Perfil de notificações de malária em gestantes de Oiapoque, Amapá / Profile of malaria reports in pregnant women from Oiapoque, Amapá / Perfil de notificaciones de malaria en gestantes de Oiapoque, Amapá

Objetivo: caracterizar as notificações de malária em gestantes no município de Oiapoque. Método: estudo documental, descritivo, retrospectivo e com abordagem quantitativa, realizado a partir de dados secundários do Sistema de Vigilância Epidemiológica da Malária em Oiapoque-Amapá, Brasil, no período de 2013 a 2017. Abordam-se as seguintes variáveis de casos autóctones de malária em gestantes: ano, mês de ocorrência, idade gestacional, espécie infectante de Plasmodium e unidade de notificação. Os dados foram apresentados e analisados mediante estatística descritiva e formulação de mapas de distribuição espacial, gerados pelo software ArcGIS. Resultados: predominaram notificações em áreas urbanas, especialmente no bairro Paraíso (74%), sendo o Plasmodium vivax o principal agente (88%), e de maior incidência entre outubro a dezembro (33%), no terceiro trimestre gestacional (35%). Conclusão: o perfil de notificações de malária em gestante desse munícipio assemelha-se a estudos anteriores nessa região quanto ao local de concentração e período de maior ocorrência. No entanto, a introdução gradativa do protozoário Plasmodium falciparum traz um alerta para a mobilização de gestores e profissionais.

Objective: to characterize the notifications of malaria in pregnant women in the municipality of Oiapoque. Method: documentary, descriptive, retrospective and quantitative study, conducted from secondary data of the Epidemiological Surveillance System of Malaria in Oiapoque-Amapá, Brazil, from 2013 to 2017. The following variables of autochthonous cases of malaria in pregnant women are addressed: year, month of occurrence, gestational age, Plasmodium infecting species and notification unit. Data were presented and analyzed using descriptive statistics and formulation of spatial distribution maps, generated by ArcGIS software. Results: notifications predominated in urban areas, especially in the Paraíso neighborhood (74%), with Plasmodium Vivax being the main agent (88%), and with a higher incidence between October and December (33%), in the third gestational quarter (35%). Conclusion: the profile of reports of malaria in pregnant women of this municipality resembles previous studies in this region, regarding the place of concentration and period of greater occurrence. However, the gradual introduction of the protozoan Plasmodium falciparum brings an alert to the mobilization of managers and professionals.

Investigação sobre a presença de Plasmodium spp. em Anophelinae (Diptera: Culicidae) do Vale do Ribeira, sudeste da Mata Atlântica, Estado de São Paulo, Brasil / Investigation of the presence of Plasmodium spp. in Anophelinae (Diptera: Culicidae) from Vale do Ribeira, southeastern Atlantic Forest, State of São Paulo, Brazil

Objetivos: Identificar espécies de anofelinos presentes na região do Vale do Ribeira, Sudeste de São Paulo, e a circulação de plasmódios por estes anofelinos. Método: Foram utilizadas armadilhas CDC com atração luminosa e armadilhas de Shannon no período que compreende das 17:00 às 22:00 horas e atração por humano protegido realizadas das 9:00 às 12:00 horas durante três dias consecutivos em seis campanhas, realizadas de setembro de 2021 a novembro de 2022. Os espécimes capturados foram identificados morfologicamente, separados por espécie e tiveram seu DNA genômico extraído em grupos de até 10 mosquitos, considerando os métodos de captura, locais, datas e horas. Os grupos de DNA genômico foram analisados utilizando tecnologia de PCR em tempo real para amplificar fragmento de 157 a 165 pares de bases da unidade 18S do DNA ribossômico, que permite identificar a presença de plasmódios. As amostras positivas foram submetidas a técnicas de PCR aninhado de fragmento do gene citocromo b do genoma mitocondrial. De oito amostras analisadas, duas foram positivas e tiveram seus amplicons sequenciados empregando tecnologia de Sanger. Resultados: Foram coletados 5.577 mosquitos classificados no gênero Kerteszia (99,62%) e gênero Anopheles (0,38%), agrupados em 811 grupos. Foram identificados oito grupos positivos para plasmódios, sendo um para Plasmodium vivax / Plasmodium simium, um para Plasmodium malariae / Plasmodium brasilianum, dois para Plasmodium falciparum e quatro grupos positivos apenas para Plasmodium spp. O sequenciamento Sanger confirmou a infecção por P. vivax / P. simium em uma amostra, e P. malariae / P. brasilianum em outra. A proporção total de anofelinos infectados por Plasmodium spp. foi 0,5% (4/811), 0,2% dos anofelinos coletados apresentavam infecção por P. falciparum (2/811), 0,1% apresentavam infecção por P. vivax (1/811) e a mesma proporção de infectados por P. malariae (1/811). A razão mínima de infecção (RMI) para Plasmodium spp. nos anofelinos coletados foi 0,125, para P. vivax foi 0,02, assim como para P. malariae e, para P. falciparum foi 0,035. As estimativas de razão entre mosquitos infectados e mosquitos coletados foram 0,007 para Plasmodium spp., 0,0002 para P. vivax, 0,0005 para P. falciparum e 0,0005 para P. malariae. A razão de infecção absoluta por P. vivax foi 0,02 em março de 2022 e 0,01 por P. falciparum em novembro de 2022 no mesmo ponto de coleta. Conclusão: Foi identificada a presença de plasmódios zoonóticos em área de reserva da Mata Atlântica do sudeste brasileiro, onde a presença de hospedeiros humanos é restrita aos moradores, turistas, trabalhadores da reserva e pesquisadores. A densidade de mosquitos infectados por P. falciparum foi maior do que a de P. vivax e P. malariae. O encontro de mosquitos, naturalmente, infectados por estas espécies de plasmódios indica a necessidade de programas de educação ambiental delineados aos frequentadores e moradores da região da reserva e do entorno. Acresce considerar a necessidade de pesquisas detalhadas sobre as taxas de Plasmodium ocorrendo na área estudada e na Mata Atlântica, com sequenciamentos dos genomas das espécies que são encontradas em localidades diversas do Brasil e América Latina.

