Association of ABO blood group and Plasmodium falciparum malaria in Dore Bafeno Area,Southern Ethiopia

Objective:To assess the distribution of ABO blood group and their relationship with Plasmodium falciparum(P.falciparum) malaria among febrile outpatients who sought medical attention at Dore Bafeno Health Center,Southern Ethiopia.Methods:A total of 269 febrile outpatients who visited Dore Bafeno Health Center,Southern Ethiopia,were examined for malaria and also tested for ABO blood groups in January 2010.The blood specimens were collected by finger pricking,stained with Geimsa,and examined microscopically.Positive cases of the parasitemia were counted.CareStart^(TM) Malaria PflPv Combo was also used to test the blood specimens for malaria.ABO blood groups were determined by agglutination test using ERYCLONE antisera.Data on socio-demographic characteristics and treatment status of the participants were also collected.Chi-square and ANOVA tests were used to assess the difference between frequencies and means,respectively.Results:Out of a total of 269 participants,178(66.2%) febrile patients were found to be infected with Plasmodium parasites,among which 146(54.3%),28(10.4%),and 4(1.5%) belonged to P.falciparum,P.vivax,and mixed infections,respectively.All febrile patients were also tested for ABO blood groups and 51.3%,23.5%,21.9%and 3.3%were found to be blood types of 0,A,B and AB,respectively.Both total malaria infection and P.falciparum infection showed significant association with blood types(P<0.05).The proportion of A or B but not 0 phenotypes was higher(P<0.05) in individuals with P.falciparum as compared with non-infected individuals.The chance of having P.falciparum infection in patients with blood groups A,B and AB was 2.5,2.5 and 3.3times more than individuals showing blood 0 phenotypes,respectively.The mean P.falciparum malaria parasitemia for blood groups A,B,AB,and 0 were 3 744/μ L,1 805/ μ L,5 331/μ L,and1 515/μ L,respectively(P<0.01).Conclusions:The present findings indicate that individuals of blood groups A,B and AB are more susceptible to P.falciparum infection as compared with individuals of blood group O.Nevertheless,further in depth studies are required to clearly establish the role that ABO blood group plays in P.falciparum malaria.

A Comparative Study of Dihydroartemisin in Compounds in Treatment of Uncomplicated Falciparum Malaria in Kampong of Cambodia

Objective: To compare the safety and efficacy of two compounds of dihydroartemisinin(DHA) -Artekin and Artekin (T) in the treatment of uncomplicated falciparum malaria. Methods:The regimen of 8-tablet for 2 days of Artekin and Artekin (T) were applied to 100 patients with uncomplicated falciparum malaria, who were randomly divided into two groups. Each group contained 50 cases. The cure rate, the mean parasites clearance time, the mean fever clearance and side-effects were observed to assess the safety and efficacy of the compounds used. Results: The mean parasites clearance time was 31. 7±9.0 hours in the Artekin group and 32. 8±8. 8 hours in Artekin (T) group respectively; the mean fever clearance time was 12. 7±7. 2 hours in Artekin group and 16. 5±7. 9 hours in Artekin (T) group; there were no recrudescence case in both groups within the 28 days of follow-up, the cure rates in Artekin group and Artekin (T) groups were 100%. It indicated that the tolerability of both compounds were very good, the side-effects such as nausea, abdominal pain were mild and self-limited. Conclusion: The study preliminarily indicated that the DHA and PQ compounds were of high efficacy, rapid acting and low toxici-ty. Artekin is very promising as a cheap, simple, effective treatment for multi-resistance malaria in Cambodia.

Effect of Primaquine on Gametocyte Carriage in the Case-Management of Uncomplicated Falciparum Malaria with Acts: Nigerian Perspective

