scholarly journals Unraveling the Complexity of Imported Malaria Infections by Amplicon Deep Sequencing

2021 ◽  
Vol 11 ◽  
Author(s):  
Xi He ◽  
Daibin Zhong ◽  
Chunyan Zou ◽  
Liang Pi ◽  
Luyi Zhao ◽  
...  
Keyword(s):  
Deep Sequencing ◽  
Epidemiological Studies ◽  
Imported Malaria ◽  
Malaria Episode ◽  
High Recurrence Rate ◽  
Antimalarial Drug Resistance ◽  
Malaria Epidemic ◽  
Recurrent Malaria ◽  
Recurrence Patterns ◽  
Molecular Patterns

Imported malaria and recurrent infections are becoming an emerging issue in many malaria non-endemic countries. This study aimed to determine the molecular patterns of the imported malaria infections and recurrence. Blood samples were collected from patients with imported malaria infections during 2016–2018 in Guangxi Zhuang Autonomous Region, China. Next-generation amplicon deep-sequencing approaches were used to assess parasite genetic diversity, multiplexity of infection, relapse, recrudescence, and antimalarial drug resistance. A total of 44 imported malaria cases were examined during the study, of which 35 (79.5%) had recurrent malaria infections within 1 year. The majority (91.4%) had one recurrent malaria episode, whereas two patients had two recurrences and one patient had three recurrences. A total of 19 recurrence patterns (the species responsible for primary and successive clinical episodes) were found in patients returning from malaria epidemic countries. Four parasite species were detected with a higher than usual proportion (46.2%) of non-falciparum infections or mixed-species infections. An increasing trend of recurrence infections and reduced drug treatment efficacy were observed among the cases of imported malaria. The high recurrence rate and complex patterns of imported malaria from Africa to non-endemic countries have the potential to initiate local transmission, thereby undermining efforts to eliminate locally acquired malaria. Our findings highlight the power of amplicon deep-sequencing applications in molecular epidemiological studies of the imported malaria recurrences.

scholarly journals Next-Generation Sequencing and Bioinformatics Protocol for Malaria Drug Resistance Marker Surveillance

2018 ◽  
Vol 62 (4) ◽  
pp. e02474-17 ◽  
Author(s):  
Eldin Talundzic ◽  
Shashidhar Ravishankar ◽  
Julia Kelley ◽  
Dhruviben Patel ◽  
Mateusz Plucinski ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Next Generation Sequencing ◽  
Deep Sequencing ◽  
Artemisinin Resistance ◽  
The United States ◽  
Imported Malaria ◽  
Chloroquine Resistance ◽  
Next Generation ◽  
Content Type ◽  
Generation Sequencing

ABSTRACT The recent advances in next-generation sequencing technologies provide a new and effective way of tracking malaria drug-resistant parasites. To take advantage of this technology, an end-to-end Illumina targeted amplicon deep sequencing (TADS) and bioinformatics pipeline for molecular surveillance of drug resistance in P. falciparum, called malaria resistance surveillance (MaRS), was developed. TADS relies on PCR enriching genomic regions, specifically target genes of interest, prior to deep sequencing. MaRS enables researchers to simultaneously collect data on allele frequencies of multiple full-length P. falciparum drug resistance genes (crt, mdr1, k13, dhfr, dhps, and the cytochrome b gene), as well as the mitochondrial genome. Information is captured at the individual patient level for both known and potential new single nucleotide polymorphisms associated with drug resistance. The MaRS pipeline was validated using 245 imported malaria cases that were reported to the Centers for Disease Control and Prevention (CDC). The chloroquine resistance crt CVIET genotype (mutations underlined) was observed in 42% of samples, the highly pyrimethamine-resistant dhps IRN triple mutant in 92% of samples, and the sulfadoxine resistance dhps mutation SGEAA in 26% of samples. The mdr1 NFSND genotype was found in 40% of samples. With the exception of two cases imported from Cambodia, no artemisinin resistance k13 alleles were identified, and 99% of patients carried parasites susceptible to atovaquone-proguanil. Our goal is to implement MaRS at the CDC for routine surveillance of imported malaria cases in the United States and to aid in the adoption of this system at participating state public health laboratories, as well as by global partners.

scholarly journals Plasmodium vivax severe imported malaria in two migrants in France

