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

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.

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Kay Thwe Han ◽  
Zay Yar Han ◽  
Kyin Hla Aye ◽  
Khin Thet Wai ◽  
Aung Thi ◽  
...  

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.


2021 ◽  
Vol 9 (4) ◽  
pp. 850
Author(s):  
José Esteban Muñoz-Medina ◽  
Concepción Grajales-Muñiz ◽  
Angel Gustavo Salas-Lais ◽  
Larissa Fernandes-Matano ◽  
Constantino López-Macías ◽  
...  

Until recently, the incidence of COVID-19 was primarily estimated using molecular diagnostic methods. However, the number of cases is vastly underreported using these methods. Seroprevalence studies estimate cumulative infection incidences and allow monitoring of transmission dynamics, and the presence of neutralizing antibodies in the population. In February 2020, the Mexican Social Security Institute began conducting anonymous unrelated sampling of residual sera from specimens across the country, excluding patients with fever within the previous two weeks and/or patients with an acute respiratory infection. Sampling was carried out weekly and began 17 days before Mexico’s first officially confirmed case. The 24,273 sera obtained were analyzed by chemiluminescent-linked immunosorbent assay (CLIA) IgG S1/S2 and, later, positive cases using this technique were also analyzed to determine the rate of neutralization using the enzyme-linked immunosorbent assay (ELISA). We identified 40 CLIA IgG positive cases before the first official report of SARS-CoV-2 infection in Mexico. The national seroprevalence was 3.5% in February and 33.5% in December. Neutralizing activity among IgG positives patients during overall study period was 86.1%. The extent of the SARS-CoV-2 infection in Mexico is 21 times higher than that reported by molecular techniques. Although the general population is still far from achieving herd immunity, epidemiological indicators should be re-estimated based on serological studies of this type.


Author(s):  
Setareh ASKARI ◽  
Mehdi NATEGHPOUR ◽  
Afsaneh MOTEVALLI HAGHI ◽  
Leila FARIVAR ◽  
Ahmad RAEISI ◽  
...  

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


2020 ◽  
Vol 21 (1) ◽  
pp. 1-11
Author(s):  
Akili Kalinga ◽  
Reginald A. Kavishe ◽  
Deus S Ishengoma ◽  
Gibson Kagaruki ◽  
Clement Mweya ◽  
...  

Background: Despite a decrease in malaria burden reported between 2000 and 2015, an increasing trend of malaria transmission has been recently reported in some endemic countries including Tanzania. Periodic monitoring to identify pocket areas for asymptomatic Plasmodium falciparum infection   is vital for malaria elimination efforts. The objective of this study was to determine prevalence of asymptomatic malaria infections among military recruits in selected camps in Tanzania. Methods: A cross-sectional study was conducted in 2015 at four military camps (Bulombora, Mgambo, Ruvu, and Rwamkoma) of National Service located in regions with varying malaria endemicity in Tanzania.  Finger prick blood samples collected from asymptomatic military recruits who had been at the camps for over two months were simultaneously tested using microscopy and malaria rapid diagnostic tests (mRDTs) to detect malaria parasite infections. Results: Malaria parasite prevalence among asymptomatic recruits was 20.3% and 19.4% by microscopy and mRDT respectively. There was moderate agreement (Kappa=0.724) between microscopy and mRDT test results. A significant difference (p<0.001) of malaria parasite prevalence among the four study camps was observed; ranging from 1.9% in Bulombora to 39.4% in Rwamkoma. The geometric mean parasite density was 11,053 asexual parasites/µl and most recruits (56.8%) had 200 to 1999 asexual parasites/µl. P. falciparum was the predominant (99.2%) malaria parasite species. Conclusion: Our study found high prevalence of asymptomatic malaria infections among military recruits in the selected camps, and this varied from one camp to another. The study has highlighted that public residence institutions such as military camps can be potential hotspots for malaria infection and therefore should not be skipped in routine national malaria surveillance system for monitoring trends of infections


Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1545 ◽  
Author(s):  
Serge Stroobandt ◽  
Roland Stroobandt

Dr. Sarah Stuckelberger and her colleagues should be commended for their cross-sectional study assessing the willingness of Swiss pregnant and breastfeeding women to be vaccinated against SARS-CoV-2 [...]


The Lancet ◽  
2021 ◽  
Vol 398 ◽  
pp. S27
Author(s):  
Jehad A Awad ◽  
Majdi I Dhair ◽  
Nedal I Ghuneim ◽  
Khaled Abu Ali ◽  
Yousef S Al-Yaqoubi ◽  
...  

2018 ◽  
Vol 69 (6) ◽  
pp. 1003-1010 ◽  
Author(s):  
Seble Girma ◽  
James Cheaveau ◽  
Abu Naser Mohon ◽  
Dewdunee Marasinghe ◽  
Ruth Legese ◽  
...  

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.


2019 ◽  
Author(s):  
Shahin Koohmanaee ◽  
Afagh Hassanzadeh Rad ◽  
Seyyedeh Forough Jafari ◽  
Marjaneh Zarkesh ◽  
Ehsan Kazemnejad Leili ◽  
...  

Abstract- We aimed to define Metabolic Syndrome (METs) from different viewpoints to determine the most appropriate method that could be used for early METs' diagnosis in general population and treat them immediately. This study was an analytic cross-sectional study which was conducted on 725, twelve year-old-girls and boys from Rasht city in Iran. METs was defined based on 7 different methods. Data were reported by descriptive statistics (number, percent, mean, and standard deviation) and analyzed by Cohen's kappa coefficient correlation and chi-square in SPSS version 19. The highest and lowest percentages of METs were obtained by DE Ferranti (17.5%) and viner et al., (0.8%) methods, respectively. Results showed that viner et al., had the highest degree of agreement with NCEP ATPIII and the lowest with DE Ferranti. Furthermore, De Ferranti showed the highest degree of agreement with NHANESIII and the lowest with Viner et al., According to results, the identification of the cut off points of obesity could help to promote public health care.


2021 ◽  
Author(s):  
Naoya Fujita ◽  
Yosuke Ono ◽  
Azusa Sano ◽  
Motohiro Kimata ◽  
Seigo Oyama ◽  
...  

Objective: Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves’ disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves’ disease. Design: Patients with destructive thyroiditis (n = 13) and Graves’ disease (n = 22) were enrolled in this cross-sectional study. Methods: We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves’ disease. Results: The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves’ disease. The ROC curve analysis showed that the serum DIT levels (≥ 359.9 pg/mL) differentiated destructive thyroiditis from Graves’ disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < .001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = .001). Conclusions: The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves’ disease.


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