Performance of an immunochromatography test for vivax malaria in the Amazon region,Brazil

The study was carried out to evaluate the diagnostic performance of the ICT malaria Pf/Pv test for vivax malaria diagnosis in Bel m, Amazon region, Brazil. The results of blood malaria parasites examination using an immunochromatography test were compared with thick blood film (TBF) examination. It was also evaluated the performance of this test storaged at three different temperatures (25 degree C, 30 degree C, and 37 degree C) for 24 hours before use. Overall sensitivity of ICT Pf/Pv was 61.8% with a specificity of 100%, positive and negative predictive value of 100% and 71.8%, respectively and accuracy of 80.6%. The test sensitivity was independent of the parasite density. This test needs to be further reviewed in order to have better performance for P. vivax malaria diagnosis.     

Differential diagnosis of bastianellii and vivax malaria

With a view to establishing criteria—applicable, if possible, in field work—for differentiating infection with Plasmodium bastianellii (of simian origin) from that with P. vivax (which is not infectious to rhesus monkeys), the authors describe the morphological characters of P. bastianellii as seen in simian and human blood and have followed the course of infection in these hosts.     

Field evaluation of the QBC technique for rapid diagnosis of vivax malaria.

The QBC (quantitative buffy coat) technique was compared with that of the Giemsa-stained thick blood film (GTF) under field conditions in Junlian and Mingshan counties, Sichuan, China, for rapid diagnosis of vivax malaria. Blood samples were collected from 364 volunteer villagers, and each sample was examined with both the QBC and GTF techniques. For each GTF sample (10 microliters of blood), as many as 300 oil-immersion fields were examined; each QBC tube was inspected for up to 5 minutes. The GTF technique resulted in 86 positive blood samples and 278 negative; the QBC technique indicated 89 positive and 275 negative samples. Relative to the results obtained with GTF, the QBC technique had a sensitivity and specificity of 87.2% and 95.0%, respectively; concordance between the tests was 93.1%. The median time-to-positive diagnosis with the QBC technique (1.12 min) was 11% of that with GTF. The distribution of different developmental stages of Plasmodium vivax parasites was also examined in the centrifuged QBC tubes: all stages except schizonts could be found in the lower part of the platelet zone (the interphase between the monocyte and platelet layers), especially ring forms.     

Retinal haemorrhage in vivax malaria

Retinal haemorrhage is often observed in patients with Plasmodium falciparum, especially when combined with cerebral malaria. However, few cases of retinopathy have been reported in P. vivax malaria. Benign tertian malaria has re-emerged among soldiers in the South Korean demilitarized zone since 1993. We report an indigenous case of retinal haemorrhage caused by P. vivax and review the relevant literature.     

Development of vaccines for Plasmodium vivax malaria

Plasmodium vivax continues to cause significant morbidity outside Africa with more than 50% of malaria cases in many parts of South and South-east Asia, Pacific islands, Central and South America being attributed to P. vivax infections. The unique biology of P. vivax, including its ability to form latent hypnozoites that emerge months to years later to cause blood stage infections, early appearance of gametocytes before clinical symptoms are apparent and a shorter development cycle in the vector makes elimination of P. vivax using standard control tools difficult. The availability of an effective vaccine that provides protection and prevents transmission would be a valuable tool in efforts to eliminate P. vivax. Here, we review the latest developments related to P. vivax malaria vaccines and discuss the challenges as well as directions toward the goal of developing highly efficacious vaccines against P. vivax malaria.     

Evaluation of rk39 immunochromatographic test with urine for diagnosis of visceral leishmaniasis

This study evaluates commercially available rK39 immunochromatographic strips using urine for diagnosis of visceral leishmaniasis (VL). Freshly collected urine and serum samples of 280 parasitologically confirmed VL patients and 66 endemic healthy controls (EHC), 48 nonendemic healthy controls (NEHC) and 45 different diseases were tested with rK39 strips. The sensitivity of rK39 in urine was 96.4% while the specificity was low varying from 66.7% in EHC, 77.08% in NEHC to 62.2% in different diseases. With serum, sensitivity was 100% whereas the specificity was 100%, 92.4% and 95.55% for the respective control groups. In the present format, the immunochromatographic strips cannot be used for the diagnosis of VL using urine samples.     

Pyrimethamine resistance in Plasmodium vivax malaria

P. vivax infection (Korean, St Elizabeth or Chesson strain) was induced in 17 neurosyphilitic patients. Pyrimethamine in single doses of either 25, 50, 100 or 200 mg was given to test the schizontocidal and sporontocidal effects.     

Variable immunogenicity of a vivax malaria blood-stage vaccine candidate

Relapsing malaria caused by Plasmodium vivax is a neglected tropical disease and an important cause of malaria worldwide. Vaccines to prevent clinical disease and mosquito transmission of vivax malaria are needed to overcome the distinct challenges of this important public health problem. In this vaccine immunogenicity study in mice, we examined key variables of responses to a P. vivax Duffy binding protein vaccine, a leading candidate to prevent the disease-causing blood-stages. Significant sex-dependent differences were observed in B cell (CD80+) and T cell (CD8+) central memory subsets, resulting in significant differences in functional immunogenicity and durability of anti-DBP protective efficacy. These significant sex-dependent differences in inbred mice were in the CD73+CD80+ memory B cell, H2KhiCD38hi/lo, and effector memory subsets. This study highlights sex and immune genes as critical variables that can impact host responses to P. vivax antigens and must be taken into consideration when designing clinical vaccine studies.     

