Diagnosis Of Malaria Parasites Research Articles

CO-INFECTION WITH MALARIA AND INTESTINAL PARASITES AND ITS ASSOCIATION WITH ANEMIA IN CHILDREN (ZERO TO TEN YEARS OLD) IN TIKO SUBDIVISION, CAMEROON.

Concomitant infections with malaria and intestinal parasitic infections may be associated with anemia in children (0-10 yr). This study determined the prevalence of co-infection with malaria and intestinal parasitic infections and determined its association with anemia in children (0-10 yr) in Tiko, Cameroon. A hospital-based cross-sectional study was carried out whereby venous blood and stool samples were collected from 377 febrile children. Blood was used to perform a full blood count. Thick and thin blood films were prepared and stained with Giemsa for malaria parasite diagnosis. The formol ether concentration technique was used to analyze the stools. Pearson's chi-square test, Student's t-test, and other statistical analyses were performed. Of the 377 participants, 139 (36.9%) were positive for malaria, 21 (5.6%) had intestinal helminths, 8 (2%) had co-infection, and 79 (21.0%) were anemic. Malaria and anemia were prevalent among the children and were significantly associated (P = 0.025). There was no statistically significant difference (P > 0.05) among age groups. Girls were more often infected with malaria (69, 37.3%), and boys were more often infected with intestinal parasites (13, 7.0%), but there was no statistical association for both malaria and intestinal parasitic infections (IPIs) for both sexes (P > 0.05). Hookworms, Ascaris lumbricoides, and Trichuris trichiura were the intestinal parasites found in this study. There was a significant association between anemia and parasitic co-infection in children (P = 0.003). Malaria and IPIs are prevalent in the Tiko municipality. They play a great role in anemia especially when there is a co-infection. Public education and awareness campaigns are necessary in this municipality.

The application of spectroscopy techniques for diagnosis of malaria parasites and arboviruses and surveillance of mosquito vectors: A systematic review and critical appraisal of evidence.

Spectroscopy-based techniques are emerging diagnostic and surveillance tools for mosquito-borne diseases. This review has consolidated and summarised recent research in the application of Raman and infrared spectroscopy techniques including near- and mid-infrared spectroscopy for malaria and arboviruses, identified knowledge gaps, and recommended future research directions. Full-length peer-reviewed journal articles related to the application of Raman and infrared (near- and mid-infrared) spectroscopy for malaria and arboviruses were systematically searched in PUBMED, MEDILINE, and Web of Science databases using the PRISMA guidelines. In text review of identified studies included the methodology of spectroscopy technique used, data analysis applied, wavelengths used, and key findings for diagnosis of malaria and arboviruses and surveillance of mosquito vectors. A total of 58 studies met the inclusion criteria for our systematic literature search. Although there was an increased application of Raman and infrared spectroscopy-based techniques in the last 10 years, our review indicates that Raman spectroscopy (RS) technique has been applied exclusively for the diagnosis of malaria and arboviruses. The mid-infrared spectroscopy (MIRS) technique has been assessed for the diagnosis of malaria parasites in human blood and as a surveillance tool for malaria vectors, whereas the near-infrared spectroscopy (NIRS) technique has almost exclusively been applied as a surveillance tool for malaria and arbovirus vectors.Conclusions/SignificanceThe potential of RS as a surveillance tool for malaria and arbovirus vectors and MIRS for the diagnosis and surveillance of arboviruses is yet to be assessed. NIRS capacity as a surveillance tool for malaria and arbovirus vectors should be validated under field conditions, and its potential as a diagnostic tool for malaria and arboviruses needs to be evaluated. It is recommended that all 3 techniques evaluated simultaneously using multiple machine learning techniques in multiple epidemiological settings to determine the most accurate technique for each application. Prior to their field application, a standardised protocol for spectra collection and data analysis should be developed. This will harmonise their application in multiple field settings allowing easy and faster integration into existing disease control platforms. Ultimately, development of rapid and cost-effective point-of-care diagnostic tools for malaria and arboviruses based on spectroscopy techniques may help combat current and future outbreaks of these infectious diseases.