2019 ◽  
Author(s):  
Arezki Izri ◽  
Sandrine Cojean ◽  
Claire Leblanc ◽  
Yves Cohen ◽  
Olivier Bouchaud ◽  
...  
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Red Blood Cells ◽  
Plasmodium Vivax ◽  
Blood Cells ◽  
Vivax Malaria ◽  
Primary Infection ◽  
Blood Film ◽  
Imported Malaria ◽  
Malaria Episode

Abstract Background: With less than one severe case per year in average, P. vivax is very rarely associated with severe imported malaria in France. We report two cases of P. vivax severe malaria in patients with no evident co-morbidity. Interestingly, both cases did not occur at the primary infection but during relapses. Case presentations Patient 1 A 27-year old male, born in Afghanistan and living in France since 2012, was admitted on August 2015 to our hospital because of abdominal pain, intense headache, fever and hypotension. The patient was hemodynamically unstable despite 5 liters of filling solution. A thin blood film showed Plasmodium vivax trophozoites within the red blood cells. To take care of the septic shock, the patient was given rapid fluid resuscitation, norepinephrine (0.5 mg/h), and intravenous artesunate. Nested polymerase chain reactions of the SSUrRNA gene were negative for P. falciparum but positive for P. vivax. The patient became apyretic in less than 24H and the parasitaemia was negative at the same time. Patient 2 A 24-year old male, born in Pakistan and living in France, was admitted on august 2016 to our hospital because of fever, abdominal pain, headache, myalgia, and nausea. The last travel of the patient in a malaria endemic area occurred in 2013. A thin blood film showed Plasmodium vivax trophozoites within the red blood cells. The patient was treated orally by artenimol-piperaquine and recovered rapidly. Nine months later, the patient returned to our hospital with a relapse of P. vivax malaria. The malaria episode was uncomplicated and the patient recovered rapidly. Three months later, the patient came back again to our hospital with a third episode of P. vivax malaria. Following a rapid hemodynamic deterioration, the patient was transferred to the intensive care unit of the hospital. In all the patient received 10 liters of filling solution to manage the septic shock. After 5 days of hospitalization and a specific treatment, the patient was discharged in good clinical conditions. Conclusion: Clinicians should be aware of the potential severe complications associated with P. vivax in imported malaria, even though the primary infection is uncomplicated.

scholarly journals Plasmodium vivax severe imported malaria in two migrants in France

2019 ◽  
Author(s):  
Arezki Izri ◽  
Sandrine Cojean ◽  
Claire Leblanc ◽  
Yves Cohen ◽  
Olivier Bouchaud ◽  
...  
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Red Blood Cells ◽  
Plasmodium Vivax ◽  
Blood Cells ◽  
Vivax Malaria ◽  
Primary Infection ◽  
Blood Film ◽  
Imported Malaria ◽  
Malaria Episode

Abstract Background With less than one severe case per year in average, Plasmodium vivax is very rarely associated with severe imported malaria in France. Two cases of P. vivax severe malaria occurred in patients with no evident co-morbidity. Interestingly, both cases did not occur at the primary infection but during relapses. Case presentations Patient 1: A 27-year old male, born in Afghanistan and living in France since 2012, was admitted on August 2015 to the Avicenne hospital because of abdominal pain, intense headache, fever and hypotension. The patient was haemodynamically unstable despite 5litres of filling solution. A thin blood film showed P. vivax trophozoites within the red blood cells. To take care of the septic shock, the patient was given rapid fluid resuscitation, norepinephrine (0.5 mg/h), and intravenous artesunate. Nested polymerase chain reactions of the SSUrRNA gene were negative for Plasmodiumfalciparum but positive for P. vivax. The patient became apyretic in less than 24H and the parasitaemia was negative at the same time. Patient 2: A 24-year old male, born in Pakistan and living in France, was admitted on august 2016 because of fever, abdominal pain, headache, myalgia, and nausea. The last travel of the patient in a malaria endemic area occurred in 2013.A thin blood film showed P. vivax trophozoites within the red blood cells. The patient was treated orally by dihydroartemisinin-piperaquine and recovered rapidly. Nine months later, the patient returned to the hospital with a relapse of P. vivax malaria. The malaria episode was uncomplicated and the patient recovered rapidly. Three months later, the patient came back again with a third episode of P. vivax malaria. Following a rapid haemodynamic deterioration, the patient was transferred to the intensive care unit of the hospital. In all the patient received 10 litres of filling solution to manage the septic shock. After 5 days of hospitalization and a specific treatment, the patient was discharged in good clinical conditions. Conclusion Clinicians should be aware of the potential severe complications associated with P. vivax in imported malaria, even though the primary infection is uncomplicated.

