Prevalence of asymptomatic malaria parasitaemia

Objective:To evaluate factors associated with prevalence of malaria parasitaemia at first antenatal care visit.Methods:The study was conducted at the University of Calabar Teaching Hospital from 1st June,2007 to 31st July,2007.A structured questionnaire was administered to a total of 545 pregnant women that were recruited in this study after obtaining informed consent and two slides of thin and thick films were prepared for each participant.Results:Five hundred and twenty(95.4%) out of the 545 participants suffered from malaria parasitaemia,the rest 4.6%of those who had no parasitaemia had experienced symptomatic malaria before and were treated in private hospitals prior to their recruitment into the study.All participants(100%) who did not have antimalarials had parasitaemia compared with 91.1%among those that had antimalarials.The proportion of moderate to severe parasitaemia was also significantly higher among the former.Besides,the difference in parasitaemia between primigravidae and multigravidae was statistically significant(P=0.000) too. Among the methods used for vector control,only insecticide treated nets(ITNS) was associated with significant reduction in the level of parasitaemia(RR=0.83).Conclusion:Malaria parasitaemia at first booking is significandy higher in primigravidae and women who have no anti-malaria treatment. The use of safe and effective antimalarial treatment along with ITNs will significandy reduce the level of parasitaemia in pregnant women.

Malaria parasitaemia and disorders of plasma electrolytes

Objective:To assess the plasma electrolyte status of patients with diagnosis of malaria but without the symptoms of diarrhea,vomiting or altered sensorium and correlation of the plasma electrolyte changes and the degree of parasitaemia. Methods:All the participants were adults,who met the clinical case definition of malaria but without the symptoms of diarrhea,vomiting or other medical illness.Blood slides were screened microscopically for malaria parasite and the parasite positive patients were grouped into A(mild),B(moderate) and C(heavy) malaria parasiteamia, depending on the malaria parasite count per high power microscopic field.Plasma sodium,potassium and chloride were estimated using the ion selective electrode method,while bicarbonate ions were determined by simple titration method.Results:A total of 200 subjects were studied which comprised of 150 patients and 50 controls.The mean plasma sodium was significantly lower in patients with heavy parasitaemia[group C,(128.8±1.2) mmol/L] compared to those with mild and moderate parasitemia[(133.5±2.8) mmol/L and(133.5±3.5) mmol/L,P【0.0001].The mean plasma chloride was lowest in those patients with heavy parasitaemia(group C) than those patients of group A and B(P【0.0001).Patients in group C also had significant hypokalaemia[(3.2±0.5) mmol/ L]when compared to those in groups A and B[(3.6±0.3) mmol/L and(4.1±0.6) mmol/L respectively,P【0. 0001].Conclusion:A disorder of plasma electrolytes in malaria patients that had no symptoms of diarrhea and vomiting was reported.And the severity of hyponatraemia and hypokalaemia correlate with the severity of the patients’ malaria parasitaemia.This data should alert clinicians on the need to assess electrolytes status of patients with malaria even without the symptoms of fluid loss,especially when malaria parasitaemia is heavy.

Evaluation of Malaria Parasitaemia and Assessing the Knowledge, Attitude and Practice of Pregnant Women Attending Health Facilities in Owerri Metropolis towards Malaria Prevention and Control

There are a few investigations on malaria in pregnancy;however, examinations zeroing in on the discernment and current acts of malaria counteraction and treatment among pregnant women are scanty. This examination was pointed toward evaluating the information, recognitions about malaria anticipation with accentuation on information about placental malaria too consistence to utilization of LLIN and IPTP among pregnant women in Owerri, South Eastern Nigeria. A cross-sectional descriptive study was conducted at an emergency department, Federal Medical Centre, Owerri using a pretested questionnaire from 200 randomly selected consenting pregnant women. Acknowledgment of malaria manifestations during pregnancy, information about IPTP and placenta malaria were things used to survey the degree of information about malaria in pregnancy. Their blood tests were additionally diagnosed for malaria parasitaemia. Malaria prevalence in the examination populace by microscopy was 13.5%. Additionally 62% of the respondents were learned about the conceivable impeding impacts of the existences of malaria during pregnancy. About 79.5% of the respondent decidedly related mosquitoes to malaria contamination while 31% and 14% related reason for malaria disease to messy encompassing and stale water individually. Malaria Prevention Mentality and Practice in this examination was acceptable (60%) while 18.5% had reasonable practice. All the more so and 15.5% of the respondents had been associated with helpless practice. About 34% of the pregnant ladies rested under a mosquito net frequently study watched factual criticalness between age, occupation and malaria counteraction rehearses (p = 0.014, 0.0089). There was likewise measurably huge relationship between respondent’s training and respondent mentality (p = 0.0034). Information with respect to the utilization of Sulphodaxine primethamine (SP) as medication of decision during pregnancy was restricted (12.0%) as utilization of chloroquine was positioned most elevated (48%). The study showed low peripheral malaria prevalence and furthermore exhibited that pregnant women’s knowledge, mentality and practice towards malaria avoidance was impressively all things considered. Be that as it may, there was helpless information about discontinuous preventive treatment of malaria (IPTP) or suggested antimalarial during pregnancy.