Objectives: Identify species of anophelines present in the Vale do Ribeira region, Southeast of São Paulo, and the circulation of plasmodia by these anophelines. Method: CDC light traps and Shannon traps were used in the period from 5:00 p.m. to 10:00 p.m. and attraction by protected human carried out from 9:00 a.m. to 12:00 p.m. for three consecutive days in 6 campaigns, carried out from September 2021 to November 2022. The captured specimens were morphologically identified, separated by species, and had their genomic DNA extracted in pools of up to 10 mosquitoes, considering capture methods, locations, dates and time. By utilizing real-time PCR technology, a 157 to 165 base pairs segment of the 18S ribosomal DNA unit was amplified to identify plasmodia within the genomic DNA pools. The positive samples were submitted to nested PCR techniques of cytochrome b gene fragment of the mitochondrial genome. Of 8 samples analyzed, two were positive and had their amplicons sequenced using Sanger technology. Results: A total of 5,577 mosquitoes belonging to the genus Kerteszia (99.62%) and to the genus Anopheles (0.38%) were collected, grouped into 811 pools. Eight positive pools for plasmodia were identified, one for Plasmodium vivax / Plasmodium simium, one for Plasmodium malariae / Plasmodium. brasilianum, two for Plasmodium falciparum and four pools positive only for Plasmodium spp. Sanger sequencing confirmed P. vivax / P. simium infection in one sample, and P. malariae / P. brasilianum in the other. The total proportion of anophelines infected with Plasmodium spp. was 0.5% (4/811), 0.2% of the collected anophelines had P. falciparum infection (2/811), 0.1% had P. vivax infection (1/811) and the same proportion of infected with P. malariae (1/811). The minimum infection rate (MIR) for Plasmodium spp. in anophelines collected was 0.125, for P. vivax was 0.02, as well as for P. malariae, and for P. falciparum it was 0.035. The ratio estimates between infected and collected mosquitoes were 0.007 for Plasmodium spp., 0.0002 for P. vivax, 0.0005 for P. falciparum, and 0.0005 for P. malariae. The absolute infection ratio for P. vivax was 0.02 in March 2022 and 0.01 for P. falciparum infection in November 2022 at the same collection point. Conclusion: The presence of zoonotic plasmodia was identified in a reserve area of the Atlantic Forest in southeastern Brazil, where the presence of human hosts is restricted to residents, tourists, reserve workers and researchers. The density of mosquitoes infected with P. falciparum was higher than that of P. vivax and P. malariae. The finding of mosquitoes naturally infected by these species of plasmodia shows the need for environmental education programs designed for visitors and residents of the reserve region and surroundings. In addition, consider the need for detailed research on the rates of Plasmodium occurring in the studied area and in the Atlantic Forest, with sequencing of the genomes of the species that are found in different locations in Brazil and Latin America.

Perfiles hematológicos en pacientes infectados con malaria en un área endémica del Perú / Hematological profiles of malaria-infected patients in an endemic area of Peru

RESUMEN Objetivos. Evaluar la variación de los perfiles hematológicos antes, durante y después del tratamiento de pacientes infectados con malaria no complicada por Plasmodium vivax (Pv) y P. falciparum (Pf) en una población de la región Loreto. Materiales y métodos. El estudio se realizó entre 2010 y 2012, en Zungarococha (Iquitos). Los 425 participantes tuvieron tres visitas (visita 1-día 0-antes del tratamiento, visita 2-día 7-durante tratamiento, visita 3-día 28-después del tratamiento), hemograma completo, diagnóstico microscópico y molecular (PCR). Resultados. En la primera visita, se encontraron 93 (21,9%) positivos a Pv y 34 (8,0%) a Pf. Todos los positivos mostraron una reducción en los indicadores hematológicos de hematocrito, recuento de glóbulos blancos (RGB), neutrófilos abastonados y segmentados, eosinófilos y plaquetas (p<0.001) en comparación con el grupo negativo. Se encontró un porcentaje mayor de neutrófilos abastonados en Pf y de neutrófilos segmentados en Pv comparado al grupo negativo. Se observó variaciones en los perfiles hematológicos después del tratamiento para ambas especies, los neutrófilos abastonados disminuyeron, las plaquetas aumentaron, los eosinófilos se incrementaron al día 7 y decaen el día 28, el hematocrito y los neutrófilos segmentados disminuyeron al día 7 y se normalizaron el día 28. Las diferencias entre especies en el tiempo mostraron una disminución diaria de neutrófilos abastonados en infectados con Pv que en Pf. Conclusiones. El perfil hematológico en pacientes positivos a malaria no complicada varía en el tiempo durante y después del tratamiento. Estos son indicadores de la progresión de la enfermedad y ayudan en la vigilancia terapéutica de pacientes infectados con Plasmodium.

ABSTRACT Objectives. To evaluate the variation of hematological profiles of patients infected with uncomplicated Plasmodium vivax (Pv) and P. falciparum (Pf) malaria before, during and after treatment in a population of the Loreto region. Materials and methods. This study was conducted between 2010 and 2012, in Zungarococha (Iquitos). The 425 participants had three visits (visit 1-day 0-before treatment, visit 2-day 7-during treatment, visit 3-day 28-after treatment), complete blood count, microscopic and molecular diagnosis (PCR). Results. At the first visit, 93 (21.9%) participants were found positive for Pv and 34 (8.0%) for Pf. All positives showed a reduction in hematocrit, white blood cell count (WBC), ablated and segmented neutrophils, eosinophils and platelets (p<0.001) compared to the negative group. A higher percentage of ablated neutrophils was found in Pf and segmented neutrophils in Pv compared to the negative group. Variations in hematological profiles were observed after treatment for both species; ablated neutrophils decreased, platelets increased, eosinophils increased at day 7 and declined at day 28, hematocrit and segmented neutrophils decreased at day 7 and normalized at day 28. Interspecies differences over time showed a bigger daily decrease in ablated neutrophils in Pv-infected when compared to Pf. Conclusions. The hematological profile in uncomplicated malaria-positive patients varies over time during and after treatment. These are indicators of disease progression and help in the therapeutic surveillance of Plasmodium-infected patients.

