Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence

Elisabeth Baum, Jetsumon Sattabongkot, Jeeraphat Sirichaisinthop, Kirakorn Kiattibutr, D. Huw Davies, Aarti Jain, Eugenia Lo, Ming Chieh Lee, Arlo Z. Randall, Douglas M. Molina, Xiaowu Liang, Liwang Cui, Philip L. Felgner, Guiyun Yan

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Abstract

Background: Malaria is a public health problem in parts of Thailand, where Plasmodium falciparum and Plasmodium vivax are the main causes of infection. In the northwestern border province of Tak parasite prevalence is now estimated to be less than 1% by microscopy. Nonetheless, microscopy is insensitive at low-level parasitaemia. The objective of this study was to assess the current epidemiology of falciparum and vivax malaria in Tak using molecular methods to detect exposure to and infection with parasites; in particular, the prevalence of asymptomatic infections and infections with submicroscopic parasite levels. Methods: Three-hundred microlitres of whole blood from finger-prick were collected into capillary tubes from residents of a sentinel village and from patients at a malaria clinic. Pelleted cellular fractions were screened by quantitative PCR to determine parasite prevalence, while plasma was probed on a protein microarray displaying hundreds of P. falciparum and P. vivax proteins to obtain antibody response profiles in those individuals. Results: Of 219 samples from the village, qPCR detected 25 (11.4%) Plasmodium sp. infections, of which 92% were asymptomatic and 100% were submicroscopic. Of 61 samples from the clinic patients, 27 (44.3%) were positive by qPCR, of which 25.9% had submicroscopic parasite levels. Cryptic mixed infections, misdiagnosed as single-species infections by microscopy, were found in 7 (25.9%) malaria patients. All sample donors, parasitaemic and non-parasitaemic alike, had serological evidence of parasite exposure, with 100% seropositivity to at least 54 antigens. Antigens significantly associated with asymptomatic infections were P. falciparum MSP2, DnaJ protein, putative E1E2 ATPase, and three others. Conclusion: These findings suggest that parasite prevalence is higher than currently estimated by local authorities based on the standard light microscopy. As transmission levels drop in Thailand, it may be necessary to employ higher throughput and sensitivity methods for parasite detection in the phase of malaria elimination

Original languageEnglish (US)
Article number95
JournalMalaria journal
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2015

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Plasmodium vivax
Thailand
Plasmodium falciparum
Malaria
Parasites
Microscopy
Asymptomatic Infections
Infection
HSP40 Heat-Shock Proteins
Vivax Malaria
Antigens
Protein Array Analysis
Parasitic Diseases
Plasmodium
Parasitemia
Falciparum Malaria
Diagnostic Errors
Coinfection
Fingers
Antibody Formation

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Infectious Diseases

Cite this

Baum, Elisabeth ; Sattabongkot, Jetsumon ; Sirichaisinthop, Jeeraphat ; Kiattibutr, Kirakorn ; Davies, D. Huw ; Jain, Aarti ; Lo, Eugenia ; Lee, Ming Chieh ; Randall, Arlo Z. ; Molina, Douglas M. ; Liang, Xiaowu ; Cui, Liwang ; Felgner, Philip L. ; Yan, Guiyun. / Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence. In: Malaria journal. 2015 ; Vol. 14, No. 1.
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title = "Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence",
abstract = "Background: Malaria is a public health problem in parts of Thailand, where Plasmodium falciparum and Plasmodium vivax are the main causes of infection. In the northwestern border province of Tak parasite prevalence is now estimated to be less than 1{\%} by microscopy. Nonetheless, microscopy is insensitive at low-level parasitaemia. The objective of this study was to assess the current epidemiology of falciparum and vivax malaria in Tak using molecular methods to detect exposure to and infection with parasites; in particular, the prevalence of asymptomatic infections and infections with submicroscopic parasite levels. Methods: Three-hundred microlitres of whole blood from finger-prick were collected into capillary tubes from residents of a sentinel village and from patients at a malaria clinic. Pelleted cellular fractions were screened by quantitative PCR to determine parasite prevalence, while plasma was probed on a protein microarray displaying hundreds of P. falciparum and P. vivax proteins to obtain antibody response profiles in those individuals. Results: Of 219 samples from the village, qPCR detected 25 (11.4{\%}) Plasmodium sp. infections, of which 92{\%} were asymptomatic and 100{\%} were submicroscopic. Of 61 samples from the clinic patients, 27 (44.3{\%}) were positive by qPCR, of which 25.9{\%} had submicroscopic parasite levels. Cryptic mixed infections, misdiagnosed as single-species infections by microscopy, were found in 7 (25.9{\%}) malaria patients. All sample donors, parasitaemic and non-parasitaemic alike, had serological evidence of parasite exposure, with 100{\%} seropositivity to at least 54 antigens. Antigens significantly associated with asymptomatic infections were P. falciparum MSP2, DnaJ protein, putative E1E2 ATPase, and three others. Conclusion: These findings suggest that parasite prevalence is higher than currently estimated by local authorities based on the standard light microscopy. As transmission levels drop in Thailand, it may be necessary to employ higher throughput and sensitivity methods for parasite detection in the phase of malaria elimination",
author = "Elisabeth Baum and Jetsumon Sattabongkot and Jeeraphat Sirichaisinthop and Kirakorn Kiattibutr and Davies, {D. Huw} and Aarti Jain and Eugenia Lo and Lee, {Ming Chieh} and Randall, {Arlo Z.} and Molina, {Douglas M.} and Xiaowu Liang and Liwang Cui and Felgner, {Philip L.} and Guiyun Yan",
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Baum, E, Sattabongkot, J, Sirichaisinthop, J, Kiattibutr, K, Davies, DH, Jain, A, Lo, E, Lee, MC, Randall, AZ, Molina, DM, Liang, X, Cui, L, Felgner, PL & Yan, G 2015, 'Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence', Malaria journal, vol. 14, no. 1, 95. https://doi.org/10.1186/s12936-015-0611-9

Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence. / Baum, Elisabeth; Sattabongkot, Jetsumon; Sirichaisinthop, Jeeraphat; Kiattibutr, Kirakorn; Davies, D. Huw; Jain, Aarti; Lo, Eugenia; Lee, Ming Chieh; Randall, Arlo Z.; Molina, Douglas M.; Liang, Xiaowu; Cui, Liwang; Felgner, Philip L.; Yan, Guiyun.

In: Malaria journal, Vol. 14, No. 1, 95, 01.01.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Submicroscopic and asymptomatic Plasmodium falciparum and Plasmodium vivax infections are common in western Thailand - Molecular and serological evidence

AU - Baum, Elisabeth

AU - Sattabongkot, Jetsumon

AU - Sirichaisinthop, Jeeraphat

AU - Kiattibutr, Kirakorn

AU - Davies, D. Huw

AU - Jain, Aarti

AU - Lo, Eugenia

AU - Lee, Ming Chieh

AU - Randall, Arlo Z.

AU - Molina, Douglas M.

AU - Liang, Xiaowu

AU - Cui, Liwang

AU - Felgner, Philip L.

AU - Yan, Guiyun

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: Malaria is a public health problem in parts of Thailand, where Plasmodium falciparum and Plasmodium vivax are the main causes of infection. In the northwestern border province of Tak parasite prevalence is now estimated to be less than 1% by microscopy. Nonetheless, microscopy is insensitive at low-level parasitaemia. The objective of this study was to assess the current epidemiology of falciparum and vivax malaria in Tak using molecular methods to detect exposure to and infection with parasites; in particular, the prevalence of asymptomatic infections and infections with submicroscopic parasite levels. Methods: Three-hundred microlitres of whole blood from finger-prick were collected into capillary tubes from residents of a sentinel village and from patients at a malaria clinic. Pelleted cellular fractions were screened by quantitative PCR to determine parasite prevalence, while plasma was probed on a protein microarray displaying hundreds of P. falciparum and P. vivax proteins to obtain antibody response profiles in those individuals. Results: Of 219 samples from the village, qPCR detected 25 (11.4%) Plasmodium sp. infections, of which 92% were asymptomatic and 100% were submicroscopic. Of 61 samples from the clinic patients, 27 (44.3%) were positive by qPCR, of which 25.9% had submicroscopic parasite levels. Cryptic mixed infections, misdiagnosed as single-species infections by microscopy, were found in 7 (25.9%) malaria patients. All sample donors, parasitaemic and non-parasitaemic alike, had serological evidence of parasite exposure, with 100% seropositivity to at least 54 antigens. Antigens significantly associated with asymptomatic infections were P. falciparum MSP2, DnaJ protein, putative E1E2 ATPase, and three others. Conclusion: These findings suggest that parasite prevalence is higher than currently estimated by local authorities based on the standard light microscopy. As transmission levels drop in Thailand, it may be necessary to employ higher throughput and sensitivity methods for parasite detection in the phase of malaria elimination

AB - Background: Malaria is a public health problem in parts of Thailand, where Plasmodium falciparum and Plasmodium vivax are the main causes of infection. In the northwestern border province of Tak parasite prevalence is now estimated to be less than 1% by microscopy. Nonetheless, microscopy is insensitive at low-level parasitaemia. The objective of this study was to assess the current epidemiology of falciparum and vivax malaria in Tak using molecular methods to detect exposure to and infection with parasites; in particular, the prevalence of asymptomatic infections and infections with submicroscopic parasite levels. Methods: Three-hundred microlitres of whole blood from finger-prick were collected into capillary tubes from residents of a sentinel village and from patients at a malaria clinic. Pelleted cellular fractions were screened by quantitative PCR to determine parasite prevalence, while plasma was probed on a protein microarray displaying hundreds of P. falciparum and P. vivax proteins to obtain antibody response profiles in those individuals. Results: Of 219 samples from the village, qPCR detected 25 (11.4%) Plasmodium sp. infections, of which 92% were asymptomatic and 100% were submicroscopic. Of 61 samples from the clinic patients, 27 (44.3%) were positive by qPCR, of which 25.9% had submicroscopic parasite levels. Cryptic mixed infections, misdiagnosed as single-species infections by microscopy, were found in 7 (25.9%) malaria patients. All sample donors, parasitaemic and non-parasitaemic alike, had serological evidence of parasite exposure, with 100% seropositivity to at least 54 antigens. Antigens significantly associated with asymptomatic infections were P. falciparum MSP2, DnaJ protein, putative E1E2 ATPase, and three others. Conclusion: These findings suggest that parasite prevalence is higher than currently estimated by local authorities based on the standard light microscopy. As transmission levels drop in Thailand, it may be necessary to employ higher throughput and sensitivity methods for parasite detection in the phase of malaria elimination

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U2 - 10.1186/s12936-015-0611-9

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