Detection and stage classification of Plasmodium falciparum from images of Giemsa stained thin blood films using random forest classifiers

BackgroundThe conventional method for the diagnosis of malaria parasites is the microscopic examination of stained blood films, which is time consuming and requires expertise. We introduce computer-based image segmentation and life stage classification with a random forest classifier. Segmentation and stage classification are performed on a large dataset of malaria parasites with ground truth labels provided by experts.MethodsWe made use of Giemsa stained images obtained from the blood of 16 patients infected with Plasmodium falciparum. Experts labeled the parasite types from each of the images. We applied a two-step approach: image segmentation followed by life stage classification. In segmentation, we classified each pixel as a parasite or non-parasite pixel using a random forest classifier. Performance was evaluated with classification accuracy, Dice coefficient and free-response receiver operating characteristic (FROC) analysis. In life stage classification, we classified each of the segmented objects into one of 8 classes: 6 parasite life stages, early ring, late ring or early trophozoite, mid trophozoite, early schizont, late schizont or segmented, and two other classes, white blood cell or debris.ResultsOur segmentation method gives an average cross-validated Dice coefficient of 0.82 which is a 13% improvement compared to the Otsu method. The Otsu method achieved a True Positive Fraction (TPF) of 0.925 at the expense of a False Positive Rate (FPR) of 2.45. At the same TPF of 0.925, our method achieved an FPR of 0.92, an improvement by more than a factor two. We find that inclusion of average intensity of the whole image as feature for the random forest considerably improves segmentation performance. We obtain an overall accuracy of 58.8% when classifying all life stages. Stages are mostly confused with their neighboring stages. When we reduce the life stages to ring, trophozoite and schizont only, we obtain an accuracy of 82.7%.ConclusionPixel classification gives better segmentation performance than the conventional Otsu method. Effects of staining and background variations can be reduced with the inclusion of average intensity features. The proposed method and data set can be used in the development of automatic tools for the detection and stage classification of malaria parasites. The data set is publicly available as a benchmark for future studies.

Diagnosis of Plasmodium vivax by Loop-Mediated Isothermal Amplification in Febrile Patient Samples from Loreto, Perú.

.Plasmodium vivax is co-endemic with Plasmodium falciparum in Peru, and optimum management requires distinguishing these two species in the blood of patients. For the differential identification of P. vivax and other Plasmodium spp., the LoopampTM Malaria Pan Detection Kit in combination with the Loopamp Malaria Pv Detection Kit (Eiken Chemical Co. Ltd., Tokyo, Japan) was used to evaluate 559 whole blood samples collected in 2017 from febrile patients with suspected malaria attending different health facilities in the Loreto region. The Loopamp Malaria Pan Detection Kit showed a sensitivity of 87.7% (95% CI: 83.5–91.9) and a specificity of 94.4% (95% CI: 91.9–96.9) and good agreement with PCR (Cohen’s kappa 0.8266, 95% CI: 0.7792–0.874). By comparison, the Loopamp Malaria Pv Detection Kit showed a similar sensitivity (84.4%, 95% CI: 79.0–89.7) and specificity (92.4%, 95% CI: 89.7–95.0) and substantial agreement with PCR (Cohen’s kappa: 0.7661, 95% CI: 0.7088–0.8234).

A new approach for microscopic diagnosis of malaria parasites in thick blood smears using pre-trained deep learning models

One of the deadly endemic diseases in sub-Saharan Africa is malaria. Its prevalence is promoted by lack of sufficient expertise to carry out accurate and timely diagnosis using the standard microscopy method. Where lab technicians are available, the results are usually subjective due to variations in expert judgement. To address this challenge, prompt interventions to improve disease control are needed. The emerging technologies of machine learning that can learn complex image patterns have accelerated research in medical image analysis. In this study, on a dataset of thick blood smear images, we evaluate and compare performance of three pre-trained deep learning architectures namely; faster regional convolutional neural network (faster R-CNN), single-shot multi-box detector (SSD) and RetinaNet through a Tensorflow object detection API. Data augmentation method was applied to optimise performance of the meta architectures. The possibility for mobile phone detector deployment was also investigated. The results revealed that faster R-CNN was the best trained model with a mean average precision of over 0.94 and SSD, was the best model for mobile deployment. We therefore deduce that faster R-CNN is best suited for obtaining high rates of accuracy in malaria detection while SDD is best suited for mobile deployment.