scholarly journals Plasmodium vivax severe imported malaria in two migrants in France

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Arezki Izri ◽  
Sandrine Cojean ◽  
Claire Leblanc ◽  
Yves Cohen ◽  
Olivier Bouchaud ◽  
...  
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Red Blood Cells ◽  
Plasmodium Vivax ◽  
Blood Cells ◽  
Primary Infection ◽  
Blood Film ◽  
Imported Malaria ◽  
Malaria Episode ◽  
Co Morbidity

Abstract Background With less than one severe case per year in average, Plasmodium vivax is very rarely associated with severe imported malaria in France. Two cases of P. vivax severe malaria occurred in patients with no evident co-morbidity. Interestingly, both cases did not occur at the primary infection but during relapses. Case presentations Patient 1: A 27-year old male, born in Afghanistan and living in France since 2012, was admitted on August 2015 to the Avicenne hospital because of abdominal pain, intense headache, fever and hypotension. The patient was haemodynamically unstable despite 5 L of filling solution. A thin blood film showed P. vivax trophozoites within the red blood cells. To take care of the septic shock, the patient was given rapid fluid resuscitation, norepinephrine (0.5 mg/h), and intravenous artesunate. Nested polymerase chain reactions of the SSUrRNA gene were negative for Plasmodium falciparum but positive for P. vivax. The patient became apyretic in less than 24H and the parasitaemia was negative at the same time. Patient 2: A 24-year old male, born in Pakistan and living in France, was admitted on August 2016 because of fever, abdominal pain, headache, myalgia, and nausea. The last travel of the patient in a malaria endemic area occurred in 2013. A thin blood film showed P. vivax trophozoites within the red blood cells. The patient was treated orally by dihydroartemisinin-piperaquine and recovered rapidly. Nine months later, the patient returned to the hospital with a relapse of P. vivax malaria. The malaria episode was uncomplicated and the patient recovered rapidly. Three months later, the patient came back again with a third episode of P. vivax malaria. Following a rapid haemodynamic deterioration, the patient was transferred to the intensive care unit of the hospital. In all the patient received 10 L of filling solution to manage the septic shock. After 5 days of hospitalization and a specific treatment, the patient was discharged in good clinical conditions. Conclusion Clinicians should be aware of the potential severe complications associated with P. vivax in imported malaria, even though the primary infection is uncomplicated.

scholarly journals Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study

2020 ◽  
pp. 1-10
Author(s):  
Andreus Roberto Schlosser ◽  
Saulo Augusto Silva Mantovani ◽  
Rayanne Alves de Arruda ◽  
Felipe Monteiro de Araújo ◽  
Rudi Nogueira ◽  
...  
Keyword(s):  
Falciparum Malaria ◽  
Rural Areas ◽  
Therapeutic Response ◽  
Malaria Episode ◽  
Brazilian Amazon Region ◽  
High Incidence ◽  
Recurrent Malaria ◽  
Age Range ◽  
The City ◽  
Maximum Interval

Background: Malaria remains a health problem in the Amazon and since 2005 the state of Acre has high incidence of malaria. Treatment with Coartem® for cases of falciparum malaria was introduced in Acre in August 2012. In Brazil, there is still no published study on the effectiveness of Coartem in endemic areas. Methods: This study was conducted in Mâncio Lima, Acre, in the western Brazilian Amazon region. All malaria cases notified in Mâncio Lima between August 01st, 2012 and October 31st, 2013 were revised. The therapeutic response to Coartem in Mâncio Lima, Acre, was evaluated. A recurrence of falciparum malaria was defined as a malaria case occurring in the same patient in a maximum interval of 40 days between the day treatments was started and the day the next diagnosis was made. Results: All malaria cases (7,171) notified between August 2012 and July 2013 were revised. About 23.72% (n = 1,701) were falciparum malaria. There were six cases of recurrent falciparum malaria that can be classified as treatment failure. All cases had low parasitemia. The minimum and maximum interval between the first and the recurrent malaria episode was 17 days and 33 days. Age range was 9 to 50 years. Two patients were from rural areas, while all others were from riverine areas. Conclusion: Possible failure to Coartem treatment was identified, however causes are not clear. Further studies are needed.

Suicidal Behavior in German Adolescents

2015 ◽  
Vol 43 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener
Keyword(s):  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Present Sample ◽  
Manic Symptoms ◽  
Symptoms Of Depression ◽  
Adolescent Sample ◽  
History Of ◽  
Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

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