Background: Drugs that kill or inhibit sexual stages of Plasmodium such as Primaqiune (PQ) could potentially amplify or synergize the impact of first line antimalarials by blocking transmission to mosquitoes. This study examined the effect of Primaquine on gametocyte carriage in the case management of uncomplicated falciparum malaria with artemisinin-based combination therapy (ACT) with the overall purpose of possibly recommending it as an adjunct drug for malaria control. Methods: A total of 181 patients with uncomplicated falciparum malaria, normal glucose-6-phosphate dehydrogenase (G6PD) enzyme levels, and haemoglobin levels ≥ 8 g/dL completed this two-arm randomized blinded clinical trial to test the efficacy of a single dose PQ (0.75 mg/kg) on falciparum gametocytaemia. 88 subjects were assigned to a standard 3-day course of Dihydroartemisinin-Piperaquine (DHP) alone (n = 88) while 93 others had DHP combined with a single dose of PQ on day 3 (n = 93). A 28-day follow-up schedule carried out in the outpatient clinic of a Primary health facility in Vom, Plateau State Nigeria where study participants were seen on days 1, 3, 7 and then weekly to assess the presence of asexual parasites and gametocytes by microscopy. A Kaplan-Meier analysis was employed to determine the survival function of gametocytes on day 3. The data was analyzed using Epi info version 7.1.5. Results: With a gametocyte prevalence of 27.1%, gametocyte carriage rate was lower in the PQ group due to higher probability of clearing gametocytes (Breslow test χ2 = 8.306, df = 1, p = 0.004) and significantly less likely to harbor gametocytes by day 7 when compared to the DHP-alone group (χ2 = 6.218, df = 1, p = 0.013). Conclusion: Addition of single-dose 0.75 mg/kg PQ was associated with reduced gametocyte carriage as a result of faster gametocyte clearance and lower incidence of gametocyte development in DHP-treated patients. PQ as gametocytocidal drug may be useful in combination with artemisinin-based combination therapy (ACT) regimen to clear gametocytes and thereby interrupt malaria transmission to mosquito vector more effectively than ACT alone.

Congenital Malaria: First Case Report in Kuwait

Background: Malaria in pregnancy poses a great health risk to the mother and her fetus and causes abortion, stillbirth, intrauterine growth retardation and low birth weight. The symptoms commonly start between 10 - 30 days of age and the symptoms mostly observed are fever, restlessness, drowsiness, jaundice, poor feeding, vomiting, diarrhea, and hepatosplenomegaly. Aim: The aim of this study was to diagnose malaria in a neonate admitted to ICU with fever, jaundice and hepatomegaly. Case Summary: A 32-day-old female child was admitted to ICU for intermittent high grade fever and rapid breathing, pallor, poor feeding, mild hepatosplenomegaly and physiological jaundice of one-week duration. The mother had malaria two years before while visiting her native country, Afghanistan and was treated with chloroquine for three days. Conclusion: High suspicion should be considered in diagnosing malaria during pregnancy to prevent congenital malaria among all neonates who present fever and splenomegaly in malaria endemic areas as well as in women from malaria endemic countries living in non-endemic areas. In this report, we describe the first case of congenital malaria in a child in non-malaria endemic Kuwait.

Prevalence of malaria infection in Sarbaz,Sistan and Bluchistan province

Objective:To survey malaria prevalence in Sarbaz from April 2009 to October 2010.Methods: Epidemiological data of 1 464 confirmed malarial patients were analyzed according to demographic status,sex,age,nationality,isolated species and residence place.Results:The majority of patients were male 930(64.8%) but 514(35.2%) were female.82.5%of patients were Iranian,14%Pakistani immigrants,and 3.5%Afghan immigrants.Data collected showed that 90% of isolated species were Plasmodium vivax,7.8%Plasmodium falciparum,and 2.2%Plasmodium malariae and mixed species.Conclusions:Therefore,it is crystal clear that refugees should be prohibited by government and controlled by experts in health centers in order to campaign effectively with this life threating disease.

Possible role of PGD_2 in malaria infections

Objective:To preliminarily investigate the possible role of prostaglandin D_2(PGD_2) in malaria infections.Methods:Blood and urinary samples(n=120 each) were collected from Thai patients with Plasmodium falciparum(P.falciparum) with moderate(n=26) and high(n=4) parasitemia,patients with Plasmodium vivax(P.vivax)(n=30),patients with fever associated with other infections(n=30),and healthy subjects(n=30).PGD_2 concentrations in plasma and urinary samples of healthy subjects,patients with fever associated with other infections and patients with malaria were determined using Prostaglandin D2-MOX express EIA kit(Cayman Chemical,USA).Results:The possible association between PGD_2 and malaria infections is clearly demonstrated with PGD_2 concentration in urine.The urinary PGD_2 concentrations were relatively high(about 5-fold) in patients with P.falciparum with moderate parasitemia and P.vivax infections compared with other groups.Furthermore,the concentration in patients with P.falciparum with moderate parasitemia and P.vivax infection were significantly higher than that in healthy subjects and patients with fever associated with other infections.Conclusions:Urinary PGD_2 concentrations may offer a more dependable and useful tool for predicting malaria severity.Confirmation is this preliminary finding is required with a larger sample size.