ASSESSMENT OF THE EFFICACY AND SAFETY OF CHLOROQUINE MONOTHERAPY FOR THE TREATMENT OF ACUTE UNCOMPLICATED GESTATIONAL MALARIA CAUSED BY P. VIVAX, CÓRDOBA, COLOMBIA, 2015-2017.

To determine the efficacy of chloroquine monotherapy in Colombian pregnant women with acute uncomplicated malaria vivax (GMV). Prospective cohort study in pregnant women who presented of their own accord between February 1, 2015 and December 31, 2017 to malaria or prenatal care centers in two Colombian towns and in whom the diagnosis of Plasmodium vivax was confirmed by means of blood spot test and and quantitative polymerase chain reaction (qPCR). Measured variables included sociodemographics, therapeutic failure (TF) and serious adverse events at 28 days and frequency of recurrence-relap (RR) over a follow-up period of 120 days. The WHO protocol was applied for the assessment of monotherapy with cloroquine (m-CQ) efficacy. Overall, 47 pregnant women were identified. During the 28-day follow-up period there were no losses, and there were two cases of TP (4.2%=2/47). Of the 45 women followed between 29 and 120 days, 11 were lost (24.4%=11/45) and there were 13 cases of RR, with an RR frequency ranging between 29 and 53 % depending on the type of analysis. Chloroquine is still highly effective as a cure of acute malaria vivax attack in GM in Colombia, and continues to be a good option for the treatment of acute phase GM. The RR frequency is high. Studies are required that evaluate therapeutic alternatives in MG. There is a pressing need for medications and/or procedures that can help reduce this very high risk.

A Descriptive Study of Hematologic Characteristics of Malaria Patients Attending A Tertiary Care Hospital in The Region of Kutch

Background: In India, the epidemiology of malaria is complex because of geo-ecological diversity, multi-ethnicity, and wide distribution of nine anopheline vectors transmitting two commonest plasmodia species. Considering the fact, it is vital that every centre has its own demographic and pathological data about the profile of malaria patients in its catchment area. Methods: The present retrospective study was carried in the Department of Pathology, Gujarat Adani Institute of Medical Sciences (GAIMS), Bhuj for a period of one year. A total of 102 cases were included in the study. The blood samples were collected in Ethylenediamine tetra-acetic acid (EDTA) vacutainers and smears were prepared. Leishman staining and field staining on thick smears was done according to the published protocols. The diagnosis of malaria parasite was confirmed by a positive peripheral smear examination. Rings, schizonts and gametocytes of the malaria parasites (plasmodium vivax and plasmodium falciparum) were viewed for diagnosis. Thrombocytopenia was considered when the platelet count was less than 150 x 109/L and leucopenia when the total leucocyte count was less than 4,000 cells /cu mm. Result: In our study, 102 malaria positive cases were investigated for platelet count and total leucocyte count. Out of the 102 cases, male population was affected more than female. Out of the various malaria species, plasmodium vivax was the most prevalent (82.35%). The most common age group affected by various species varied, with age group of 1-10 years being most common for plasmodium falciparum cases, 21 to 30 years being most common for plasmodium vivax and 11 to 20 years being most common for mixed infection. All the cases of plasmodium falciparum were found to be with normal leucocyte count whereas in plasmodium vivax 82.14% cases were with normal leucocyte count and only 17.85% cases with leucopenia. Mixed infection had almost similar scenario with 71.42% cases with normal leucocyte count and 28.57% with leucopenia. In our study more number of cases of plasmodium falciparum was associated with thrombocytopenia (25%) as compared to plasmodium vivax (11.9%) and none in mixed infection. Conclusion: The high prevalence of malaria suggests the importance of timely diagnosis . The early identification of thrombocytopenia and leucopenia aids in timely management. This helps to decrease complicated malaria cases and its related mortality.

