Oasis Malaria, Northern Mauritania 1

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Abstract

A malaria survey was conducted in Atar, the northernmost oasis city in Mauritania, during 2015–2016. All febrile patients in whom malaria was suspected were screened for malaria by using rapid diagnostic testing and microscopic examination of blood smears and later confirmed by PCR. Of 453 suspected malaria cases, 108 (23.8%) were positive by rapid diagnostic testing, 154 (34.0%) by microscopic examination, and 162 (35.7%) by PCR. Malaria cases were observed throughout the year and among all age groups. Plasmodium vivax was present in 120/162 (74.1%) cases, P. falciparum in 4/162 (2.4%), and mixed P. falciparum– P. vivax in 38/162 (23.4%). Malaria is endemic in northern Mauritania and could be spreading farther north in the Sahara, possibly because of human-driven environmental changes. Further entomologic and parasitologic studies and monitoring are needed to relate these findings to major Anopheles mosquito vectors and to design and implement strategies for malaria prevention and control.

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Global Epidemiology of Plasmodium vivax

Rosalind E. Howes, Katherine Battle, Kamini N. Mendis … (2017)

Plasmodium vivax is the most widespread human malaria, putting 2.5 billion people at risk of infection. Its unique biological and epidemiological characteristics pose challenges to control strategies that have been principally targeted against Plasmodium falciparum. Unlike P. falciparum, P. vivax infections have typically low blood-stage parasitemia with gametocytes emerging before illness manifests, and dormant liver stages causing relapses. These traits affect both its geographic distribution and transmission patterns. Asymptomatic infections, high-risk groups, and resulting case burdens are described in this review. Despite relatively low prevalence measurements and parasitemia levels, along with high proportions of asymptomatic cases, this parasite is not benign. Plasmodium vivax can be associated with severe and even fatal illness. Spreading resistance to chloroquine against the acute attack, and the operational inadequacy of primaquine against the multiple attacks of relapse, exacerbates the risk of poor outcomes among the tens of millions suffering from infection each year. Without strategies accounting for these P. vivax-specific characteristics, progress toward elimination of endemic malaria transmission will be substantially impeded.

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Absence of seasonal variation in malaria parasitaemia in an area of intense seasonal transmission.

T. Smith, J.D. Charlwood, J Kihonda … (1993)

Parasitological surveys carried out in two villages of the Kilombero district of Tanzania indicated a very high prevalence of Plasmodium falciparum parasitaemia throughout the year (all ages mean prevalence = 69.2%) and a low, unstable prevalence of P. malariae (all ages mean prevalence = 4.5%). Fevers (temperature > or = 37.5 degrees C) in both children and adults showed irregular changes in prevalence over time, but there was no seasonal pattern. Neither was there seasonal variation in either P. falciparum parasite prevalence or parasite densities. This was despite marked seasonality in vectors caught in CDC light-traps and in estimated sporozoite inoculations determined by ELISA. The estimated mean annual inoculation rate was extremely high, over 300 infectious bites per person per year, the main vectors being members of the A. gambiae complex and Anopheles funestus. There was considerable variation between houses but even in houses with relatively low mosquito numbers the inoculation rate was sufficient to maintain a maximal P. falciparum prevalence. Heterogeneities in exposure cannot explain why the parasite prevalence is not always 100%. In areas of such high transmission, parasitaemias are likely to be determined mainly by the interaction of schizogony and anti-blood stage immunity, since parasites arising from new inoculations generally comprise only a small proportion of the total in the circulation. In any one individual, this will lead to periodic fluctuations in levels of parasitaemia. These are unlikely to show a close relationship to either seasonal variation in inoculations or to differences between households in the local inoculation rate.

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An innovative tool for moving malaria PCR detection of parasite reservoir into the field

Lydie Canier, Nimol Khim, Saorin Kim … (2013)

Background To achieve the goal of malaria elimination in low transmission areas such as in Cambodia, new, inexpensive, high-throughput diagnostic tools for identifying very low parasite densities in asymptomatic carriers are required. This will enable a switch from passive to active malaria case detection in the field. Methods DNA extraction and real-time PCR assays were implemented in an “in-house” designed mobile laboratory allowing implementation of a robust, sensitive and rapid malaria diagnostic strategy in the field. This tool was employed in a survey organized in the context of the MalaResT project (NCT01663831). Results The real-time PCR screening and species identification assays were performed in the mobile laboratory between October and November 2012, in Rattanakiri Province, to screen approximately 5,000 individuals in less than four weeks and treat parasite carriers within 24–48 hours after sample collection. An average of 240 clinical samples (and 40 quality control samples) was tested every day, six/seven days per week. Some 97.7% of the results were available <24 hours after the collection. A total of 4.9% were positive for malaria. Plasmodium vivax was present in 61.1% of the positive samples, Plasmodium falciparum in 45.9%, Plasmodium malariae in 7.0% and Plasmodium ovale in 2.0%. Conclusions The operational success of this diagnostic set-up proved that molecular testing and subsequent treatment is logistically achievable in field settings. This will allow the detection of clusters of asymptomatic carriers and to provide useful epidemiological information. Fast results will be of great help for staff in the field to track and treat asymptomatic parasitaemic cases. The concept of the mobile laboratory could be extended to other countries for the molecular detection of malaria or other pathogens, or to culture vivax parasites, which does not support long-time delay between sample collection and culture.

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Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): February 2019

Volume: 25

Issue: 2

Pages: 282-289

Affiliations

[1]Unité Mixte de Recherche 216, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, Paris, France (J. Deida, R. Tahar);

[2]Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania (J. Deida, K. Mint Lekweiry, A. Ould Mohamed Salem Boukhary);

[3]Ministry of Health, Nouakchott (Y. Ould Khalef, M.L. Ould Khairy); Ministry of Health, Atar (A. Hmeyade);

[4]Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, Institut de Recherche pour le Développement–Centre National de Recherche Scientifique– Université Montpellier, Montpellier, France (F. Simard);

[5]Institut de Recherche Biomédicale des Armées, Marseille (H. Bogreau);

[6]Centre National de Référence du Paludisme, Marseille (H. Bogreau);

[7]Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique–Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France (H. Bogreau, L. Basco, A. Ould Mohamed Salem Boukhary)

Author notes

Address for correspondence: Ali Ould Mohamed Salem Boukhary, Unité de Recherche Génomes et Milieux (JEAI), Université de Nouakchott Al-Aasriya, PO Box 5026, Nouakchott, Mauritania; email: alimedsalem@ 123456gmail.com

Article

Publisher ID: 18-0732

DOI: 10.3201/eid2502.180732

PMC ID: 6346462

PubMed ID: 30666926

SO-VID: 7d2461d2-26a9-4735-bac0-e5e00be87e86

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Most cited references 28

Global Epidemiology of Plasmodium vivax

Absence of seasonal variation in malaria parasitaemia in an area of intense seasonal transmission.

An innovative tool for moving malaria PCR detection of parasite reservoir into the field

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