Susceptibility to vivax malaria in Ethiopia.

Plasmodium vivax prevalence rates for Nilotic and Hamitic-Semitic residents of an Ethiopian town were compared. Over a ten-year period, 8,316 blood films from Nilotes were examined and 59 P. vivax infections (0.7%) were diagnosed. In 1,630 films from Hamito-Semites, 75 probable P. vivax infections (4.6%) were found. The problem of morphological differentiation between P. vivax and P. ovale was evaded by combining the two diagnoses. P. vivax/ovale infection rates for Hamitic-Semitic subjects were higher than for Nilotic subjects in all age groups. It was concluded that the two populations are inately different in susceptibility to patient infection with vivax malaria.     

Contribution of inflammasome genetics in Plasmodium vivax malaria

Recent reports showed that, in mice, symptomatic Plasmodium infection triggers NLRP3/NLRP12-dependent inflammasome formation and caspase-1 activation in monocytes. In humans, few works demonstrated that inflammasome is activated in malaria. As Plasmodium vivax is a potent inducer of inflammatory response we hypothesised that inflammasome genetics might affect P. vivax malaria clinical presentation. For this purpose, selected SNPs in inflammasome genes were analysed among patients with symptomatic P. vivax malaria.157 Brazilian Amazon patients with P. vivax malaria were genotyped for 10 single nucleotide polymorphisms (SNPs) in inflammasome genes NLRP1, NLRP3, AIM2, CARD8, IL1B, IL18 and MEFV. Effect of SNPs on hematologic and clinical parameters was analysed by multivariate analysis.Our data suggested an important role of NLRP1 inflammasome receptor in shaping the clinical presentation of P. vivax malaria, in term of presence of fever, anaemia and thrombocytopenia. Moreover IL1B rs1143634 resulted significantly associated to patients' parasitaemia, while IL18 rs5744256 plays a protective role against the development of anaemia.Polymorphisms in inflammasome genes could affect one or other aspects of malaria pathogenesis. Moreover, these data reveal novel aspects of P. vivax/host interaction that involved NLRP1-inflammasome.     

影响邳州市间日疟残存病例分布的因素

目的探讨影响邳州市灭疟后期疟疾残存病例分布的危险因素。方法采用病例对照的流行病学调查方法，用预先设计的问卷收集人口学信息、疟疾知识、蚊帐使用、输血史和流动史等信息。结果共调查50例患者和50名对照。采用单因素和多因素回归法分析了35个因素。单因素分析发现6个因素与疟疾发病有关，多因素分析发现5个独立的因素，露宿、输血史、外出疟区史和家人发热史是疟疾发病的危险因素。结论疟疾控制措施应重点放在献血人员和流动人口管理、发热病例血检及野外住宿人员的个人防护上。     

Standardization of a rapid immunochromatographic test with the recombinant antigens K39 and K26 for the diagnosis of canine visceral leishmaniasis

The serological diagnosis of canine visceral leishmaniasis (CVL) remains problematic because there areno reliable commercially available tests. Most laboratories use domestically prepared tests such as the enzyme-linked immunosorbent assay (ELISA) or the indirect immunofluorescent antibody test (IFAT). We evaluated rapid immunochromatographic (RICH) test kits for the diagnosis of CVL. The tests were assembled with either Leishmania chagasi recombinant antigens K39 or K26 and with either gold-labelled Staphylococcus aureus protein A or Streptococcus pyogenes protein G. Fifty sera from dogs with CVL, 14 sera from dogs with Chagas disease, and 50 sera from normal healthy dogs were tested. The results show that the RICH test using recombinant antigen K39 has a sensitivity of 96% and 100% specificity for the diagnosis of CVL. No significant differences were observed in the tests assembled with either protein A or protein G. The RICH tests using recombinant antigen K26 were equally specific but less sensitive than those using K39. However, the 2 antigens complemented each other and increased the overall sensitivity of the test. Because of its simplicity and performance the RICH test is a quick and reliable alternative for the diagnosis of CVL either in conventional laboratories or for remote areas where laboratories are not readily accessible for conventional assays.     

Treatment of acute vivax malaria with tafenoquine

Tafenoquine is an 8-aminoquiniline related to primaquine with pre-clinical activity against a range of malaria species. We treated two acute cases of vivax malaria with tafenoquine (800 mg over three days) alone, instead of conventional chloroquine (1500 mg over three days) and primaquine (420 mg over 14 days). In addition to the convenience of this regimen, the rapid parasite clearances observed, coupled with a good clinical response and lack of recrudescence or relapse, indicate that further investigation of tafenoquine in the treatment of vivax malaria is warranted.