Performance assessment in microscopic diagnosis of malaria in the laboratory network of the National Institute of Health of Peru, 2012-2017

Timely diagnosis of malaria is a strategy proposed by the World Health Organization to reduce malaria morbidity and mortality. A study was conducted to assess performance in microscopic diagnosis of malaria in the network of laboratories under the National Malaria Reference Laboratory of the National Institute of Health between 2012 and 2017. In the years of study, the laboratories obtained a rating of "acceptable" in the diagnosis of Plasmodium by 38.4%, 43.7%, 60.0%, 83.3%, 90.9%, and 95.8%, respectively, in the evaluation of species by 0%, 6.2%, 15.0%, 50.0%, 40.9%, and 54.1%, respectively; in stage assessment by 23.0%, 25.0%, 35.0%, 83.3%, 54.5%, and 79.1%, respectively; and in parasitic density assessment by 0%, 6.2%, 10.0%, 33.3%, 0%, and 12.5%, respectively. We conclude that in the period under evaluation, the percentage of laboratories that diagnosed and recognized the species and stage increases, which is not the case for recognition of parasitic density.

Comparative assessment of urine-based RDT in malaria diagnosis during febrile and non-febrile conditions

Malaria due to Plasmodium falciparum is a life-threatening disease that requires prompt diagnosis for its management. As a result, Rapid Diagnostic Test (RDT) was provided because it is simple to use and provides quick result without the need for good microscopy equipment and operators. Although blood is the specimen most frequently used for RDT, urine has been suggested as an alternative specimen. The study compares the performance of Urine-based RDT (uRDT) with Microscopy and Blood-based RDT (bRDT) in malaria diagnosis. This study was conducted using blood and urine specimens collected from 350 humans that attended Primary Health Centres at Amansea and Igbariam in Awka North and Anambra East LGAs of Anambra State respectively. Care-start® and Fyodor® test kits were used for malaria rapid diagnosis while Giemsa stained thick and thin blood films were used as standard. Malaria parasite prevalence in the study was 57.1% by microscopy, 22.0% by bRDT and 11.1% by uRDT (p<0.05). Under febrile condition, prevalence records were 83.2% by microscopy, 34.9% by bRDT and 16.8% by uRDT (p<0.05). Compared to the non-febrile group, the Odd Ratio of malaria in febrile group is 8.16, 3.77 and 2.69 for microscopy, bRDT and uRDT respectively. In both (febrile; non-febrile) conditions, the sensitivity of blood based RDT (39.5%; 28.9%) is higher than that of uRDT (18.5%; 17.1%). However, the specificity of the uRDT (92.0%; 99.2%) is higher than that of the bRDT (88.0%; 97.6%). At malaria parasite count of ≤ 120 parasites/μl of blood, (>120 to < 430) parasites/μl and ≥ 430 parasites/μl of blood, bRDT recorded increasing higher prevalence values than the uRDT that followed the same pattern. There was significant weak positive correlation between malaria parasite density of microscopy and the RDTs. Among the febrile and non-febrile subjects who tested positive for malaria using uRDT, 92.0% and 71.4% respectively had thick line shown (p>0.05). Using the Receiver-Operator Characteristic (ROC) curves, the uRDT can be used to diagnose malaria infection even when the parasitaemia level is as low as 260 parasites/μl of blood at 76.9% sensitivity and 82.5% specificity. bRDT can detect malaria parasites at the same level but with sensitivity level of 85.9% and specificity level of 77.5% for febrile and non-febrile conditions. In conclusion, the uRDT followed similar pattern of malaria parasite diagnosis with microscopy and bRDT though with lower performance.Keywords: Malaria diagnosis; urine-based RDT; blood based RDT; microscopy; febrile; non-febrile