Evaluación de la efectividad de la prueba rápida OptiMAL-IT™ para el seguimiento de pacientes con diagnóstico de malaria en la Amazonía peruana / Evaluation of the effectiveness of the OptiMAL-IT™ rapid test in the follow up of patients diagnosed with malaria in the Peruvian Amazon

Introducción. En Perú, la microscopía óptica con gota gruesa continúa utilizándose en el seguimiento de los pacientes con malaria o paludismo. Esta prueba es sencilla, pero requiere de equipamiento microscópico y personal idóneo que realice la lectura de las muestras. Los estudios sugieren que la prueba rápida OptiMAL-IT™ es una opción para dicho seguimiento. Objetivo. Evaluar la efectividad de OptiMAL-IT™ como test de seguimiento en pacientes con malaria en áreas endémicas del Perú. Materiales y métodos. Se hizo un estudio observacional, transversal y analítico de pruebas diagnósticas en pacientes con malaria. Se seleccionó a todos los pacientes que cumplían con los criterios de inclusión, procedentes de diferentes establecimientos de salud de los departamentos peruanos de San Martín y Loreto. El diagnóstico se hizo mediante microscopía óptica con gota gruesa y la prueba rápida de diagnóstico inmunocromatográfico OptiMAL-IT™ en los días 2, 3, 7 y 14 para Plasmodium vivax y hasta el día 21 de seguimiento para Plasmodium falciparum. Se calculó el porcentaje de los correctamente clasificados y los valores predictivos, y se compararon los resultados de la selva occidental y la selva oriental mediante ji al cuadrado o prueba exacta de Fisher. Resultados. Se registraron 262 pacientes de San Martín y 302 de Loreto. Los porcentajes correctamente clasificados y el valor predictivo negativo fueron superiores a 92,0 y 93,0 %, respectivamente, a partir del tercer día de seguimiento; no se encontraron diferencias estadísticas en los resultados obtenidos en la Amazonía occidental y los de la oriental. Conclusiones. La prueba OptiMAL-IT™ sería efectiva como test de seguimiento en los pacientes con diagnóstico de malaria en áreas endémicas del Perú.

Introduction: In Peru, optical microscopy with the thick smear test continues to be performed for the follow-up of malaria patients. This test is simple but it requires microscopic equipment and suitable staff to perform the reading of the samples. Studies suggest that the rapid OptiMAL-IT™ test is an option for follow-up. Objective: To evaluate the effectiveness of OptiMAL-IT™ as a follow-up test in malaria patients in endemic areas of Perú. Materials and methods: We conducted an observational, analytical cross-sectional study of diagnostic tests performed in patients with malaria. We selected all the patients attending different health facilities in the Peruvian departments of San Martín and Loreto who met the inclusion criteria. Optical microscopy with thick smear and OptiMAL-IT™ was used on days 2, 3, 7, and 14 for Plasmodium vivax and until day 21 of follow-up for Plasmodium falciparum. Percentages of correctly classified samples and predictive values were calculated, and the results were compared between the western jungle and the eastern jungle using Chi2 or Fisher's exact tests. Results: We registered 262 patients from San Martín and 302 from Loreto. The percentage of correctly classified cases and the negative predictive value were higher than 92.0% and 93,0%, respectively, from the third day of follow-up; no statistical differences were found in the results obtained from the western jungle and those from the eastern jungle. Conclusions: The OptiMAL-IT™ test would be effective as a follow-up test in patients diagnosed with malaria in endemic areas of Perú.

Diversidad de vectores de Plasmodium y rasgos funcionales de los árboles del bosque perturbado en Tingo María, 2022 / Diversity of Plasmodium vectors and functional traits of trees in the disturbed forest in Tingo María, 2022

Las comunidades vegetales en la zona de Tingo María, Perú, se encuentran sometidas a los efectos del cambio climático, generando modificaciones en su biodiversidad, impactando su ecosistema. Por otra parte, se ha referido que actividades que ocasionan perturbación de bosques tropicales pueden favorecer la persistencia de vectores de enfermedades metaxénicas como la malaria, la cual representa un problema de salud pública por la alta tasa de morbimortalidad en la región. Se realizó un estudio descriptivo para evaluar los rasgos funcionales del bosque perturbado de Tingo María, observando que la especie vegetal Parkia panurensis presentó mayor promedio en altura total; 47% de las especies presentaron una densidad básica alta de árboles en pie; la familia Euphorbiaceae y la especie Senefeldera inclinata presentaron el valor más alto de biomasa, mientras que Micropholis guyanensis y Pierre Subsp. Guyanensis mostraron el mayor porcentaje y cobertura de copa, respectivamente; Asimismo, Pseudopiptadenia suaveolens presentó la mayor longitud de copa, Eugenia egensis mostró mayor diámetro y Senefeldera inclinata tuvo mejor índice de valor de importancia. Además, se demostró alta circulación de vectores de malaria en la zona, siendo An. Pseudopunctipennis, An. Benarrochi, An. Darling y An. Evansae los más frecuentes, mientras que los géneros de insectos más comunes resultaron ser Anófeles, Aedes, Coqueletilia y Cúlex. Los rasgos funcionales de las especies vegetales les han permitido adaptarse a las condiciones adversas, no obstante, la presencia de abundantes vectores de malaria, hace necesario implementar estrategias de impacto ambiental, que reduzcan el riesgo de malaria en la región(AU)