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.

Malaria:role of antibodies in protection and pathogenesis:an overview

The research scenario for malaria has improved in the last three decades to understand the epidemiology and host immune responses to plasmodial infection.Due to the augmented episodes of resistance development against the commonly used antimalarials in plasmodium parasites,especially in Plasmodium falciparum,neutralization of infection through effective vaccine(s) remains the feasible alternative in malaria control.In this direction,lot of attention was paid towards the identification of stage specific malaria antigens targeted by host ’s immune system.Preparation of synthetic or recombinant peptides and evaluation of their immunogenecity in naturally occurring antibody response were also given much importance,as these studies could help in finding potential candidates for future malaria vaccine(s).Attention was also paid.on the pathogenic consequences of antibody formation in malaria infection as polyclonal activation of B cells,which is a very prominent feature in malaria infection.Formation of circulating immune complexes in chronic malaria infection was also viewed as pathogenic parameter of severe malaria.The present survey focuses mainly on protective and pathogenic aspects of malaria antibodies(eliciting against various,stage specific antigens),and future research plan in antibodymediated immune response.

Malaria epidemiology and interventions in Ethiopia from 2001 to 2016

Background:Ethiopia is one of the African countries where Plasmodium falciparum and P.vivax co-exist.Monitoring and evaluation of current malaria transmission status is an important component of malaria control as it is a measure of the success of ongoing interventions and guides the planning of future control and elimination efforts.Main text:We evaluated changes in malaria control policy in Ethiopia,and reviewed dynamics of country-wide confirmed and clinical malaria cases by Plasmodium species and reported deaths for all ages and less than five years from 2001 to 2016.Districts level annual parasite incidence was analysed to characterize the malaria transmission stratification as implemented by the Ministry of Health.We found that Ethiopia has experienced major changes from 2003 to 2005 and subsequent adjustment in malaria diagnosis,treatment and vector control policy.Malaria interventions have been intensified represented by the increased insecticide treated net(ITN)and indoor residual spraying(IRS)coverage,improved health services and improved malaria diagnosis.However,countrywide ITN and IRS coverages were low,with 64%ITN coverage in 2016 and IRS coverage of 92.5%in 2016 and only implemented in epidemic-prone areas of>2500 m elevation.Clinical malaria incidence rate dropped from an average of 43.1 cases per 1000 population annually between 2001 and 2010 to 29.0 cases per 1000 population annually between 2011 and 2016.Malaria deaths decreased from 2.1 deaths per 100000 people annually between 2001 and 2010 to 1.1 deaths per 100000 people annually between 2011 to 2016.There was shrinkage in the malaria transmission map and high transmission is limited mainly to the western international border area.Proportion of P.falciparum malaria remained nearly unchanged from 2000 to 2016 indicating further efforts are needed to suppress transmission.Conclusions:Malaria morbidity and mortality have been significantly reduced in Ethiopia since 2001,however,malaria case incidence is still high,and there were major gaps between ITN ownership and compliance in malarious areas.Additional efforts are needed to target the high transmission area of western Ethiopia to sustain the achievements made to date.

Malaria epidemiology in Kobeni department,southeastern Mauritania from 2015 to 2017