Comparison of Malaria Rapid Diagnostic Test Kit and Microscopy

Malaria is the most common single diagnosis made in many countries in Africa. Microscopy is the gold standard for laboratory diagnosis of malaria parasite, but it requires adequate training and the time to get results is longer than that for Rapid Diagnostic Tests (RDTs). Use of RDTs is an alternative diagnostic method. This method is quick and easy to carry out. This study examined 412 blood samples of patients who met the study inclusion criteria from the health centres. All of the samples obtained were tested by SD Bioline malaria Ag P.f test commonly available in Nigeria and parasite count was done from thick film prepared. The results obtained were presented as a proportion positive in comparison to the total number of participants enrolled. Of the 412 enrollees, 284 were tested positive with malaria using the RDT, 400 were tested positive with microscopy and 12 were negative using microscopy and RDT. This study confirms the superior sensitivity of microscopy to RDTs in diagnosis of malaria. Although RDTs are very useful for quick diagnosis of malaria, particularly in areas where access to the use of microscopy is not available, the possibility of a low performance by RDTs in malaria diagnosis should be emphasized on health practitioners and microcopy should be encouraged as much as possible.

Evaluation of children with protein energy malnutrition and level of malaria parasitemia in Kwara State, Nigeria

Malaria and Protein-Energy-Malnutrition (PEM) are two major causes of childhood mortality in sub-Saharan Africa. Malaria can predispose a child to PEM and the reverse may also be true. Recent studies have presented inconsistent findings about nutritional status and the occurrence of malaria among the children. The goal of this study was to evaluate the association between PEM and malaria parasitemia if any. A case control study in which 90 children diagnosed for PEM (aged 6-59 months), and another well-nourished 90 children age and sex-matched controls were evaluated for malaria parasitemia. A semi-structured proforma was used to obtain relevant information on the children’s sociodemographic characteristics, nutritional indices amongst others. Venous blood sample was collected and thick and thin blood film were prepared and viewed under the microscope. Malaria parasitemia was present in 82 (91.1%) of malnourished group and 12 (13.3%) of the well-nourished group (P<0.05 OR=66.62). Malaria parasitemia was highest in those with kwashiorkor and marasmic kwashiorkor compared with underweight. These differences were statistically significant (P<0.05). The study demonstrates that malnourished children have higher degree of malaria parasitemia and are at risk of malaria. It also shows that severe forms of malnutrition are associated with heavier malaria parasitemia. It is therefore recommended that all malnourished children should have access to use of Insecticide Treated Nets (ITN), malaria chemoprophylaxis as well as empiric treatment of malaria in endemic areas where access to malaria parasite diagnosis is difficult.

Malaria occurrence and awareness amongst <i>Almajirai</i> in some selected traditional <i>Qur’anic</i> centres of Kano Municipal and Gwale Local Government Areas of Kano State

Malaria an infectious mosquito-borne disease of humans remains a great cause of poverty in Africa. This study aimed at assessing the occurrence of malaria Parasitaemia and anaemia among different aged group Almajirai in selected traditional Qur’anic centres residing in Municipal and Gwale L.G.As of Kano State. Total of 454 Blood samples from Almajirai of Municipal and Gwale Local Government Areas of Kano Municipal were examined for malaria parasitaemia (MP) using method for microscopic diagnosis of malaria parasites. Anaemia was diagnosed as mild and severe when Packed Cells Volumes (PCV) was below 33% and 25% respectively. Result of the blood (MP) from the two (2) local governments showed that only Plasmodium falciparum species, was encountered. The total positive sample recorded were 162 (35.7%). The highest occurrence 47.4% was recorded within 9-13 age group and the least 1.8% was recorded within 24-28 age groups in Gwale. Statistically no significant difference (P-value ˃ 0.05) was observed among the various age groups of the two local governments. Anaemia was compared between malaria parasitized and non- parasitized subject, anaemia was observed to be associated with the severity of malaria infection. Almajirai should be given free malaria treatment in all government hospital so that those who could not go to hospital due to treatment cost will avail themselves of such opportunities received quality medical care. There is need to introduce appropriate intervention strategies against malaria and its vector, as well increase distribution of Insecticide Treated Nets to Almajirai.Keywords: Malaria, Almajirai, Tsangayu, Municipal, Gwale

