Malaria Prevalence in a Low Transmission Area, Jazan District of Southwestern Saudi Arabia
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Detailed description of malaria in low transmission areas is crucial for elimination. The current study aimed to provide a comprehensive description for malaria transmission in Jazan, a low transmission district, southwestern Saudi Arabia. Patients at a tertiary care hospital were recruited in our study between August 2016 and September 2018. Malaria diagnosis was performed through a species-specific nested polymerase chain reaction (nested PCR), microscopy and Paramax-3TM rapid detection test (RDT). Malaria was detected in 30 patients by the PCR, with point prevalence of 10.9%. Of these malaria infections, 80% was imported, 26.6% was asymptomatic and 23.3% was sub-microscopic. Malaria was reported throughout the year, with February/March and September/October peaks. Infection was significantly more in males than in females (P=0.01). Likewise, infections were detected more in febrile than in non-febrile patients (P=0.01). Adult aged 15-24 years, fever and travel were identified as high-risk factors. Malaria was primarily attributed to Plasmodi- um falciparum mono-infections, followed by P. vivax mono-infections and lastly to falciparum/vivax mixed infections ac- counting 76.6%, 16.6%, and 6.6% of PCR-confirmed malaria cases, respectively. The nested PCR was superior to the smear microscopy (sensitivity 76.6%; specificity 100%) and the RDT (sensitivity 83.3%, specificity 94.2%). The overall percent agreement between microscopy and the RDT was 92.7% (kappa = 0.63). High proportion of imported malaria in- cluding sub-microscopic and sub-patent cases were described. We suggest that incorporation of molecular tool into the conventional malaria diagnosis is beneficial in Jazan district.
Abstract
Detailed description of malaria in low transmission areas is crucial for elimination. The current study aimed to provide a comprehensive description for malaria transmission in Jazan, a low transmission district, southwestern Saudi Arabia. Patients at a tertiary care hospital were recruited in our study between August 2016 and September 2018. Malaria diagnosis was performed through a species-specific nested polymerase chain reaction (nested PCR), microscopy and Paramax-3TM rapid detection test (RDT). Malaria was detected in 30 patients by the PCR, with point prevalence of 10.9%. Of these malaria infections, 80% was imported, 26.6% was asymptomatic and 23.3% was sub-microscopic. Malaria was reported throughout the year, with February/March and September/October peaks. Infection was significantly more in males than in females (P=0.01). Likewise, infections were detected more in febrile than in non-febrile patients (P=0.01). Adult aged 15-24 years, fever and travel were identified as high-risk factors. Malaria was primarily attributed to Plasmodi- um falciparum mono-infections, followed by P. vivax mono-infections and lastly to falciparum/vivax mixed infections ac- counting 76.6%, 16.6%, and 6.6% of PCR-confirmed malaria cases, respectively. The nested PCR was superior to the smear microscopy (sensitivity 76.6%; specificity 100%) and the RDT (sensitivity 83.3%, specificity 94.2%). The overall percent agreement between microscopy and the RDT was 92.7% (kappa = 0.63). High proportion of imported malaria in- cluding sub-microscopic and sub-patent cases were described. We suggest that incorporation of molecular tool into the conventional malaria diagnosis is beneficial in Jazan district.
참고문헌 (40)
- World Malaria Report 2017, "World Health Organization", World Health Organization, ~ (2017)
- Zhou R, "Characterization of Plasmodium ovale spp. imported from Africa to Henan Province, China", Sci Rep, 9, pp.2191~ (2019)
- Bousema T, "Epidemiology and infectivity of Plasmodium falciparum and Plasmodium vivax gametocytes in relation to malaria control and elimination", Clin Microbiol Rev, 24, pp.377~410 (2011)
- Bronzan RN, "Diagnosis of malaria : challenges for clinicians in endemic and non-endemic regions", Mol Diagn Ther, 12, pp.299~306 (2008)
- Mathison BA, "Update on malaria diagnostics and test utilization", J Clin Microbiol, 55, pp.2009~2017 (2017)
- Roth JM, "Molecular malaria diagnostics : a systematic review and meta-analysis", Crit Rev Clin Lab Sci, 53, pp.87~105 (2016)
- Coleman M, "A country on the verge of malaria elimination–the Kingdom of Saudi Arabia", PLoS One, 9, pp.e105980~ (2014)
- Al-Zanbagi NA, "Review of malaria in Saudi Arabia, current status and future prospects", J Int Acad Res Multidiscip, 2, pp.1~15 (2014)
- Bousema T, "Asymptomatic malaria infections : detectability, transmissibility and public health relevance", Nature Rev Microbiol, 12, pp.833~840 (2014)
- Lin JT, "The role of submicroscopic parasitemia in malaria transmission : what is the evidence", Trends Parasitol, 30, pp.183~190 (2014)