Asiatic acid-pectin hydrogel matrix patch transdermal delivery system influences parasitaemia suppression and inflammation reduction in P. berghei murine malaria infected Sprague-Dawley rats

Objective: To report the influence of transdermal delivery of asiatic acid(AA) in Plasmodium berghei-infected Sprague Dawley rats on physicochemical changes, %parasitaemia and associated pathophysiology. Methods: A topical once-off AA(5, 10, and 20 mg/kg)- or chloroquine(CHQ)-pectin patch was applied on the shaven dorsal neck region of Plasmodium berghei-infected Sprague Dawley rats(90-120 g) on day 7 after infection. Eating and drinking habits, weight changes, malaria effects and %parasitaemia were compared among animal groups over 21 d. Results: AA-pectin patch application preserved food and water intake together with %weight gain. All animals developed stable parasitaemia(15%-20%) by day 7. AA doses suppressed parasitaemia significantly. AA 5 mg/kg patch was most effective. AA and CHQ displayed bimodal time-spaced peaks. CHQ patch had a longer time course to clear parasitaemia. Conclusions: AA influences bio-physicochemical changes and parasitaemia suppression in dose dependent manner. In comparison by dose administered, AA has much better efficacy than CHQ. AA may be a useful antimalarial. AA and CHQ displays bimodal peaks suggesting possible synergism if used in combination therapy.

Plasmodium Parasitaemia among Pregnant Women in the Niger Delta Region of Nigeria

Introduction: Malaria is a febrile illness caused by the Plasmodium species. The mangrove swamp forest vegetation and high annual rainfall characteristic of the Niger Delta region of Nigeria encourage all year round transmission of malaria. This study aimed to determine the prevalence and speciation of Plasmodium parasitaemia among pregnant women in the Niger Delta region of Nigeria. Methodology: Cross-sectional study carried out in three states of the Niger Delta region;Akwa-Ibom, Delta and Rivers between April and June 2019. Study Sites were chosen by stratified random sampling. Demographic information was collected using pretested interviewer-administered questionnaires via the Open Data Kit application on android mobile phones. Diagnosis was by rapid diagnostic test (RDT) and Microscopy. Ethical approval and informed consent were obtained. Data was analyzed using the SPSS v25 software. Chi-square statistic and Fischer’s exact test were used to compare data, all at a 95% confidence interval and significance level of 0.05. Results: Two thousand, eight hundred and twenty (2820) pregnant women were studied;948, 992 and 880 from Akwa-Ibom, Delta and Rivers respectively. Overall prevalence of parasitaemia using RDT and Microscopy was 6.8% and 6.7% respectively. All except 1% of malaria was attributed to falciparum species. The other species were plasmodium ovale and plasmodium malariae. Conclusion: The prevalence of Plasmodium parasitaemia among pregnant women in the Niger Delta region of Nigeria has reduced considerably, giving credence to the malaria preventive strategies applied in antenatal care. When properly stored and used as recommended, malaria RDTs compare favorably with microscopy;therefore, no case of malaria should be missed due to a facility’s incapability to carry out microscopic diagnosis.