Nanopore sequencing of drug-resistance-associated genes in malaria parasites, Plasmodium falciparum

Here, we report the application of a portable sequencer, MinION, for genotyping the malaria parasite Plasmodium falciparum. In the present study, an amplicon mixture of nine representative genes causing resistance to anti-malaria drugs is diagnosed. First, we developed the procedure for four laboratory strains (3D7, Dd2, 7G8, and K1), and then applied the developed procedure to ten clinical samples. We sequenced and re-sequenced the samples using the obsolete flow cell R7.3 and the most recent flow cell R9.4. Although the average base-call accuracy of the MinION sequencer was 74.3%, performing >50 reads at a given position improves the accuracy of the SNP call, yielding a precision and recall rate of 0.92 and 0.8, respectively, with flow cell R7.3. These numbers increased significantly with flow cell R9.4, in which the precision and recall are 1 and 0.97, respectively. Based on the SNP information, the drug resistance status in ten clinical samples was inferred. We also analyzed K13 gene mutations from 54 additional clinical samples as a proof of concept. We found that a novel amino-acid changing variation is dominant in this area. In addition, we performed a small population-based analysis using 3 and 5 cases (K13) and 10 and 5 cases (PfCRT) from Thailand and Vietnam, respectively. We identified distinct genotypes from the respective regions. This approach will change the standard methodology for the sequencing diagnosis of malaria parasites, especially in developing countries.

The use of microscopy and rapid diagnostic test in diagnosing the prevalence of malaria among women attending antenatal clinic in Dutsin Ma, Katsina State, Nigeria

Malaria during pregnancy continues to be an overwhelming health problem in endemic countries especially in sub-Saharan Africa with clinical consequences. This study was to determine the occurrence of malaria parasite and to compare the use of Microscopy and Rapid Diagnostic Tests (RDTs) in diagnosis of malaria parasite in pregnant women in Dutsin-Ma LGA of Katsina State. Two hundred (200) blood samples were collected from pregnant women and tested for malaria parasites using thin smears and RDTs. Interviews were conducted and structured questionnaires administered to obtain information on the clinical and social aspects of malaria; of which the response was 85% positive to the symptoms and causes of malaria, 60.5% were found to be infected with malaria and 39.5% where negative. Out of 60.5% that tested positive for malaria, only 20% tested positive using RDTs. Plasmodium falciparum was the only specie isolated.The result showed that malaria infection was prevalent during pregnancy and young women (age-groups 15-19 years) recorded the highest prevalence (78.4%). The pregnant women in their second gestational period recorded the highest occurrence of 77.9% (p>0.05). Among the gravid-status, Primigravidae had the highest prevalence rate of 65.7% (p<0.05); while among the educational group, those with tertiary education had the highest percentage (72.7%). A high percentage of the respondents attributed malaria infection to mosquito bites. The result from this work shows that RDTs might not be an accurate diagnosis in demonstrating the presence of parasitaemia.Keywords: Diagnosis; rapid diagnostic test; Dutsin-Ma; Katsina; microscopy; malaria; prevalence; pregnancy; Nigeria

Comparative study of malaria parasite diagnosis: Microscopy and rapid diagnostic-testing

The conventional microscopy is the gold standard in laboratory diagnosis of malaria but time-consuming and requires a lot of training and expertise. However, Rapid Diagnostic Tests (RDTs) could be considered in endemic regions especially in poor settings, where there is shortage of power supply and less qualified personnel. This is a comparative study between Microscopy and RDTs. The study was carried out in two health facilities in Kano metropolis; Sir, Muhammad Sunusi Specialist hospital (SMSSH) and Bayero University Health Clinic (BUHC). A retrospective analysis was carried out in which the capacities of facilities for malaria parasites (MP) microscopy and RDT were assessed for the previous year. Later a prospective analysis was carried out by implementing a modified Lot Quality Assurance Sampling (LQAS) model over a period of 3 months. Giemsa stained Slides for Malaria Parasite Microscopy were sampled giving a total Slides of 432 and their corresponding blood specimens also sampled for the respective RDTs using SD Bioline Kits. The specificity of MP slide microscopy and RDTs in SMSSH and BUHC were 84% and 94% respectively while that of RDTs were 95% and 94% respectively. However, the sensitivity of MP microscopy in SMSSH and BUHC was found to be 95% and 94% and that of RDT was 72% and 78% respectively. Result showed that microscopic examination of malaria parasite is still the method of choice and also gold standard especially for confirmation of clinical diagnosis.Keywords: Malaria; microscopy; RDTs; sensitivity and specificity