Plant communities in the area of Tingo María, Peru, are subject to the effects of climate change, generating modifications in their biodiversity, impacting their ecosystem. On the other hand, it has been reported that activities that cause disturbance of tropical forests can favor the persistence of vectors of metaxenic diseases such as malaria, which represents a public health problem due to the high rate of morbidity and mortality in the region. A descriptive study was carried out to evaluate the functional traits of the disturbed forest of Tingo María, observing that the plant species Parkia panurensis presented a higher average total height; 47% of the species presented a high basic density of standing trees; the Euphorbiaceae family and the species Senefeldera inclinata presented the highest biomass value, while Micropholis guyanensis and Pierre Subsp. Guyanensis showed the highest percentage and crown cover, respectively; Likewise, Pseudopiptadenia suaveolens had the longest crown length, Eugenia egensis had the largest diameter and Senefeldera inclinata had the best importance value index. In addition, high circulation of malaria vectors was demonstrated in the area, being An. pseudopunctipennis, An. benarrochi, An. darling and An. evansae the most frequent, while the most common insect genera were Anopheles, Aedes, Coqueletilia and Culex. The functional traits of plant species have allowed them to adapt themselves to adverse conditions, however, the presence of abundant malaria vectors makes it necessary to implement environmental impact strategies that reduce the risk of malaria in the region(AU)

Reasearch on lipid metabolism of Plasmodium and antimalarial mechanism of artemisinin / 中国中药杂志

As a unicellular organism, Plasmodium displays a panoply of lipid metabolism pathways that are seldom found together in a unicellular organism. These pathways mostly involve the Plasmodium-encoded enzymatic machinery and meet the requirements of membrane synthesis during the rapid cell growth and division throughout the life cycle. Different lipids have varied synthesis and meta-bolism pathways. For example, the major phospholipids are synthesized via CDP-diacylglycerol-dependent pathway in prokaryotes and de novo pathway in eukaryotes, and fatty acids are synthesized mainly via type Ⅱ fatty acid synthesis pathway. The available studies have demonstrated the impacts of artemisinin and its derivatives, the front-line compounds against malaria, on the lipid metabolism of Plasmodium. Therefore, this article reviewed the known lipid metabolism pathways and the effects of artemisinin and its derivatives on these pathways, aiming to deepen the understanding of lipid synthesis and metabolism in Plasmodium and provide a theoretical basis for the research on the mechanisms and drug resistance of artemisinin and other anti-malarial drugs.

Malária símia: detecção de plasmodium em fezes de primatas não humanos / Simian malaria: detection of plasmodium in feces of non-human primates

Introdução. A malária é uma doença infecciosa vetorial sendo atualmente considerada uma das maiores protozooses do mundo, mantendo-se endêmica principalmente na África, na região Amazônica da América do Sul e no Sudeste Asiático. Essa doença é causada por protozoários do gênero Plasmodium, sendo que cinco espécies são capazes de infectar humanos: P. vivax, P. falciparum, P. malariae, P. ovale e o mais recente, P. knowlesi, que é considerado como um parasito zoonótico. Há fatos que demonstram que esses parasitas que hoje infectam humanos, descendem de Plasmodium símios, e as infecções de símios continuam ocorrendo até os dias atuais. No Brasil os principais agentes de malária símia são Plasmodium brasilianum e Plasmodium simium (similar com P. malariae e P. vivax, respectivamente), sendo que esses dois parasitos estão envolvidos em situações zoonóticas no bioma Mata Atlântica, sendo o seu vetor o Anopheles cruzii. Tendo em vista esse cenário epidemiológico da malária residual, foi verificada a importância de realizar uma revisão sobre os principais estudos baseados e detecção de Plasmodium em fezes de primatas não humanos. Objetivo. Realizar uma revisão bibliográfica e atualização das principais técnicas existentes de detecção de Plasmodium em fezes de primatas não humanos descritas na literatura; bem como conhecer e realizar as técnicas de extração de DNA de fezes de primatas não humanos e técnicas de PCR em tempo real e PCR convencional para rastreamento de DNA de primatas não humanos e de plasmódios. Materiais e Métodos. Foi realizado levantamento bibliográfico nas bases de dados da SciELO, Lilacs, PubMed, MedLine e na Biblioteca Virtual em Saúde (BVS), de artigos e livros que descrevam a utilização de técnicas de detecção de Plasmodium em fezes de primatas não humanos, utilizando um total de 46 artigos publicados entre os anos de 1951 a 2021. Resultados. No delineamento da revisão foram selecionados 46 artigos que apresentassem menção explicita sobre as técnicas de detecção de Plasmodium, fezes e/ou menção explicita sobre malária e/ou malária símia. Na prática laboratorial, foram realizadas extrações de DNA e realizadas reações de PCR em Tempo real (TaqMan 18S rRNA) e PCR para amplificação de fragmento de cyt b de gênero Plasmodium em trinta e cinco amostras fecais de Alouatta guariba clamitans do Parque Estadual da Cantareira, município de São Paulo (Projeto FAPESP 2014/10.919-4, coordenado pela Dra. Ana Maria R. de C. Duarte). Discussão/Conclusão. Após a realização da revisão e das práticas laboratoriais, foi possível conhecer a abrangência do uso da técnica não invasiva e diagnostico de plasmódios em fezes de primatas não humanos no mundo, em especial na África e Sudeste Asiático, e também levantar as principais vantagens e desvantagens da utilização de fezes para detecção de Plasmodium. Diante disso, conclui-se que a utilização das técnicas PCR utilizando DNA oriundo das fezes podem trazer relevantes benefícios nos estudos de malária símia e humana em situações zoonóticas, bem como auxiliar nas atividades de Vigilância e Controle.