Background:Plasmodium falciparum malaria is endemic in the southern sahelian zone of Mauritania where intense internal and trans-border human and livestock movement occurs.The risk of importation and spread of drugresistant parasites need to be regularly assessed in this region.The objective of the study was to assess the recent malaria situation near the Mauritania-Mali border.Methods:Between February 2015 and December 2017,patients with fever or history of fever during the previous 48 h,presenting at the health centre of Kobeni city,were screened for malaria using a rapid diagnostic test(RDT)and microscopic examination of blood smears.The diagnosis was later confirmed by PCR.Cohen’s kappa statistics was used to estimate the degree of agreement between diagnostic methods.Fisher’s exact test was used to compare proportions.The odds ratio was calculated to measure the association between the use of bed nets and malaria infection.Results:A total of 2326 febrile patients(mean age,20.2 years)were screened for malaria.The presence of malaria parasites was detected by RDT and microscopy in 53.0%and 49.3%of febrile patients,respectively,and was confirmed by PCR in 59.7%(45 missing data).Of 1361 PCR-positive samples,1205(88.5%)were P.falciparum,47(3.5%)P.vivax,and 99(7.3%)P.falciparum-P.vivax mixed infection.Malaria transmission occurred mostly during and shortly after the rainy season.The annual rainfall was relatively low in 2016(267 mm)and 2017(274 mm),compared to 2015(448 mm),and coincided with a decline in malaria prevalence in 2016–2017.Although 71.8%of febrile patients reported to possess at least one bed net in the household in our questionnaire,its reported use was not protective against malaria infection(odds ratio:1.1,95%CI:0.91–1.32).Conclusions:Our study confirmed that P.falciparum is the dominant species in the sahelian zone and that malaria transmission is seasonal and associated with rainfall in this zone.The application of the current national policy based on rapid and reliable malaria diagnosis,case management with artemisinin-based combination therapy,intermittent preventive treatment for pregnant women,distribution and use of long-lasting insecticide impregnated bed nets,and the planned introduction of seasonal malaria chemoprevention for all children under 6 years old is expected to sustainably reduce malaria transmission in this zone.

Prevalence and hematological indicators of G6PD deficiency in malaria-infected patients

Background:This study aimed to evaluate the prevalence and alteration of hematological parameters in malaria patients with a glucose-6-phosphate dehydrogenase(G6PD)deficiency,in the western region of Thailand,an endemic region for malaria.Methods:Data about patients with malaria hospitalized between 2013 and 2015 were collected.Clinical and sociodemographic characteristics such as age and gender,diagnosis on admission,and parasitological results were mined from medical records of the laboratory unit of the Phop Phra Hospital in Tak Province,Thailand.Venous blood samples were collected at the time of admission to hospital to determine G6PD deficiency by fluorescence spot test and detect malaria parasites by thick and thin film examination.Other data such as complete blood count and parasite density were also collected and analyzed.Results:Among the 245 malaria cases,28(11.4%)were diagnosed as Plasmodium falciparum infections and 217 cases(88.6%)were diagnosed as P.vivax infections.Seventeen(6.9%)patients had a G6PD deficiency and 228(93.1%)patients did not have a G6PD deficiency.Prevalence of male patients with G6PD deficiency was higher than that of female patients(P<0.05,OR=5.167).Among the patients with a G6PD deficiency,two(11.8%)were infected with P.falciparum,while the remaining were infected with P.vivax.Malaria patients with a G6PD deficiency have higher monocyte counts(0.6×10^(3)/μL)than those without a G6PD deficiency(0.33×10^(3)/μL)(P<0.05,OR=5.167).Univariate and multivariate analyses also confirmed that malaria patients with a G6PD deficiency have high monocyte counts.The association between G6PD status and monocyte counts was independent of age,gender,nationality,Plasmodium species,and parasite density(P<0.005).Conclusion:This study showed a prevalence of G6PD deficiency in a malaria-endemic area.This study also supported the assertion that patients with G6PD-deficient red blood cells had no protection against the P.falciparum infection.In addition,malaria patients with a G6PD deficiency had higher monocyte counts than those without a G6PD deficiency.These findings will help to recognize and diagnose malaria patients with a G6PD deficiency,as well as to identify the risks and protective factors against malaria in endemic areas.

快速免疫色谱测试卡诊断恶性疟和间日疟的效果评价

目的： 评价快速免疫色谱测试卡（ Ｉ Ｃ Ｔ） 在疟区诊断恶性疟和间日疟的效果。方法： 以疟原虫镜检结果为标准， 用 Ｉ Ｃ Ｔ 检测门诊“四热”病人中的恶性疟和间日疟。结果： Ｉ Ｃ Ｔ 检测恶性疟与间日疟的敏感性分别为９６７ ％ 和９０４ ％ ， 特异性为９８６ ％ 。与原虫镜检结果的符合率为９４７ ％ 。恶性疟与间日疟之间无交叉反应。结论： 免疫色谱测试卡可同时检测恶性疟和间日疟， 较镜检法快速、简易。