Effect of HIV and malaria parasites co-infection on immune-hematological profiles among patients attending anti-retroviral treatment (ART) clinic in Infectious Disease Hospital Kano, Nigeria

BackgroundHuman immunodeficiency virus (HIV) and malaria co-infection may present worse health outcomes in the tropics. Information on HIV/malaria co-infection effect on immune-hematological profiles is critical for patient care and there is a paucity of such data in Nigeria.ObjectiveTo evaluate immune-hematological profiles among HIV infected patients compared to HIV/malaria co-infected for ART management improvement.MethodsThis was a cross sectional study conducted at Infectious Disease Hospital, Kano. A total of 761 consenting adults attending ART clinic were randomly selected and recruited between June and December 2015. Participants’ characteristics and clinical details including two previous CD4 counts were collected. Venous blood sample (4ml) was collected in EDTA tube for malaria parasite diagnosis by rapid test and confirmed with microscopy. Hematological profiles were analyzed by Sysmex XP-300 and CD4 count by Cyflow cytometry. Data was analyzed with SPSS 22.0 using Chi-Square test for association between HIV/malaria parasites co-infection with age groups, gender, ART, cotrimoxazole and usage of treated bed nets. Mean hematological profiles by HIV/malaria co-infection and HIV only were compared using independent t-test and mean CD4 count tested by mixed design repeated measures ANOVA. Statistical significant difference at probability of <0.05 was considered for all variables.ResultsOf the 761 HIV infected, 64% were females, with a mean age of ± (SD) 37.30 (10.4) years. Prevalence of HIV/malaria co-infection was 27.7% with Plasmodium falciparum specie accounting for 99.1%. No statistical significant difference was observed between HIV/malaria co-infection in association to age (p = 0.498) and gender (p = 0.789). A significantly (p = 0.026) higher prevalence (35.2%) of co-infection was observed among non-ART patients compared to (26%) ART patients. Prevalence of co-infection was significantly lower (20.0%) among cotrimoxazole users compared to those not on cotrimoxazole (37%). The same significantly lower co-infection prevalence (22.5%) was observed among treated bed net users compared to those not using treated bed nets (42.9%) (p = 0.001). Out of 16 hematology profiles evaluated, six showed significant difference between the two groups (i) packed cell volume (p = <0.001), (ii) mean cell volume (p = 0.005), (iii) mean cell hemoglobin concentration (p = 0.011), (iv) absolute lymphocyte count (p = 0.022), (v) neutrophil percentage count (p = 0.020) and (vi) platelets distribution width (p = <0.001). Current mean CD4 count cell/μl (349±12) was significantly higher in HIV infected only compared to co-infected (306±17), (p = 0.035). A significantly lower mean CD4 count (234.6 ± 6.9) was observed among respondents on ART compared to non-ART (372.5 ± 13.2), p<0.001, mean difference = -137.9).ConclusionThe study revealed a high burden of HIV and malaria co-infection among the studied population. Co-infection was significantly lower among patients who use treated bed nets as well as cotrimoxazole chemotherapy and ART. Six hematological indices differed significantly between the two groups. Malaria and HIV co-infection significantly reduces CD4 count. In general, to achieve better management of all HIV patients in this setting, diagnosing malaria, prompt antiretroviral therapy, monitoring CD4 and some hematology indices on regular basis is critical.