Guia de tratamento da malária no Brasil / Malaria treatment guide in Brazil

Este documento constitui-se em um guia de orientação geral para o tratamento da malária, e fundamenta-se em uma revisão das melhores evidências da eficácia e da segurança dos antimaláricos. Entretanto, é indispensável lembrar-se de que casos que não estejam contemplados neste Guia devem ser discutidos diretamente com profissionais e unidades de referência.

Traditional medicinal plants for arthropod-borne diseases of five countries in Lancang-Mekong region:a review / 中国中药杂志

Arthropod-borne diseases, such as malaria and dengue fever, have frequently beset five countries(Cambodia, Vietnam, Laos, Myanmar, and Thailand) in the tropical rainy Lancang-Mekong region, which pose a huge threat to social production and daily life. As a resort to such diseases, chemical drugs risk the resistance in plasmodium, non-availability for dengue virus, and pollution to the environment. Traditional medicinal plants have the multi-component, multi-target, and multi-pathway characteristics, which are of great potential in drug development. Exploring potential medicinals for arthropod-borne diseases from traditional medicinal plants has become a hot spot. This study summarized the epidemiological background of arthropod-borne diseases in the Lancang-Mekong region and screened effective herbs from the 350 medicinal plants recorded in CHINA-ASEAN Traditional Medicine. Based on CNKI, VIP, and PubMed, the plants for malaria and dengue fever and those for killing and repelling mosquitoes were respectively sorted out. Their pharmacological effects and mechanisms were reviewed and the material basis was analyzed. The result is expected to serve as a reference for efficient utilization of medicinal resources, development of effective and safe drugs for malaria and dengue fever, and the further cooperation between China and the other five countries in the Lancang-Mekong region.

Malaria placentaria submicroscópica: histopatología y expresión de mediadores de procesos fisiológicos / Submicroscopic placental malaria: histopathology and expression of physiological process mediators

RESUMEN Objetivos: Relacionar entre sí los eventos histopatológicos de malaria placentaria (MP), el comportamiento de células inmunitarias y la expresión de genes asociados a citoquinas, hipoxia, inflamación y angiogénesis en placentas con o sin infección plasmodial. Materiales y métodos: Diseño transversal, con tres grupos independientes. Las mujeres y sus placentas fueron captadas en 2009-2016, en los hospitales de Puerto Libertador y Tierralta, noroccidente de Colombia. El tamaño muestral se definió por conveniencia. El diagnóstico malárico se basó en PCR cuantitativa en tiempo real. Resultados: Se estudiaron 20 casos con MP por P. vivax (MP-V), 20 casos de MP por P. falciparum (MP-F) y 19 sin MP; 95% de los casos de MP son infección plasmodial placentaria submicroscópica (IPPS). Los tres grupos difieren en frecuencia y cantidad de eventos histopatológicos. Los mediadores de procesos fisiológicos presentaron diferencia significativa entre grupos, excepto IL-2, VEGF, VEGFR-1 y C5a. Conclusiones: Las placentas con infección difieren claramente de las no infectadas. P. vivax se comporta tan patógeno como P. falciparum. Se resalta la aproximación al abordaje integral del problema de MP. La infección plasmodial placentaria submicroscópica causa alteraciones tisulares y en mediadores fisiológicos como lo hace la infección microscópica, aunque probablemente en menor grado.

ABSTRACT Objetives: To relate histopathological events of placental malaria (PM), immune cell behavior and gene expression associated with cytokines, hypoxia, inflammation and angiogenesis in placentas with or without plasmodial infection. Materials and methods: Transversal design, with three independent groups. Women were recruited, and their placentas were collected in 2009-2016, in the hospitals of Puerto Libertador and Tierralta, northwestern Colombia. The sample size was defined by convenience. The malaria diagnosis was based on real-time quantitative PCR. Results: We studied 20 cases of PM by P. vivax (PM-V), 20 cases of PM by P. falciparum (PM-F) and 19 without PM; 95% of the cases of PM are submicroscopic placental plasmodial infection (SPPI). The three groups differ in frequency and number of histopathological events. Physiological process mediators showed significant difference between groups, except IL-2, VEGF, VEGFR-1 and C5a. Conclusions: Infected placentas are clearly different from uninfected ones. P. vivax behaves as pathogenic as P. falciparum. The approximation to the integral approach of the problem of PM is underlined. Submicroscopic placental plasmodial infection causes tissue and physiological mediator alterations as does microscopic infection, although probably to a lesser degree.

The impact of imported malaria by gold miners in Roraima: characterizing the spatial dynamics of autochthonous and imported malaria in an urban region of Boa Vista

BACKGROUND The number of malaria cases in Roraima nearly tripled from 2016 to 2018. The capital, Boa Vista, considered a low-risk area for malaria transmission, reported an increasing number of autochthonous and imported cases. OBJECTIVES This study describes a spatial analysis on malaria cases in an urban region of Boa Vista, which sought to identify the autochthonous and imported cases and associated them with Anopheles habitats and the potential risk of local transmission. METHODS In a cross-sectional study at the Polyclinic Cosme e Silva, 520 individuals were interviewed and diagnosed with malaria by microscopic examination. Using a global positional system, the locations of malaria cases by type and origin and the breeding sites of anopheline vectors were mapped and the risk of malaria transmission was evaluated by spatial point pattern analysis. FINDINGS Malaria was detected in 57.5% of the individuals and there was a disproportionate number of imported cases (90.6%) linked to Brazilian coming from gold mining sites in Venezuela and Guyana. MAIN CONCLUSIONS The increase in imported malaria cases circulating in the west region of Boa Vista, where there are positive breeding sites for the main vectors, may represent a potential condition for increased autochthonous malaria transmission in this space.

