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      Detection of Plasmodium simium gametocytes in non-human primates from the Brazilian Atlantic Forest

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          Abstract

          Background

          Plasmodium species of non-human primates (NHP) are of great interest because they can naturally infect humans. Plasmodium simium, a parasite restricted to the Brazilian Atlantic Forest, was recently shown to cause a zoonotic outbreak in the state of Rio de Janeiro. The potential of NHP to act as reservoirs of Plasmodium infection presents a challenge for malaria elimination, as NHP will contribute to the persistence of the parasite. The aim of the current study was to identify and quantify gametocytes in NHP naturally-infected by P. simium.

          Methods

          Whole blood samples from 35 NHP were used in quantitative reverse transcription PCR (RT-qPCR) assays targeting 18S rRNA, Pss25 and Pss48/45 malaria parasite transcripts. Absolute quantification was performed in positive samples for 18S rRNA and Pss25 targets. Linear regression was used to compare the quantification cycle (Cq) and the Spearman's rank correlation coefficient was used to assess the correlation between the copy numbers of 18S rRNA and Pss25 transcripts. The number of gametocytes/µL was calculated by applying a conversion factor of 4.17 Pss25 transcript copies per gametocyte.

          Results

          Overall, 87.5% of the 26 samples, previously diagnosed as P. simium, were positive for 18S rRNA transcript amplification, of which 13 samples (62%) were positive for Pss25 transcript amplification and 7 samples (54%) were also positive for Pss48/45 transcript. A strong positive correlation was identified between the Cq of the 18S rRNA and Pss25 and between the Pss25 and Pss48/45 transcripts. The 18S rRNA and Pss25 transcripts had an average of 1665.88 and 3.07 copies/µL, respectively. A positive correlation was observed between the copy number of Pss25 and 18S rRNA transcripts. Almost all gametocyte carriers exhibited low numbers of gametocytes (< 1/µL), with only one howler monkey having 5.8 gametocytes/µL.

          Conclusions

          For the first time, a molecular detection of P. simium gametocytes in the blood of naturally-infected brown howler monkeys ( Alouatta guariba clamitans) was reported here, providing evidence that they are likely to be infectious and transmit P. simium infection, and, therefore, may act as a reservoir of malaria infection for humans in the Brazilian Atlantic Forest.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12936-023-04601-7.

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          Most cited references70

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          The silent threat: asymptomatic parasitemia and malaria transmission.

          Scale-up of malaria control interventions has resulted in a substantial decline in global malaria morbidity and mortality. Despite this achievement, there is evidence that current interventions alone will not lead to malaria elimination in most malaria-endemic areas and additional strategies need to be considered. Use of antimalarial drugs to target the reservoir of malaria infection is an option to reduce the transmission of malaria between humans and mosquito vectors. However, a large proportion of human malaria infections are asymptomatic, requiring treatment that is not triggered by care-seeking for clinical illness. This article reviews the evidence that asymptomatic malaria infection plays an important role in malaria transmission and that interventions to target this parasite reservoir may be needed to achieve malaria elimination in both low- and high-transmission areas.
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            High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction

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              First case of a naturally acquired human infection with Plasmodium cynomolgi

              Since 1960, a total of seven species of monkey malaria have been reported as transmissible to man by mosquito bite: Plasmodium cynomolgi, Plasmodium brasilianum, Plasmodium eylesi, Plasmodium knowlesi, Plasmodium inui, Plasmodium schwetzi and Plasmodium simium. With the exception of P. knowlesi, none of the other species has been found to infect humans in nature. In this report, it is described the first known case of a naturally acquired P. cynomolgi malaria in humans. The patient was a 39-year-old woman from a malaria-free area with no previous history of malaria or travel to endemic areas. Initially, malaria was diagnosed and identified as Plasmodium malariae/P. knowlesi by microscopy in the Terengganu State Health Department. Thick and thin blood films stained with 10% Giemsa were performed for microscopy examination. Molecular species identification was performed at the Institute for Medical Research (IMR, Malaysia) and in the Malaria & Emerging Parasitic Diseases Laboratory (MAPELAB, Spain) using different nested PCR methods. Microscopic re-examination in the IMR showed characteristics of Plasmodium vivax and was confirmed by a nested PCR assay developed by Snounou et al. Instead, a different PCR assay plus sequencing performed at the MAPELAB confirmed that the patient was infected with P. cynomolgi and not with P. vivax. This is the first report of human P. cynomolgi infection acquired in a natural way, but there might be more undiagnosed or misdiagnosed cases, since P. cynomolgi is morphologically indistinguishable from P. vivax, and one of the most used PCR methods for malaria infection detection may identify a P. cynomolgi infection as P. vivax. Simian Plasmodium species may routinely infect humans in Southeast Asia. New diagnostic methods are necessary to distinguish between the human and monkey malaria species. Further epidemiological studies, incriminating also the mosquito vector(s), must be performed to know the relevance of cynomolgi malaria and its implication on human public health and in the control of human malaria. The zoonotic malaria cannot be ignored in view of increasing interactions between man and wild animals in the process of urbanization.
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                Author and article information

                Contributors
                cristiana.brito@fiocruz.br
                Journal
                Malar J
                Malar J
                Malaria Journal
                BioMed Central (London )
                1475-2875
                2 June 2023
                2 June 2023
                2023
                : 22
                : 170
                Affiliations
                [1 ]GRID grid.418068.3, ISNI 0000 0001 0723 0931, Grupo de Pesquisa em Biologia Molecular e Imunologia da Malária, Instituto René Rachou, , Fundação Oswaldo Cruz (Fiocruz), ; Belo Horizonte, Brazil
                [2 ]GRID grid.419134.a, ISNI 0000 0004 0620 4442, Laboratório de Doenças Febris Agudas, , Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, ; Rio de Janeiro, Brazil
                [3 ]GRID grid.418068.3, ISNI 0000 0001 0723 0931, Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Fiocruz, ; Rio de Janeiro, Brazil
                [4 ]GRID grid.418068.3, ISNI 0000 0001 0723 0931, Laboratório de Pesquisa em Malária, , Instituto Oswaldo Cruz, Fiocruz, ; Rio de Janeiro, Brazil
                [5 ]GRID grid.411173.1, ISNI 0000 0001 2184 6919, Departamento de Doenças Infecciosas e Parasitárias, , Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense, ; Niterói, Brazil
                [6 ]Programa de Conservação do Bugio Ruivo, Joinville, Brazil
                [7 ]Centro de Pesquisas Biológicas de Indaial, Indaial, Brazil
                [8 ]GRID grid.412404.7, ISNI 0000 0000 9143 5704, Universidade Regional de Blumenau – FURB, ; Blumenau, Brazil
                [9 ]Centro de Primatologia do Rio de Janeiro/INEA, Guapimirim, Brazil
                [10 ]GRID grid.442239.a, ISNI 0000 0004 0573 2534, Centro Universitário Serra dos Órgãos, ; Teresópolis, Brazil
                Article
                4601
                10.1186/s12936-023-04601-7
                10239093
                1115cb9a-dba6-4bcc-961b-9e228fef5d38
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 13 February 2023
                : 20 May 2023
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Infectious disease & Microbiology
                malaria,zoonoses,infectious disease transmission,plasmodium simium,non-human primate,gametocytes

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