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Increased detection of Plasmodium knowlesi in Sandakan division, Sabah as revealed by PlasmoNex™.

Goh XT, Lim YA, Vythilingam I, Chew CH, Lee PC, Ngui R, Tan TC, Yap NJ, Nissapatorn V, Chua KH - Malar. J. (2013)

Bottom Line: Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum).Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy.Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

ABSTRACT

Background: Plasmodium knowlesi is a simian malaria parasite that is widespread in humans in Malaysian Borneo. However, little is known about the incidence and distribution of this parasite in the Sandakan division, Malaysian Borneo. Therefore, the aim of the present epidemiological study was to investigate the incidence and distribution of P. knowlesi as well as other Plasmodium species in this division based on a most recent developed hexaplex PCR system (PlasmoNex™).

Methods: A total of 189 whole blood samples were collected from Telupid Health Clinic, Sabah, Malaysia, from 2008 to 2011. All patients who participated in the study were microscopically malaria positive before recruitment. Complete demographic details and haematological profiles were obtained from 85 patients (13 females and 72 males). Identification of Plasmodium species was conducted using PlasmoNex™ targeting the 18S ssu rRNA gene.

Results: A total of 178 samples were positive for Plasmodium species by using PlasmoNex™. Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum). Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy. Plasmodium knowlesi was detected in all four districts of Sandakan division with the highest incidence in the Kinabatangan district. Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

Conclusions: The discovery of P. knowlesi in Sandakan division showed that prospective studies on the epidemiological risk factors and transmission dynamics of P. knowlesi in these areas are crucial in order to develop strategies for effective malaria control. The availability of advanced diagnostic tool PlasmoNex™ enhanced the accuracy and accelerated the speed in the diagnosis of malaria.

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Location of human Plasmodium knowlesi infection in Sabah, Malaysia. The inset map of Southeast Asia shows the location of Sabah. Note: The location of human P. knowlesi detected in this study is marked by triangles. Stars represented the distribution of this parasite reported by previous studies [10,35-38].
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Figure 1: Location of human Plasmodium knowlesi infection in Sabah, Malaysia. The inset map of Southeast Asia shows the location of Sabah. Note: The location of human P. knowlesi detected in this study is marked by triangles. Stars represented the distribution of this parasite reported by previous studies [10,35-38].

Mentions: Of the 49 samples which were reported as P. malariae by microscopy examination, only two (1.1%) were found to be P. malariae by PlasmoNex™ (Table 1). Thirty-five (71.4% of 49) cases of P. knowlesi were microscopically misdiagnosed as P. malariae in this study. Besides, four cases of P. knowlesi were microscopically misdiagnosed as P. falciparum and three cases of P. knowlesi were also misdiagnosed as P. vivax (Table 1). Interestingly, P. knowlesi was detected in all four districts in Sandakan division and Kinabatangan had the highest incidence of P. knowlesi (31.6%). Figure 1 showed the location of P. knowlesi cases detected in this study. No P. ovale was detected by using PlasmoNex™. Six P. falciparum cases were misdiagnosed as P. malariae by microscopy examination as well as one mixed infection of P. falciparum/P. vivax was misdiagnosed as P. vivax/P. malariae (Table 1).


Increased detection of Plasmodium knowlesi in Sandakan division, Sabah as revealed by PlasmoNex™.

Goh XT, Lim YA, Vythilingam I, Chew CH, Lee PC, Ngui R, Tan TC, Yap NJ, Nissapatorn V, Chua KH - Malar. J. (2013)

Location of human Plasmodium knowlesi infection in Sabah, Malaysia. The inset map of Southeast Asia shows the location of Sabah. Note: The location of human P. knowlesi detected in this study is marked by triangles. Stars represented the distribution of this parasite reported by previous studies [10,35-38].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3733977&req=5

Figure 1: Location of human Plasmodium knowlesi infection in Sabah, Malaysia. The inset map of Southeast Asia shows the location of Sabah. Note: The location of human P. knowlesi detected in this study is marked by triangles. Stars represented the distribution of this parasite reported by previous studies [10,35-38].
Mentions: Of the 49 samples which were reported as P. malariae by microscopy examination, only two (1.1%) were found to be P. malariae by PlasmoNex™ (Table 1). Thirty-five (71.4% of 49) cases of P. knowlesi were microscopically misdiagnosed as P. malariae in this study. Besides, four cases of P. knowlesi were microscopically misdiagnosed as P. falciparum and three cases of P. knowlesi were also misdiagnosed as P. vivax (Table 1). Interestingly, P. knowlesi was detected in all four districts in Sandakan division and Kinabatangan had the highest incidence of P. knowlesi (31.6%). Figure 1 showed the location of P. knowlesi cases detected in this study. No P. ovale was detected by using PlasmoNex™. Six P. falciparum cases were misdiagnosed as P. malariae by microscopy examination as well as one mixed infection of P. falciparum/P. vivax was misdiagnosed as P. vivax/P. malariae (Table 1).

Bottom Line: Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum).Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy.Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

ABSTRACT

Background: Plasmodium knowlesi is a simian malaria parasite that is widespread in humans in Malaysian Borneo. However, little is known about the incidence and distribution of this parasite in the Sandakan division, Malaysian Borneo. Therefore, the aim of the present epidemiological study was to investigate the incidence and distribution of P. knowlesi as well as other Plasmodium species in this division based on a most recent developed hexaplex PCR system (PlasmoNex™).

Methods: A total of 189 whole blood samples were collected from Telupid Health Clinic, Sabah, Malaysia, from 2008 to 2011. All patients who participated in the study were microscopically malaria positive before recruitment. Complete demographic details and haematological profiles were obtained from 85 patients (13 females and 72 males). Identification of Plasmodium species was conducted using PlasmoNex™ targeting the 18S ssu rRNA gene.

Results: A total of 178 samples were positive for Plasmodium species by using PlasmoNex™. Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum). Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy. Plasmodium knowlesi was detected in all four districts of Sandakan division with the highest incidence in the Kinabatangan district. Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

Conclusions: The discovery of P. knowlesi in Sandakan division showed that prospective studies on the epidemiological risk factors and transmission dynamics of P. knowlesi in these areas are crucial in order to develop strategies for effective malaria control. The availability of advanced diagnostic tool PlasmoNex™ enhanced the accuracy and accelerated the speed in the diagnosis of malaria.

Show MeSH
Related in: MedlinePlus