of the asymptomatic Plasmodium reservoir detected by nPCR. The detectability of infections was particularly low in older age groups and low transmission settings. These findings highlight the need for sensitive diagnostic tools to detect the entire parasite reservoir and potential infection transmitters.

scholarly journals The cardiac profile and electrocardiographic standard of at-height workers

2018 ◽  
Vol 64 (5) ◽  
pp. 448-453
Author(s):  
Tatiana Soares ◽  
Maria Claudia Irigoyen ◽  
Sílvia Goldmeier
Keyword(s):  
Control Program ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Demographic Variables ◽  
Medical Assessment ◽  
Cross Sectional ◽  
Medical Control ◽  
Medicine Service ◽  
Electrocardiographic Changes ◽  
Electrocardiogram Ecg

SUMMARY BACKGROUND The Medical Control Program for Occupational Health establishes the required supplementary exams, according to the activity exercised by the worker and its inherent risks. The Regulatory Norm No. 35, recently deployed, stipulates that at-height workers must undergo electrocardiogram exams as an additional routine examination. OBJECTIVE To evaluate the electrocardiographic standard in at-height. METHODOLOGY A cross-sectional study, developed from May 2014 to January 2015 with male at-height workers. Anthropometric and clinical data were collected after the electrocardiogram (ECG). The workers included in the program were evaluated by an occupational medicine service of Serra Gaúcha, responsible for medical assessment and occupational tests. All workers were assessed by the researcher. RESULTS A total of 561 at-height workers participated in the study. The average age was 35.9 ± 12.2 years. A total of 176 (31%) presented electrocardiographic changes in the analysis of the resting ECG. Regarding the amendments in the resting ECG, 15.7% were attributed to changes in ventricular repolarization, 8% as blocks conductions, and 5.8% as left ventricular overload. Demographic variables were not associated with changes in the electrocardiographic tracing CONCLUSION This study demonstrated the electrocardiographic alterations and the profile of at-height workers. These findings can help determine prevention strategies and provide warnings of possible future harms to the health of these workers.

Prevalence and Epidemiological Characteristics of Asymptomatic Malaria Based on Ultrasensitive Diagnostics: A Cross-sectional Study

2018 ◽  
Vol 69 (6) ◽  
pp. 1003-1010 ◽  
Author(s):  
Seble Girma ◽  
James Cheaveau ◽  
Abu Naser Mohon ◽  
Dewdunee Marasinghe ◽  
Ruth Legese ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Rapid Diagnostic Tests ◽  
World Health ◽  
Asymptomatic Malaria ◽  
Global Public Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Qrt Pcr ◽  
Epidemiological Characteristics

Abstract Background As the global public-health objectives for malaria evolve from malaria control towards malaria elimination, there is increasing interest in the significance of asymptomatic infections and the optimal diagnostic test to identify them. Method We conducted a cross-sectional study of asymptomatic individuals (N = 562) to determine the epidemiological characteristics associated with asymptomatic malaria. Participants were tested by rapid diagnostic tests (CareStart, Standard Diagnostics [SD] Bioline, and Alere ultrasensitive RDT [uRDT]), loop-mediated isothermal amplification (LAMP), and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine malaria positivity. Hemoglobin values were recorded, and anemia was defined as a binary variable, according to World Health Organization guidelines. Results Compared to reference qRT-PCR, LAMP had the highest sensitivity (92.6%, 95% confidence interval [CI] 86.4–96.5), followed by uRDT Alere Malaria (33.9%, 95% CI 25.5–43.1), CareStart Malaria (14.1%, 95% CI 8.4–21.5), microscopy (5.0%, 95% CI 1.8–10.5), and SD Bioline (5.0%, 95% CI 1.8–10.5). For Plasmodium falciparum specimens only, the sensitivity for uRDT Alere Malaria was 50.0% (95% CI 38.8–61.3) and SD Bioline was 7.3% (95% CI 2.7–15.3). Based on multivariate regression analysis with qRT-PCR as the gold standard, for every 3.2% increase in the prevalence of asymptomatic malaria, hemoglobin decreased by 1 gram per deciliter (prevalence ratio 0.968, 95% CI 0.940–0.997; P = .032). Deletions (4.8%) in hrp2 were noted. Conclusions While uRDT Alere Malaria has superior sensitivity to rapid diagnostic tests and microscopy in detecting asymptomatic malaria, LAMP is superior still. Ultrasensitive diagnostics provide the accurate prevalence estimates of asymptomatic malaria required for elimination.