A review on automated diagnosis of malaria parasite in microscopic blood smears images

Malaria is a life-threatening disease caused by parasite of genus plasmodium, which is transmitted through the bite of infected Anopheles. A rapid and accurate diagnosis of malaria is demanded for proper treatment on time. Mostly, conventional microscopy is followed for diagnosis of malaria in developing countries, where pathologist visually inspects the stained slide under light microscope. However, conventional microscopy has occasionally proved inefficient since it is time consuming and results are difficult to reproduce. Alternate techniques for malaria diagnosis based on computer vision were proposed by several researchers. The aim of this paper is to review, analyze, categorize and address the recent developments in the area of computer aided diagnosis of malaria parasite. Research efforts in quantification of malaria infection include normalization of images, segmentation followed by features extraction and classification, which were reviewed in detail in this paper. At the end of review, the existent challenges as well as possible research perspectives were discussed.

Comparison of Texture Features Used for Classification of Life Stages of Malaria Parasite.

Malaria is a vector borne disease widely occurring at equatorial region. Even after decades of campaigning of malaria control, still today it is high mortality causing disease due to improper and late diagnosis. To prevent number of people getting affected by malaria, the diagnosis should be in early stage and accurate. This paper presents an automatic method for diagnosis of malaria parasite in the blood images. Image processing techniques are used for diagnosis of malaria parasite and to detect their stages. The diagnosis of parasite stages is done using features like statistical features and textural features of malaria parasite in blood images. This paper gives a comparison of the textural based features individually used and used in group together. The comparison is made by considering the accuracy, sensitivity, and specificity of the features for the same images in database.

Comparison of Microscopic Determination and Rapid Diagnostic Tests (RDTs) in the Detection of Plasmodium Infection

Malaria infection is the most common diagnosis made in Africa. Efficient diagnosis of malaria parasite is very vital for treatment of malaria infection. The efficacy of rapid diagnostic tests (RDTs) in comparison to microscopy, the gold standard, in the diagnosis of malaria in Nigeria has not been fully ascertained. This study compared the sensitivity, specificity and predictive values of RDTs available in Nigeria market with microscopy. Two RDT kits were used and their results were compared with the gold standard, microscopy using thick and thin blood films (TBF and tBF). TBF had sensitivity of 85%, specificity of 30%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 66.6%; tBF had sensitivity of 80%, specificity of 35%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 63.6%. Among the RDTs, Care Start HRP2 kit had sensitivity of 65%, specificity of 50%, positive predictive value (PPV) of 56.5%, and negative predictive value (NPV) of 59% while SD Bioline kit had sensitivity of 55%, specificity of 65%, PPV of 61%, and NPV of 59%. It can thus be inferred that rapid diagnostic test kits are not as sensitive as microscopy in diagnosis of malaria parasite, but they are more accurate and are thus suitable alternatives to microscopy.

Severe morbidity and mortality risk from malaria in the United States, 1985-2011.

Background. Recent reports of Plasmodium vivax associated with severe syndromes and mortality from malaria endemic areas questions the “benign” course of non-falciparum malarias.Methods. We retrospectively analyzed data from patients reported to the US Centers for Disease Control and Prevention with a diagnosis of malaria parasite single-species infection between 1985 and 2011. Patients classified as having severe illness were further classified according to outcome (survival versus death) and clinical syndrome.Results. Among all cases, .9% of Plasmodium falciparum cases resulted in death and 9.3% were classified as severe, whereas .09% of P. vivax cases resulted in death and 1.3% were classified as severe. The odds ratios for severe illness among 15 272 diagnoses of P. falciparum relative to patients diagnosed with P. vivax (n = 12 152), Plasmodium malariae (n = 1254), or Plasmodium ovale (n = 903) was 7.5, 5.7, and 5.0, respectively (P < .0001 for all); in contrast, the corresponding odds ratios for death among those severely ill was 1.6, 1.1, and .8 (P > .1 for all), respectively. Compared with P. vivax (n = 163), the odds of P. falciparum cases classified as severely ill (n = 1416) were 1.9 (P = .0006), .5 (P = .001), and 1.3 times (P = .1) as likely to present as cerebral, acute respiratory distress, and renal syndromes, respectively.Conclusions. Although less common, patients presenting with non-falciparum even in the United States can develop severe illness, and severe illness in patients having malaria of any species threatens life.