标签引物-套式/多重PCR检测恶性疟原虫和间日疟原虫的研究

目的建立简便、灵敏、低本底、可同时检测恶性疟原虫和间日疟原虫的套式/多重聚合酶链反应(PCR)系统。方法应用标签引物扩增技术、PrimerPremier5.0软件、美国生物信息中心(NCBI-BLAST)网络资源和矩阵试验法优化套式/多重PCR,检测疟疾患者滤纸血样并与镜检结果进行比较。结果新建立的标签引物套式/多重PCR,检测模拟现场滤纸血样的敏感性为恶性疟原虫1～2个虫/μl血,间日疟原虫5～10个虫/μl血。检测71份现场采集的镜检疟原虫阳性滤纸血样(恶性疟24份和间日疟47份)的结果与镜检结果的符合率分别为87.5%和100%。结论通过标签引物扩增技术优化的套式/多重PCR系统,适用于检测现场采集的滤纸血样,其检出低原虫血症的敏感性和鉴定虫种的准确性均优于镜检法,是很有潜力的疟疾诊断技术。

双氢青蒿素与磷酸萘酚喹伍用治疗恶性疟的疗效观察

目的 观察双氢青蒿素与磷酸萘酚喹配伍使用治疗恶性疟的疗效。 方法 以显微镜血检单纯恶性疟原虫阳性患者为观察对象 ,药物为双氢青蒿素 1 60mg加磷酸萘酚喹 40 0mg(成人量 ) ,一次顿服 ,服药后按时测量体温和血检原虫 ,随访 2 8d ,观察治疗效果。 结果 收治 37例恶性疟患者 ,有 1例复燃 ,治愈率为 97.3 %。平均退热时间为(1 5 .8± 8.7)h ,2 4h平均原虫下降率为 96 .7%± 2 6 .5 % ,原虫无性体转阴时间平均为 (2 7.6± 1 3 .2 )h ,药后无明显不良反应。

套式／多重PCR方法应用于疟疾诊断与监测的初步评价

目的与镜检法比较评价标签引物-套式/多重PCR(UT-PCR)在疟疾监测中的应用价值。方法在海南、云南省恶性疟和间日疟混合流行区和广西疟疾控制区的疟疾监测中,采集初诊为疟疾或疑似疟疾的发热患者的血片与滤纸血样400份,在双盲条件下比较镜检法与UT-PCR的初检结果,对结果不一致的血片再次镜检复查,同时对其滤纸血样重复PCR2～3次;评估UT-PCR与镜检法的敏感性和特异性。结果400例发热患者血样中,镜检法初检检出疟原虫阳性234例,其中恶性疟125例,间日疟109例;UT-PCR检出疟原虫阳性235例,其中恶性疟124例,间日疟109例;恶性疟和间日疟混合感染2例。两法初检结果一致的血样占92.5%(370/400),其中阴性154例,阳性216例(间日疟117例,恶性疟99例)。复查25份初检结果不一致的血样,包括镜检阴性PCR阳性11例,镜检阳性PCR阴性10例,镜检为恶性疟PCR为间日疟3例,镜检为间日疟而PCR为混合感染1例,其中15份与UT-PCR的初检结果一致,7份"假阳性"原因不明,仅3份为PCR的假阴性。根据复查结果评估PCR的敏感性为99.6%,特异性为98.8%。结论采用更敏感的UT-PCR疟疾诊断方法有助于解决疟疾诊断与鉴别诊断中的疑难问题,提高疟疾监测的质量和效率。

套式/多重PCR诊断疟疾的敏感性、特异性和稳定性初探

目的提高标签引物-套式/多重PCR诊断疟疾的敏感性、特异性与稳定性。方法用滤纸法采集非疟疾发热病人血样30份及其他传染病(感冒,流感,伤寒,肝炎等)患者血样20份;抽取恶性疟和间日疟各1例患者血4m1,进行系列稀释制备不同疟原虫含量的感染血样;健康者血样作对照。用热裂解法制备DNA模板,用线粒体细胞色素氧化酶基因作为靶基因,应用相关软件和网络资源(PrimerPremier5.0,PUBMED,NCBI-BLAST和Mfold服务器)设计和优化标签引物-套式/多重PCR,并用于检测所采集制备的各种血样。结果间日疟与恶性疟患者血系列稀释为含1000、100、10和1个虫/μl后经标签引物-套式/多重PCR检测,恶性疟和间日疟患者各稀释含虫血样分别在611bp和255bp出现1条带,能检测到原虫密度均为1个虫/μl血;非疟疾发热病人血样30份及其他传染病患者血样均为阴性;健康者血样未出现扩增条带,每种血样反复测试3次以上均获得同样结果。结论经优化的标签引物-套式/多重PCR在疟疾诊断中具有较高的敏感性、特异性和稳定性。