A comparative laboratory diagnosis of malaria:microscopy versus rapid diagnostic test kits

Objective:To compare the two methods of rapid diagnostic tests(RDTs)and microscopy in the diagnosis of malaria.Methods:RDTs and microscopy were carried out to diagnose malaria. Percentage malaria parasitaemia was calculated on thin films and all non-acute cases of plasmodiasis with less than 0.001%malaria parasitaemia were regarded as negative.Results were simply presented as percentage positive of the total number of patients under study.The results of RDTs were compared to those of microscopy while those of RDTs based on antigen were compared to those of RDTs based on antibody.Patients' follow-up was made for all cases.Results: All the 200 patients under present study tested positive to RDTs based on malaria antibodies(serum)method(100%).128 out of 200 tested positive to RDTs based on malaria antigen(whole blood)method(64%),while 118 out of 200 patients under present study tested positive to visual microscopy of Lieshman and diluted Giemsa(59%).All patients that tested positive to microscopy also tested positive to RDTs based on antigen.All patients on the second day of follow-up were non-febrile and had antimalaria drugs.Conclusions;We conclude based on the present study that the RDTs based on malaria antigen(whole blood)method is as specific as the traditional microscopy and even appears more sensitive than microscopy.The RDTs based on antibody(serum)method is unspecific thus it should not be encouraged.It is most likely that Africa being an endemic region,formation of certain levels of malaria antibody may not be uncommon.The present study also supports the opinion that a good number of febrile cases is not due to malaria. We support WHO's report on cost effectiveness of RDTs but,recommend that only the antigen based method should possibly,be adopted in Africa and other malaria endemic regions of the world.

Effect of a Malaria Control Program on the Prevalence of Malaria, Fever and Anaemia in Children under Five Years in the Hohoe Municipality of Ghana: A Comparative Analysis of Cross-Sectional Surveys

Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities which provided In-secticide Treated Bed-Nets (ITNs) to resident children under five years and Artemisinin Combination Therapies (ACTs) for the management of malaria were introduced into the Hohoe Municipality. Before the introduction of the control programme, baseline surveys were carried out in communities in the Hohoe municipality to determine the prevalence of malaria, fever, anaemia, malaria parasite density, gametocytaemia and ITN ownership and use in June and November 2006 ahead of the intervention programme. Similar surveys were conducted in 2010 after the intervention to assess changes in the earlier indicators in the same communities. This report presents an evaluation of the intervention by comparing findings before and after the malaria control interventions. Methods: In 2010, two community-based surveys were carried out in thirty communities among children aged five years and below. The first one was at the beginning of the rainy and high malaria transmission season in June and the other was in November at the end of the rainy season. The surveys were to determine the prevalence of malaria, fever, anaemia and ITN ownership, use and effectiveness among children less than 5 years. Data were collected in the form of interviews using questionnaire and collection of biological samples. Findings were compared to those similar surveys conducted in the same communities and age groups in 2006. Pr-testi was used to analyze two sample tests for proportions and t-test was used for means. Findings: Malaria prevalence decreased by 20% [9.0% vs. 7.2%;p = 0.0.40], fever decreased by 47.8% [2.3% vs. 1.2%;p = 0.008] and anaemia decreased by 32.9% [7.8% vs. 5.3%;p = 0.002]. ITN ownership increased by 67.9% [20.8% vs. 64.8%;p < 0.001], ITN use increased by 64.2% [15.1% vs. 42.2%;p < 0.001] and ITN effectiveness increased by 41.7% [20.0% vs. 34.3%;p < 0.001]. The proportion of children with high density parasitaemia reduced by 17.9% [2.8% vs. 2.3%;p = 0.223]. Gameto-cytaemia decreased by 82.5% [0.8% vs. 0.14%;p = 0.002. Similarly data comparing 2006 and 2010 post-rainy season showed that malaria prevalence decreased by 16.8% [40.4% vs. 33.6%;p < 0.001], fever decreased by 14% [5.0% vs. 4.3%;p = 0.347] and anaemia decreased by 64.2% [12% vs. 4.3%;p < 0.001]. The proportion of children with high density parasitaemia also reduced by 69.5% [10.5% vs. 3.2%;p < 0.001] and gametocytaemia decreased by 78.5% [0.8% vs. 0.17%;p = 0.008]. Conclusion: This study suggested that there was an association between the current intervention and reduction in the prevalence of malaria, fever and anaemia. High parasite density and gametocytaemia prevalence have also significantly reduced over the five years of the introduction of the control measures. There has also been a significant increase in the ownership and use of ITNs.

Could the Level in Parasitaemia of <i>Plasmodium</i>Determine Sensitivity to Various Diagnostic Tests?

