ABSTRACT
BACKGROUND: Human African trypanosomiasis (HAT) is one of the most complex parasitic diseases known to humankind. It usually occurs in endemic areas in Africa, but is occasionally detected in returning travelers and migrants in non-endemic countries. CASE PRESENTATION: In August 2017, a case of HAT was diagnosed in China in a traveler returning from the Masai Mara area in Kenya and the Serengeti area in Tanzania. The traveler visited Africa from 23 July to 5 August, 2017. Upon return to China, she developed a fever (on 8 August), and Trypanosoma brucei rhodesiense infection was confirmed by laboratory tests (on 14 August) including observation of parasites in blood films and by polymerase chain reaction. She was treated with pentamidine followed by suramin, and recovered 1 month later. CONCLUSIONS: This is the first imported rhodesiense HAT case reported in China. This case alerts clinical and public health workers to be aware of HAT in travelers, and expatriates and migrants who have visited at-risk areas in Africa.
Subject(s)
Communicable Diseases, Imported/diagnosis , Trypanosoma brucei rhodesiense/isolation & purification , Trypanosomiasis, African/diagnosis , Adult , China , Communicable Diseases, Imported/blood , Communicable Diseases, Imported/drug therapy , Female , Humans , Parks, Recreational , Pentamidine/administration & dosage , Polymerase Chain Reaction , Suramin/administration & dosage , Tanzania , Travel , Treatment Outcome , Trypanosomiasis, African/blood , Trypanosomiasis, African/drug therapyABSTRACT
An imported case previously misdiagnosed as vivax malaria was reviewed. The epidemiological data and blood sample were collected. The detection was conducted by microscopy, rapid diagnostic test (RDT) and nested PCR. The case was finally comfirmed as the first imported case of Plasmodium ovale infection in Nanping.
Subject(s)
Malaria/diagnosis , Plasmodium ovale , China , Humans , Malaria, Vivax , Microscopy , Polymerase Chain ReactionABSTRACT
Malaria used to be a serious health problem in Fujian province in the past, but no local malaria transmission has been found since 2000. In order to eliminate the potential residual cases and prevent re-introduction of malaria so as to achieve the final goal of malaria elimination in Fujian province, various strategy and intervention approaches were tailored to the local settings. For instance, the monitoring of febrile patients by blood smear examinations and vector surveillance and control were strengthened in addition to the routine intervention in the mountainous area of Fujian province, where malaria was highly endemic and the mosquito Anopheles anthropophagus distributed with a high vectorial capacity. There were two local cases who got infected due to imported cases found in the building site of an expressway in 2004 and 2005, respective. All other imported malaria cases were detected during post-elimination stage through surveillance system. Based on results from post-transmission surveillance, malaria transmission has been interrupted in Fujian province for 13 years. Therefore, post-transmission surveillance and response is an important intervention to maintain the malaria elimination achievements in Fujian province.
Subject(s)
Disease Eradication , Epidemiological Monitoring , Malaria/prevention & control , Animals , China/epidemiology , Humans , Malaria/epidemiologyABSTRACT
OBJECTIVE: To study the genetic diversity of apical membrane antigen-1 gene from Plasmodium falciparum (PfAMA-1). METHODS: Filter paper blood samples were collected from 23 imported P. falciparum malaria patients who returned to Fujian Province from 2006 to 2012. Nested PCR were used to amplify the PfAMA-1 gene. The umplified fragments were sequenced, and analyzed by bioinformatic software. RESULTS: All 23 samples were amplified a 505 bp band. Thirty-two nucleotides were found to be variable, resulting in 18 haplotypes. Eight of these 18 halotypes were being reported here for the first time. The parasites collected from Africa showed the higher level of variability [haplotypes diversity (Hd)= 0.0985, nucleotide diversity (π)=0.0258] as compared to the isolates from Asia (Hd=0.909, π=0.0221). The average difference of dN-dS for all 23 PfAMA-1 sequences was 0.031±0.006. Sequence-based neutrality tests were not significant in Africa and Asia (P>0.05). The minimum number of recombination events (Rm) was 10, and the linkage disequilibrium index (R2) evidently declined with the increase of nucleotide distance. A molecular phylogenetic tree constructed using the neighbor-joining method showed that the 23 isolates were assigned to three clades (G1, G2 and G3). Most samples from Africa formed G1, and G3 contained most of Asian isolates. CONCLUSION: Plasmodium falciparum isolates from Africa show a higher genetic diversity than the isolates from Asia for PfAMA-1 gene.