First molecular detection of Haemoproteus spp. and Plasmodium spp. in eared doves (Zenaida auriculata) in Brazil / Primeira detecção molecular de Haemoproteus spp. e Plasmodium spp. em pombos (Zenaida auriculata) no Brasil

Abstract The aim of this study was to verify the presence and identify the species of haemosporidian parasites in eared doves (Zenaida auriculata) in Brazil. Two hundred and eleven male and female eared doves were trap-captured in four different regions of Londrina city, in southern Brazil. Whole blood was collected in EDTA tubes through heart puncture after euthanasia in a CO2 chamber. A nested PCR targeting the mitochondrial cytochrome b gene (cyt b) of Haemoproteus spp./Plasmodium spp. was performed, followed by an enzymatic digestion to identify the genus. Phylogenetic trees were constructed to determine the closely related species. Out of 211 eared doves, 209 (99.05%) were positive for Haemoproteus spp. and/or Plasmodium spp. RFLP analysis showed that 72.72% (152/209) of eared doves were positive only for Haemoproteus spp., 6.22% (13/209) were positive only for Plasmodium spp., and 21.05% (44/209) of eared doves had mixed infections. Genetic analysis found four samples that were homologous with Haemoproteus multipigmentatus and one that was homologous with Plasmodium sp. This is the first molecular study of hemoparasites from eared doves in Brazil, and it is also the first description of H. multipigmentatus and Plasmodium spp. infection in eared doves in Brazil.

Resumo O objetivo deste estudo foi verificar a presença e a identificação espécies de parasitas hemosporídeos em pombos (Zenaida auriculata) no Brasil. Duzentos e onze pombos machos e fêmeas foram capturados em quatro regiões diferentes de Londrina, sul do Brasil. Amostra de sangue foi coletada em tubos contendo EDTA por meio de punção cardíaca, após eutanásia em câmara de CO2. Uma nested PCR com alvo no gene mitocondrial citocromo b (cyt b) de Haemoproteus spp./Plasmodium spp. foi realizada, seguida de digestão enzimática para identificar o gênero. A árvore filogenética foi construída para determinar a relação com outras espécies. Das 211 pombas, 209 (99,05%) foram positivas para Haemoproteus spp./Plasmodium spp. A análise RFLP demonstrou que 72,72% (152/209) das pombas foram positivas somente para Haemoproteus spp.; 6,22% (13/209) foram positivas somente para Plasmodium e 21,05% (44/209) das pombas tiveram infecções mistas. A análise genética mostrou quatro amostras homólogas com H. multipigmentatus e uma com Plasmodium spp. Este é o primeiro estudo molecular de hemoparasitas em pombos no Brasil. E é também a primeira descrição da infecção por H. multipigmentatus e Plasmodium spp. em pombos Z. auriculata no Brasil.

Caracterização fenotípica e funcional de células do sistema imune inato na malária cerebral experimental / Phenotypic and functional characterization of innate immune cells in experimental cerebral malaria

A malária cerebral (MC) é responsável por muitas mortes ocasionadas pela infecção por Plasmodium falciparum. Devido à dificuldade em estudar os mecanismos imunes envolvidos no desenvolvimento de MC em humanos, o uso de modelos murinos de malária cerebral experimental (MCE) tem sido amplamente empregado. Este estudo tem como objetivo investigar o papel das células imunes inatas no desenvolvimento ou não de MCE utilizando os modelos experimentais de camundongos C57BL/6 e BALB/c infectados com Plasmodium berghei ANKA. A sobrevida, parasitemia, peso, temperatura corporal e a quebra da barreira hematoencefálica confirmaram a resistência e suscetibilidade dos camundongos BALB/c e C57BL/6 parasitados ao desenvolvimento de MCE, respectivamente. Embora os camundongos BALB/c e C57BL/6 infectados tenham apresentado diferentes cursos clínicos da doença, eles exibiram a mesma parasitemia. A esplenomegalia foi observada em ambas as linhagens de camundongos durante a infecção. Entre as subpopulações mieloides investigadas, encontramos o influxo de neutrófilos e monócitos inflamatórios em cinética e proporções diferentes entre as linhagens. Já os macrófagos da polpa vermelha (MPV) dos camundongos BALB/c mantiveram seus valores constante ao longo da infecção, entretanto, responderam ao processo infeccioso ampliando a expressão do receptor de manose CD206. Interessantemente, os animais C57BL/6 apresentaram redução no número total dos MPV e MPV CD206+ após a infecção.

A redução nos valores de MPV CD206+ foi acompanhada pelo aumento no número e percentual de MPV iNOS+. Curiosamente, o número total de macrófagos da polpa branca (MPB) e MPB iNOS+ aumentou nos animais BALB/c e se manteve constante nos animais C57BL/6 infectados. Ao avaliarmos a expressão de CD206 nos MPB, observamos diminuição no percentual e número total dessas células em ambos os animais após infecção. Também realizamos a análise da expressão de CD206 e iNOS em microglias, macrófagos residentes do sistema nervoso central. Estas células, em ambas as linhagens, apresentaram a mesma cinética de aumento na expressão do receptor de manose CD206, e redução diferenciada na expressão de iNOS ao longo da infecção. Toda essa regulação dos marcadores fenotípicos nos macrófagos esplênicos de camundongos BALB/c ocorreu na presença de níveis séricos elevados de INF-γ e da citocina regulatória IL-10, no 4º dia após infecção, quando comparados aos camundongos C57BL/6. Nossos dados sugerem que, apesar de camundongos resistentes à MCE desenvolverem uma forte resposta imune ao parasito, o animal é favorecido pelo desencadeamento de um perfil antiinflamatório de resposta, como a ativação de macrófagos do tipo M2 e produção de citocinas regulatórias. Enquanto que os animais suscetíveis ao desenvolvimento de MCE respondem a infecção montando uma resposta com perfil pró-inflamatório nos momentos inicias da resposta imune, através do aumento no número de macrófagos com perfil M1 e pela produção de TNF e IL-6. (AU)