scholarly journals THE CORRELATION BETWEEN FAT INTAKE AND PLASMA SUPEROXIDE DISMUTASE ACTIVITY WITH TELOMERE LENGTH OF MINANGKABAU ETHNICITY MEN, IN WEST SUMATERA, INDONESIA

2019 ◽  
pp. 305-309
Author(s):  
AFRIWARDI AFRIWARDI ◽  
DELMI SULASTRI ◽  
YUNIAR LESTARI ◽  
DESMAWATI DESMAWATI ◽  
PRIMA MINERVA
Keyword(s):  
Superoxide Dismutase ◽  
Enzyme Activity ◽  
Fatty Acid ◽  
Telomere Length ◽  
Saturated Fatty Acids ◽  
Cross Sectional Study ◽  
Fat Intake ◽  
Sod Activity ◽  
Cross Sectional ◽  
Total Fat

Objective: The purpose of this research is to investigate the correlation between fat intake and plasma superoxide dismutase (SOD) enzyme activity with telomere length of Minangkabau ethnic men in West Sumatera, Indonesia. Materials and Methods: This cross-sectional study was conducted in Padang City in 2016, using a sample of 107 Minangkabau ethnic men, aged between 40 and 50 years. The total fat, saturated fatty acids (SFA), monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) intake were collected using a food frequency questionnaire, and blood sample analysis to measure telomere length and plasma SOD activity. Results: This research indicated that an average telomere length was 584.59±305.92 bp, fat intake consists of total fat was 27.01±6.68% calorie, SFA was 24,7510.07% calorie, MUFA was 10.24±5.41% calorie, and PUFA was 7.35±3.54% calorie. Average of plasma SOD activity was 5.85±3.41 u/mL. There were no correlations between fat intake (total fat, SFA, MUFA, and PUFA) with telomere length (p>0.05), but there was a significant positive correlation between plasma SOD enzyme activity with telomere length (r=−0.202, p=0.037). Conclusion: Fat intake within normal limits does not correlate with telomere length, and plasma SOD activity is a risk factor for telomere shortening in ethnic Minangkabau men.

scholarly journals An evaluation of compliance with the cigarettes and other tobacco products act 2003 in Koppal district, Karnataka

2019 ◽  
Vol 6 (7) ◽  
pp. 3113
Author(s):  
Vijaykumar P. Mane ◽  
Yuvaraj Bhanot Yenkanaik ◽  
Shankrappa Dhanapur ◽  
Sangappa Yallammanavar ◽  
Rashmi Sreenivasamurthy
Keyword(s):  
Tobacco Use ◽  
Sample Selection ◽  
Age Groups ◽  
Data Entry ◽  
Control Program ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Tobacco Products

Background: Tobacco is a major risk factor for a number of diseases affecting all age groups. One person dies every six seconds due to tobacco use and up to half of current users will eventually die of a tobacco-related disease. Government of India has enacted cigarette and other tobacco products act (COTPA) in the year 2003 to control tobacco use. The objective of study was to estimate the level of compliance to selected sections (4 to 9) of COTPA (cigarette and other tobacco products – prohibition of advertisement and regulation of trade and commerce, production, supply and distribution) act, 2003 in Koppal district, Karnataka.Methods: The present study was a cross sectional study conducted as an independent evaluation of COTPA act 2003 in Koppal district as per National Tobacco Control Program guidelines. Cluster sampling technique was used for sample selection and sample consisted of 158 public places, 102 educational institutional, 87 shops/ sell points and 60 tobacco products. Data entry and analysis was done using microsoft office excel 2013.Results: The prevalence of compliance to section 4, 5, 6A, 6B, 7, 8 and 9 of COTPA act 2003 in Koppal district were 80.3%, 96.5%, 98.9%, 64.8%, 53.3%, 63.3% and 50% respectively.Conclusions: Compliance level was poor especially in relation to display of health warnings on tobacco products which needs to be tackled through strict enforcement of the existing laws.

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