The discovery of Plasmodium parasites and its incrimination as the principal cause of malaria in humans has continued to excite researchers towards inventing possible easier methods of diagnosing and identifying these pathological agents in order to mitigate, control and eliminate its continuous scourge to humanity. Currently, three diagnostic methods have been proposed, but agreements as to whether the level of parasitaemia in an individual could connote likely confirmations in the three methods i.e. gold standard, RDTs’ and PCR/NESTED PCR, have continued to be a subject of debate. To lay to rest the debate as reported in many studies, we collected blood samples from 100 symptomatic patients who reported to the Jos-Nigeria hospital and using the gold standard methods, we were able to confirm that 30 (30%) samples out of the 100 blood samples collected were positive to P. falciparum, chiefly recorded among duffy-negative Africans. Excited with our findings, we prepared the thick blood films for each sample and used it to estimate the levels of parasitaemia (parasites density) per μl of blood (i.e. 1+;2+;3+ and 4+) per 100 high power fields (|HPF). We then subjected the individually confirmed parasite density samples to the other two methods i.e. Rapid Diagnostic Test (one-step RTD and optimal-IT® RDT) and to molecular assay (PCR and the nested PCR). Interestingly, of the 30 positive samples, 18 (60%) were confirmed positive to the one-step and optimal-IT® RDTS, while 3 (30%) out of the 10 (100%) samples of various parasite density subjected to molecular assay (PCR and the nested PCR) were positive to only P. falciparum. Statistical analysis of variance based on single factor computed using SPSS indicates a no significant difference (P > 0.05) in the parasitaemia levels of the four groups/categories of patients;i.e. variance ratio of 0.011976 calculated was less than F-critical (2.816466) at 5% (0.05). Whereas gold standard could be considered as the optimal method, for the PCR/NESTED PCR, the sensitivity is dependent on high level of parasitaemia.

Clinical features of severe malaria:Protective effect of mixed plasmodial malaria

Objective: To investigate clinically severe malaria patients with Plasmodium falciparum(P. falciparum), Plasmodium vivax(P. vivax) and mixed species infections.Methods: This study was conducted at Dr. Saiful Anwar General Hospital, Malang,Indonesia, from December 2011 to May 2013. Twenty nine patients(mean age of 41 years, 22% female), who suffered from severe malaria according to World Health Organization criteria(major and minor) and other criteria based on previous studies, were selected by consecutive sampling. Blood samples were obtained at admission from peripheral blood for microscopic diagnostic, nested PCR and laboratory examination of blood chemistry. Laboratory results were compared between the groups and correlated to each other.Results: From 29 samples, eight(28%) were diagnosed as P. falciparum mono-infection,12(41%) as P. vivax mono-infection and nine(31%) as mixed infections, confirmed by PCR. Cerebral malaria occurred in P. falciparum or mixed species infection only. Parasitaemia was highest in P. falciparum mono-infection. Mean haemoglobin was significantly lower in P. falciparum than P. vivax infection(P = 0.01). Mean thrombocyte count(77 138/m L) was low in all groups. Mean urea, creatinine, total and direct bilirubin were significantly higher in P. falciparum mono-infection compared to other groups, whereas aspartate aminotransferase and alanine aminotransferase showed no significant differences. Parasitaemia was positively correlated with an increase in urea, creatinine, bilirubin and leucocytosis in all species.Conclusions: Both Plasmodium species can solely or in combination cause severe malaria. Mixed infection was generally more benign than P. falciparum mono-infection and seemed to have some protective effects.

疟史与疟原虫血症关系的研究(英文)

目的 研究疟史对健康人和发热病人原虫血症的作用。 方法 1989年 5月和 10月在中国云南省沧源县班老乡作了两次横断面调查。专业人员在对健康人采血、涂片、镜检的同时 ,进行问卷调查 ,调查内容包括疟史、性别、居住地海拔及村名 5个方面。在 4月和 10月期间收集发热病人的情况 ,用 EPI INFO 6 .0和 STATA 5 .0软件对数据进行处理。 结果 单因素分析发现疟史和年龄是无症状带虫者 [ML H比值比为 3.98(95 %可信限为 2 .48～ 6 .40 ) ,年龄 2 1～ 40的比值比为 0 .19(95 %可信限为 0 .0 9～0 .39) ,年龄≥ 40的比值比为 0 .38(95 %可信限为 0 .16～ 0 .90 ) ]的危险因素。多因素分析发现年龄是混杂因素 ,冲淡了疟史的作用 ;而疟史是原虫血症发热病人的保护因素 [比值比为 0 .37(95 %可信限为 0 .2 1～ 0 .6 5 ) ]。 结论 有疟史者很有可能是无症状的带虫者 ,是传播疟疾的传染源 ,应在早期阶段就对其重新治疗。