Consecuencias de la infección malárica gestacional en la función inmune y en la inmunomodulación de la madre y el neonato / Consequences of gestational malaria infection in the immune function and immunomodulation of mother and newborn

Resumen La malaria asociada al embarazo es un evento poco estudiado en América Latina. Los abundantes trabajos sobre el problema en África llevan a pensar que esta infección genera una modulación de la respuesta inmune y alteraciones en el ambiente placentario, eventos cruciales para el adecuado desarrollo del feto y el neonato. La inmunidad contra Plasmodium spp es compleja porque involucra diversos factores que amplían las posibilidades de desenlaces, los que finalmente conducen a los diferentes fenotipos clínicos de la enfermedad. Uno de los desenlaces inmunológicos en infecciones por Plasmodium spp es la modulación de la respuesta inmune hacía un perfil regulador. Esta regulación inducida por la infección malárica resulta ventajosa para la persistencia del parásito en el hospedero, y adicionalmente, podría generar eventos adversos en la respuesta inmune general de los individuos infectados. El objetivo de esta revisión es abordar los mecanismos con los cuales Plasmodium spp modula la respuesta inmune del hospedero y exponer las consecuencias de las infecciones maláricas en el contexto madre-neonato.

Pregnancy-associated malaria is an understudied event in Latin America. Most works about malaria in pregnancy have been conducted in Africa. These studies indicate that the infection generates immune response modulation and alterations in the placental environment, key factors for the proper development of the fetus and neonate. Immunity against Plasmodium spp is complex since involves several factors that increase the possible infection outcomes. One of these immunological outcomes is the immune response modulation towards a regulatory profile, which is advantageous for the persistence of the parasite in the host; additionally, it could generate adverse events in the general immune response of infected individuals. The objective of this review is to address the Plasmodium spp mechanisms of modulation in the host immune response and expose the consequences of malarial infections in the mother-neonate context.

Comparative morphometric evaluation of hepatic hemosiderosis in wild Magellanic penguins (Spheniscus magellanicus) infected with different Plasmodium spp. subgenera / Avaliação morfométrica comparativa da hemossiderose hepática em pinguins-de-Magalhães (Spheniscus magellanicus) de vida livre infectados por diferentes subgêneros de Plasmodium spp

Abstract Avian malaria is one of the most important diseases of captive penguins. We employed morphometric techniques to evaluate hepatic hemosiderosis in rehabilitating wild Magellanic penguins (Spheniscus magellanicus) that were negative (n = 9) or naturally infected by different subgenera of Plasmodium spp. (n = 24), according with: Plasmodium subgenera (Haemamoeba, Huffia, Other lineages, and Unidentified lineages), severity of Plasmodium histopathological lesions, and concurrent diseases, age class (juvenile or adult plumage), sex (male, female or not determined), body score (emaciated, thin, good, excellent, not available), molt, presence or absence of oil contamination upon admission, iron supplementation, and rehabilitation center. The percentage of the area occupied by hemosiderin was called 'Index of Hepatic Hemosiderosis (IHH)'. Plasmodium-positive females presented significantly higher IHH values (17.53 ± 12.95%) than males (7.20 ± 4.25%; p = 0.041). We observed higher levels of congestion (p = 0.0182) and pneumonia (p = 0.0250) severity between Unidentified lineages vs. Huffia. We believe that the hepatic hemosiderosis observed in this study was multifactorial, the result of pathological processes caused by malaria, molting, hemoglobin and myoglobin catabolism during migration, anemia, concomitant diseases, and iron supplementation, all possibly potentiated by decreased liver mass. Further studies are needed to clarify the mechanisms of these hypotheses.

Resumo Malária aviária é uma das mais relevantes doenças em pinguins cativos. Foram aplicadas técnicas morfométricas para avaliar a hemossiderose hepática em pinguins-de-Magalhães (Spheniscus magellanicus ) de vida livre em reabilitação negativos (n = 9) e naturalmente infectados por diferentes subgêneros de Plasmodium spp. (n = 24), quanto a: subgênero de Plasmodium (Haemamoeba , Huffia, Outras Linhagens, e Linhagens não identificadas), severidade das lesões histopatológicas causadas por Plasmodium e doenças concomitantes, faixa etária (plumagem juvenil ou adulta), sexo (macho, fêmea, indeterminado), condição corporal (emaciado, magro, bom, excelente, indisponível), muda, presença/ausência de óleo a admissão, suplementação de ferro, e centro de reabilitação. A porcentagem da área ocupada por hemossiderina foi denominada "Índice de Hemossiderose Hepática (IHH)". Fêmeas Plasmodium -positivas apresentaram IHH significativamente mais elevado que machos, respectivamente, 17,53 ± 12,95% e 7,20 ± 4,25% (p = 0,041). Níveis mais elevados de congestão (p = 0,0182) e pneumonia (p = 0,0250) foram observados entre Linhagens não identificadas vs. Huffia. Possivelmente, a hemossiderose hepática observada nesse estudo seja multifatorial, resultado de processos patológicos causados por malária, muda, catabolismo de hemoglobina e mioglobina durante a migração, anemia, doenças concomitantes e suplementação de ferro, potencialmente intensificados por massa hepática reduzida. Estudos complementares são necessários para esclarecer os mecanismos de tais hipóteses.