- El Hassan IM, "Progress toward malaria elimination in Jazan Province, Kingdom of Saudi Arabia : 2000-2014", Malaria J, 14, pp.444~ (2015)
- Dafalla OM, "Identification of Plasmodium species from outdated blood samples by nested-PCR compared with microscopy diagnosis in Jazan region, Saudi Arabia", Biosci Biotech Res Comm, 10, pp.68~75 (2017)
- Şen Z, "Climate change impact and runoff harvesting in arid regions", Arab J Geosci, 6, pp.287~295 (2013)
- Makler MT, "A review of practical techniques for the diagnosis of malaria", Ann Trop Med Parasitol, 92, pp.419~433 (1998)
- Isozumi R, "Improved detection of malaria cases in island settings of Vanuatu and Kenya by PCR that targets the Plasmodium mitochondrial cytochrome c oxidase III(cox3)gene", Parasitol Int, 64, pp.304~308 (2015)
- Hasona N, "Hematological alterations and parasitological studies among infected patients with Plasmodium vivax and Plasmodium falciparum in Hail, Kingdom of Saudi Arabia", Asian Pac J Trop Dis, 6, pp.695~658 (2016)
- Wangdi K, "Cross-border malaria : a major obstacle for malaria elimination", Adv Parasitol, 89, pp.79~107 (2015)
- Al Zahrani MH, "Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia", BMC Med, 16, pp.98~ (2018)
- Al-Farsi HM, "Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia", Infect Genet Evol, 12, pp.1253~1259 (2012)
- Soliman RH, "Imported and autochthonous malaria in West Saudi Arabia : results from a reference hospital", Malaria J, 17, pp.286~ (2018)
- Alshahrani AM, "Risk associated with malaria infection in Tihama Qahtan, Aseer region, Kingdom of Saudi Arabia: 2006-2007", Malaria Contr Elimination, 5 (2016)
- Farag E, "Epidemiology of Malaria in the State of Qatar, 2008-2015", Mediterr J Hematol Infect Dis, 10, pp.e2018050~ (2018)
- Jenkins R, "Prevalence of malaria parasites in adults and its determinants in malaria endemic area of Kisumu County, Kenya", Malaria J, 14, pp.263~ (2015)
- Al-Zaydani IA, "Severe unresolving Plasmodium falciparum malaria following artemisinin combination therapy : Emergence of drug resistance in Saudi Arabia", Indian J Med Microbiol, 34, pp.553~ (2016)
- Bin Dajem SM, "Molecular investigation of mixed malaria infections in Southwest Saudi Arabia", Saudi Med J, 36, pp.248~251 (2015)
- Gupta B, "High proportion of mixed-species Plasmodium infections in India revealed by PCR diagnostic assay", Trop Med Int Health, 15, pp.819~824 (2010)
- Dawoud HA, "Evaluation of a real-time polymerase chain reaction assay for the diagnosis of malaria in patients from Jazan area, Saudi Arabia", J Egypt Soc Parasitol, 38, pp.339~350 (2008)
- Manjurano A, "Association of sub-microscopic malaria parasite carriage with transmission intensity in north-eastern Tanzania", Malar J, 10, pp.370~ (2011)
- Al-Harthi SA, "Comparison of a genus-specific conventional PCR and a species-specific nested-PCR for malaria diagnosis using FTA collected samples from Kingdom of Saudi Arabia", J Egy Soc Parasitol, 45, pp.457~466 (2015)
- Baum E, "Common asymptomatic and sub-microscopic malaria infections in Western Thailand revealed in longitudinal molecular and serological studies : a challenge to malaria elimination", Malaria J, 15, pp.333~ (2016)
- Whittaker C, "Variation in the prevalence of sub-microscopic malaria infections : historical transmission intensity and age as key determinants", bioRxiv, 1, pp.554311~ (2019)
- Steenkeste N, "Sub-microscopic malaria cases and mixed malaria infection in a remote area of high malaria endemicity in Rattanakiri province, Cambodia : implication for malaria elimination", Malaria J, 9, pp.108~ (2010)
- Mahende C, "Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe district, Tanzania", Malaria J, 15, pp.391~ (2016)
- Iqbal J, "Persistent histidine-rich protein 2, parasite lactate dehydrogenase, and panmalarial antigen reactivity after clearance of Plasmodium falciparum monoinfection", J Clin Microbiol, 42, pp.4237~4241 (2004)
- Gatton ML, "An assessment of false positive rates for malaria rapid diagnostic tests caused by non-Plasmodium infectious agents and immunological factors", PLoS One, 13, pp.e0197395~ (2018)
- Koita OA, "False-negative rapid diagnostic tests for malaria and deletion of the histidine-rich repeat region of the hrp2 gene", Am J Trop Med Hyg, 86, pp.194~198 (2012)
- Shakely D, "The usefulness of rapid diagnostic tests in the new context of low malaria transmission in Zanzibar", PLoS One, 8, pp.e72912~ (2013)
- Ranadive N, "Limitations of rapid diagnostic testing in patients with suspected malaria : a diagnostic accuracy evaluation from Swaziland, a low-endemicity country aiming for malaria elimination", Clin Infect Dis, 64, pp.1221~1227 (2017)
- Kurup R, "A comparison of microscopic examination and rapid diagnostic tests used in Guyana to diagnose malaria", Malaria Report, 2, pp.e2~ (2012)
- Sepúlveda N, "Sample size and power calculations for detecting changes in malaria transmission using antibody seroconversion rate", Malaria J, 14, pp.529~ (2015)