双氢青蒿素和奎宁对恶性疟原虫早期配子体作用的随机比较

【目的】研究双氢青蒿素对恶性疟原虫早期配子体的抑杀作用。【方法】仅骨髓带恶性疟原虫早期配子体而骨髓与外周血液均无成熟配子体的患者 11例 ,随机分为A、B 2组。A组 6例口服双氢青蒿素片 7d总量 4 80mg ;B组 5例口服硫酸奎宁片 7d总量 10 50 0mg ,定时取骨髓和外周血液涂片 ,观察两组配子体密度的变化。【结果】A组骨髓早期配子体药后 10d全部转阴 ;而B组全部阳性 ,至药后 14d仍有 2 / 5例阳性。外周血液配子体转阴时间 ,A组为 ( 4 .8± 0 .9)d ;B组为 ( 2 2 .0± 5.8)d。【结论】双氢青蒿素能杀灭恶性疟原虫早期配子体 。

双氢青蒿素哌喹片治疗无并发症恶性疟的临床随机对照试验

目的 :探讨双氢青蒿素哌喹片在柬埔寨马德望省治疗无并发症恶性疟的有效性和安全性。方法 :无并发症恶性疟疾病人 5 0例 ,按随机数字表随机分成 2组 ,每组 2 5例 ,一组用双氢青蒿素哌喹片 ,一组用复方双氢青蒿素片 ,采用 2d内 4次给药 ,成人总量 8片的给药方案 ,观察治愈率、复燃率、平均原虫转阴时间、退热时间和不良反应。结果 :双氢青蒿素哌喹片组的原虫转阴时间为 (36±s 2 0 )h ,复方双氢青蒿素片组为 (36± 17)h ;退热时间双氢青蒿素哌喹片组为 (4 2± 2 5 )h ,复方双氢青蒿素片为(31± 2 1)h ;随访 2 8d ,双氢青蒿素哌喹片组治愈率为 10 0 % ,复方双氢青蒿素片组有 1例于d 2 1复燃 ,治愈率为 96 %。病人对两药均有较好的耐受性 ,个别病人在服药过程中出现恶心、腹痛等症状 ,均轻微而且是自限性的。结论 :双氢青蒿素复方具有高效、速效、低毒、病人顺应好等优点。

多重PCR快速检测恶性疟和间日疟的研究

目的建立一种简便快速、能同时检测恶性疟和间日疟的核酸检测方法。方法针对两种疟原虫18SrRNA基因设计2对(3条引物),优化引物浓度与退火温度,建立可扩增出两种疟原虫基因片段的多重PCR。并进行最低检测限确定和临床标本检测,以镜检法为金标准分析灵敏度和特异度等指标。结果该方法可扩增出431bp(恶性疟原虫)和341bp(间日疟原虫)基因片段,最低检测限为102copies/反应,检测临床标本的结果与镜检法无差别(P>0.05),敏感度为93.55%,特异度为70.83%,阳性预测值为89.23%,阴性预测值为80.95%。结论所建立的多重PCR方法可快速检测疟疾感染并鉴别分型,灵敏度高,值得推广。

双氢青蒿素哌喹复方片治疗缅甸恶性疟的临床观察

目的观察双氢青蒿素哌喹复方片对缅甸无并发症恶性疟的疗效。方法 2007-2008年,分别在缅甸佤邦和克钦邦两个区,选择6～60岁无并发症、原虫无性体密度为500～200 000个/μl的单纯恶性疟病例,使用双氢青蒿素哌喹复方片治疗,成人总剂量8片(每片含双氢青蒿素40 mg,磷酸哌喹320 mg),儿童剂量按年龄递减,疗程3 d。观察患者的退热时间、原虫转阴时间、无性体清除情况和不良反应等。结果共完成治疗134例患者,平均退热时间为(25.5±2.8)h,平均原虫转阴时间为(39.5±7.8)h,无性体7 d清除率100%,治后28 d有4例复燃;16例在服药后出现中枢神经系统及胃肠道反应,如头痛、恶心、呕吐和腹泻等轻微症状,停药后即自行消失。结论双氢青蒿素哌喹复方片在缅甸治疗无并发症恶性疟效果良好。