Mixed Infection with Plasmodium falciparum and Plasmodium ovale in a Returned Traveller: the First Case in Korea

Mixed-species malaria infections are often unrecognized or underestimated. We hereby report the first described case of mixed infection with Plasmodium falciparum and Plasmodium ovale malaria in a returned traveller in Korea. In August 2016, a 25-year-old returned traveller from Cameroon and Democratic Republic of Congo presented with fever. He was diagnosed as P. falciparum malaria and successfully treated with artesunate. And 5 weeks after the completion of treatment, he presented with fever and diagnosed as P. ovale infection. P. ovale infection is a rare cause of malaria and often shows delayed presentation due to its dormant liver stage as hypnozoites. At re-presentation, the immunochromatographic test and microscopic examinations of our patient did not reveal P. ovale, which was only detected via polymerase chain reaction (PCR) assay. This case highlights the importance of considering malaria infection even in persons who have previously received malaria treatment. It also shows the usefulness of PCR testing for diagnosing P. ovale infections, which often present with a low level of parasitaemia.

Molecular characterization of Plasmodium juxtanucleare in Thai native fowls based on partial cytochrome C oxidase subunit I gene / 대한수의학회지

Avian malaria is one of the most important general blood parasites of poultry in Southeast Asia. Plasmodium (P.) juxtanucleare causes avian malaria in wild and domestic fowl. This study aimed to identify and characterize the Plasmodium species infecting in Thai native fowl. Blood samples were collected for microscopic examination, followed by detection of the Plasmodium cox I gene by using PCR. Five of the 10 sampled fowl had the desired 588 base pair amplicons. Sequence analysis of the five amplicons indicated that the nucleotide and amino acid sequences were homologous to each other and were closely related (100% identity) to a P. juxtanucleare strain isolated in Japan (AB250415). Furthermore, the phylogenetic tree of the cox I gene showed that the P. juxtanucleare in this study were grouped together and clustered with the Japan strain. The presence of P. juxtanucleare described in this study is the first report of P. juxtanucleare in the Thai native fowl of Thailand.

Genetic Diversity of Plasmodium vivax in Clinical Isolates from Southern Thailand using PvMSP1, PvMSP3 (PvMSP3α, PvMSP3β) Genes and Eight Microsatellite Markers

Plasmodium vivax is usually considered morbidity in endemic areas of Asia, Central and South America, and some part of Africa. In Thailand, previous studies indicated the genetic diversity of P. vivax in malaria-endemic regions such as the western part of Thailand bordering with Myanmar. The objective of the study is to investigate the genetic diversity of P. vivax circulating in Southern Thailand by using 3 antigenic markers and 8 microsatellite markers. Dried blood spots were collected from Chumphon, Phang Nga, Ranong and, Surat Thani provinces of Thailand. By PCR, 3 distinct sizes of PvMSP3α, 2 sizes of PvMSP3β and 2 sizes of PvMSP1 F2 were detected based on the length of PCR products, respectively. PCR/RFLP analyses of these antigen genes revealed high levels of genetic diversity. The genotyping of 8 microsatellite loci showed high genetic diversity as indicated by high alleles per locus and high expected heterozygosity (H(E)). The genotyping markers also showed multiple-clones of infection. Mixed genotypes were detected in 4.8% of PvMSP3α, 29.1% in PvMSP3β and 55.3% of microsatellite markers. These results showed that there was high genetic diversity of P. vivax isolated from Southern Thailand, indicating that the genetic diversity of P. vivax in this region was comparable to those observed other areas of Thailand.

Molecular Surveillance of Pfkelch13 and Pfmdr1 Mutations in Plasmodium falciparum Isolates from Southern Thailand

Artemisinin-based combination therapy (ACT) resistance is widespread throughout the Greater Mekong Subregion. This raises concern over the antimalarial treatment in Thailand since it shares borders with Cambodia, Laos, and Myanmar where high ACT failure rates were reported. It is crucial to have information about the spread of ACT resistance for efficient planning and treatment. This study was to identify the molecular markers for antimalarial drug resistance: Pfkelch13 and Pfmdr1 mutations from 5 provinces of southern Thailand, from 2012 to 2017, of which 2 provinces on the Thai- Myanmar border (Chumphon and Ranong), one on Thai-Malaysia border (Yala) and 2 from non-border provinces (Phang Nga and Surat Thani). The results showed that C580Y mutation of Pfkelch13 was found mainly in the province on the Thai-Myanmar border. No mutations in the PfKelch13 gene were found in Surat Thani and Yala. The Pfmdr1 gene isolated from the Thai-Malaysia border was a different pattern from those found in other areas (100% N86Y) whereas wild type strain was present in Phang Nga. Our study indicated that the molecular markers of artemisinin resistance were spread in the provinces bordering along the Thai-Myanmar, and the pattern of Pfmdr1 mutations from the areas along the international border of Thailand differed from those of the non-border provinces. The information of the molecular markers from this study highlighted the recent spread of artemisinin resistant parasites from the endemic area, and the data will be useful for optimizing antimalarial treatment based on regional differences.

Previous Infection with Plasmodium berghei Confers Resistance to Toxoplasma gondii Infection in Mice

Both Plasmodium spp. and Toxoplasma gondii are important apicomplexan parasites, which infect humans worldwide. Genetic analyses have revealed that 33% of amino acid sequences of inner membrane complex from the malaria parasite Plasmodium berghei is similar to that of Toxoplasma gondii. Inner membrane complex is known to be involved in cell invasion and replication. In this study, we investigated the resistance against T. gondii (ME49) infection induced by previously infected P. berghei (ANKA) in mice. Levels of T. gondii-specific IgG, IgG1, IgG2a, and IgG2b antibody responses, CD4+ and CD8+ T cell populations were found higher in the mice infected with P. berghei (ANKA) and challenged with T. gondii (ME49) compared to that in control mice infected with T. gondii alone (ME49). P. berghei (ANKA) + T. gondii (ME49) group showed significantly reduced the number and size of T. gondii (ME49) cysts in the brains of mice, resulting in lower body weight loss compared to ME49 control group. These results indicate that previous exposure to P. berghei (ANKA) induce resistance to subsequent T. gondii (ME49) infection.