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Plasmodium ovale infection in Malaysia: first imported case.

Lim YA, Mahmud R, Chew CH, T T, Chua KH - Malar. J. (2010)

Bottom Line: However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale.Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. limailian@um.edu.my

ABSTRACT

Background: Plasmodium ovale infection is rarely reported in Malaysia. This is the first imported case of P. ovale infection in Malaysia which was initially misdiagnosed as Plasmodium vivax.

Methods: Peripheral blood sample was first examined by Giemsa-stained microscopy examination and further confirmed using a patented in-house multiplex PCR followed by sequencing.

Results and discussion: Initial results from peripheral blood smear examination diagnosed P. vivax infection. However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale. Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.

Conclusions: The current finding should serve as an alert to epidemiologists, clinicians and laboratory technicians in the possibility of finding P. ovale in Malaysia. P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale. It is also timely that conventional diagnosis of malaria via microscopy should be coupled with more advanced molecular tools for effective diagnosis.

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Related in: MedlinePlus

Multiplex PCR results on Plasmodium spp. Lane 1, 7: 50 bp molecular weight ladder; Lane 2: Patient sample containing P. vivax; Lane 3: Patient sample containing P. knowlesi; Lane 4: Patient sample containing P. ovale; Lane 5: Patient sample containing P. malariae; Lane 6: Patient sample containing P. falciparum; lane 8: Positive controls with all the bands amplified from 5 types of Plasmodium constructs. Lane 9: Patient with mix infection, sample containing P. falciparum and P. vivax.
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Figure 1: Multiplex PCR results on Plasmodium spp. Lane 1, 7: 50 bp molecular weight ladder; Lane 2: Patient sample containing P. vivax; Lane 3: Patient sample containing P. knowlesi; Lane 4: Patient sample containing P. ovale; Lane 5: Patient sample containing P. malariae; Lane 6: Patient sample containing P. falciparum; lane 8: Positive controls with all the bands amplified from 5 types of Plasmodium constructs. Lane 9: Patient with mix infection, sample containing P. falciparum and P. vivax.

Mentions: Total genomic of this patient's blood DNA together with the Plasmodium DNA from the patient was extracted using QIAamp DNA Mini Kit (Qiagen, USA) according to the manufacturer's instructions. The extracted DNA was subjected to a patented in-house PCR targeting the SSU rRNA gene. Following that, the PCR products were electrophoresed on 3% (w/v) ethidium bromide stained agarose gel. Results showed that the patient was infected with P. ovale instead of P. vivax, as previously diagnosed by conventional microscopy (Figure 1, lane 4). Further confirmation with PCR amplification was also carried out using genus specific primers (rPLU5/rPLU6) followed by sequencing.


Plasmodium ovale infection in Malaysia: first imported case.

Lim YA, Mahmud R, Chew CH, T T, Chua KH - Malar. J. (2010)

Multiplex PCR results on Plasmodium spp. Lane 1, 7: 50 bp molecular weight ladder; Lane 2: Patient sample containing P. vivax; Lane 3: Patient sample containing P. knowlesi; Lane 4: Patient sample containing P. ovale; Lane 5: Patient sample containing P. malariae; Lane 6: Patient sample containing P. falciparum; lane 8: Positive controls with all the bands amplified from 5 types of Plasmodium constructs. Lane 9: Patient with mix infection, sample containing P. falciparum and P. vivax.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2959071&req=5

Figure 1: Multiplex PCR results on Plasmodium spp. Lane 1, 7: 50 bp molecular weight ladder; Lane 2: Patient sample containing P. vivax; Lane 3: Patient sample containing P. knowlesi; Lane 4: Patient sample containing P. ovale; Lane 5: Patient sample containing P. malariae; Lane 6: Patient sample containing P. falciparum; lane 8: Positive controls with all the bands amplified from 5 types of Plasmodium constructs. Lane 9: Patient with mix infection, sample containing P. falciparum and P. vivax.
Mentions: Total genomic of this patient's blood DNA together with the Plasmodium DNA from the patient was extracted using QIAamp DNA Mini Kit (Qiagen, USA) according to the manufacturer's instructions. The extracted DNA was subjected to a patented in-house PCR targeting the SSU rRNA gene. Following that, the PCR products were electrophoresed on 3% (w/v) ethidium bromide stained agarose gel. Results showed that the patient was infected with P. ovale instead of P. vivax, as previously diagnosed by conventional microscopy (Figure 1, lane 4). Further confirmation with PCR amplification was also carried out using genus specific primers (rPLU5/rPLU6) followed by sequencing.

Bottom Line: However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale.Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. limailian@um.edu.my

ABSTRACT

Background: Plasmodium ovale infection is rarely reported in Malaysia. This is the first imported case of P. ovale infection in Malaysia which was initially misdiagnosed as Plasmodium vivax.

Methods: Peripheral blood sample was first examined by Giemsa-stained microscopy examination and further confirmed using a patented in-house multiplex PCR followed by sequencing.

Results and discussion: Initial results from peripheral blood smear examination diagnosed P. vivax infection. However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale. Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.

Conclusions: The current finding should serve as an alert to epidemiologists, clinicians and laboratory technicians in the possibility of finding P. ovale in Malaysia. P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale. It is also timely that conventional diagnosis of malaria via microscopy should be coupled with more advanced molecular tools for effective diagnosis.

Show MeSH
Related in: MedlinePlus