Presence Of Malaria Parasites Research Articles

Prevalence of Malaria Parasitaemia among Pregnant Women Attending Three Selected Health Centers in Ideato South Local Government Area, Imo State

This a community based study of prevalence of malaria parasitaemia in pregnancy carried out in three selected health centres in Idea to south LGA of Imo state. A simple random sampling technique was used to select the areas of study as well as the 120 participants used for the study. A checklist was used to collect the socio-demographic data of the subjects within the age range of 16-40years. Venous blood sample of the subjects were collected from the subjects and examined for presence of malaria parasites using standard procedures of haemoglobin and packed cell volume. Seventy-eight (66.7%) tested positive to malaria parasite with the highest prevalence occurring in the third trimester (79.2%). Also, the distribution of occurrence in different gravidity groups observed the highest prevalence occurrence amongst the primigravidae (71.0%), followed by secundigravidae (63.2%) and multigravidae (40.0%). The result shows reduction in both the PCV and HB levels of the pregnant women indicating anaemia especially in their third trimester. The chi-square statistics indicated that there is a significant relationship between age and malaria parasitaemia among pregnant women, (x 2 =1.84, df=4, p =0.05). The null hypothesis was therefore rejected at 0.05 alpha level.

Application of magnetic cytosmear for the estimation of Plasmodium falciparum gametocyte density and detection of asexual stages in asymptomatic children.

BackgroundConventional malaria parasite detection methods, such as rapid diagnostic tests (RDT) and light microscopy (LM), are not sensitive enough to detect low level parasites and identification of gametocytes in the peripheral blood. A modified and sensitive laboratory prototype, Magnetic Deposition Microscopy (MDM) was developed to increase the detection of sub-microscopic parasitaemia and estimation of gametocytes density in asymptomatic school children.MethodsBlood samples were collected from 303 asymptomatic school children from seven villages in Bagamoyo district in Tanzania. Participants were screened for presence of malaria parasites in the field using RDT and MDM whereas further examination of malaria parasites was done in the laboratory by LM. LM and MDM readings were used to calculate densities and estimate prevalence of asexual and sexual stages of the parasite.ResultsPlasmodium falciparum parasites (asexual and sexual stages) were detected in 23 (7.6 %), 52 (17.2 %), and 59 (19.5 %) out of 303 samples by LM, RDT and MDM respectively. Gametocytes were detected in 4 (1.3 %) and 12 (4.0 %) out of the same numbers of samples by LM, and MDM, respectively. Likewise, in vitro results conducted on two laboratory strains of P. falciparum, 3D7 and NF54 to assess MDM sensitivity on gametocytes detection and its application on concentrating gametocytes indicated that gametocytes were enriched by MDM by 10-fold higher than LM. Late stages of the parasite strains, 3D7 and NF54 were enriched by MDM by a factor of 20.5 and 35.6, respectively. MDM was more specific than LM and RDT by 87.5 % (95 %, CI 71.2–89.6 %) and 89.0 % (95 % CI 82.9–91.4) respectively. It was also found that MDM sensitivity was 62.5 % (95 % CI 49.5–71.8) when compared with RDT while with LM was 36.5 % (95 % CI 32.2–60.5).ConclusionsThese findings provide strong evidence that MDM enhanced detection of sub-microscopic P. falciparum infections and estimation of gametocyte density compared to current malaria diagnostic tools. In addition, MDM is superior to LM in detecting sub-microscopic gametocytaemia. Therefore, MDM is a potential tool for low-level parasitaemia identification and quantification with possible application in malaria transmission research.

Plasmodium falciparum malaria in northern Côte d'Ivoire: prevalence in the general hospital of Tanda sanitary district.

Until about 2010, the majority of data collected on malaria in Côte d'Ivoire were based on presumptive cases, particularly in the northern part of the country, where parasitological research had rarely been carried out. Recently, WHO recommended restricting treatment to confirmed malaria cases only. Thus, the purpose of this study determine the actual malaria prevalence amongst presumptive cases admitted to one of the general hospitals in the Northern part of the country, where malaria diagnosis is suboptimal. A cr oss-sectional study was conducted in the general medicine, maternity and paediatric wards between January and August 2010. Patients of all ages, suspected of having malaria, were included after giving their informed oral consent. Several parameters were investigated: the presence of Plasmodium using thick blood film, HIV/ Plasmodium co-infection, signs of severity, aspects of malaria treatment and other associated factors. Of 379 patients included, with a median age of 4 yrs [range 1 month - 71 yrs], 9% were HIV-positive, 74% were ≤ 15 yrs of age, 60% were urbanised and 23% were using long-lasting insecticide-treated nets. Malaria prevalence was 67.5% and was significantly associated with the rainy season (p < 0.001), age ≤ 5 yrs (p = 0.004) and no cotrimoxazole chemoprophylaxis in HIV-infected patients (p = 0.04). Only P. falciparum was detected, with a mean density of 12,523 trophozoites/μl of blood, but with 12,610 trophozoites/μl of blood in HIV-positive patients and 7,055 trophozoites/μl of blood in HIV-negative patients (p < 0.001). Severe malaria accounted for 77% of cases. Prescribed antimalarial drugs were: IM artemether (56%), quinine (28%), artemether + lumefantrine (10%) and artesunate + amodiaquine (6%). Apyrexia and parasite clearance were observed at day 2-3 post treatment in 87% of patients. Adverse events were reported among 60 patients (17%). The outcome was marked by: a healing rate of 90%, a rate of 5% lost to follow-up and a 7% lethality for severe malaria, significantly associated with the age ≤ 5 yrs (p=0.02), hyperparasitaemia >20% (p=0.004), neurological disorders (p < 0.001) and respiratory distress (p=0.007). Malaria prevalence in the general hospital of Tanda remains high, with a predominance of sever e malaria affecting children under the age of 5 yrs.

High Risk of Transfusion-Transmitted Malaria (TTM) from Student Blood Donors Living in the Town of Douala, Cameroon

Objective: Despite its contribution in managing and saving human lives, blood transfusion nonetheless can represent one obvious hazard in the transmission of many infectious diseases, among which malaria. This study aimed at determining the risk of transfusion-transmitted malaria (TTM) from student donors. Methods: A cross-sectional study was carried out in January 2015 in students living in the town of Douala, Cameroon. One hundred and seventy nine (179) students aged between 18 and 32 years were included in the study and their blood tested for the presence of malaria parasites using thick blood films. A questionnaire form was administered to each participant for documenting socio demographical, clinical and malaria-related data. Results: The prevalence of malaria infection among donors was 27.54%. Overall prevalence of the asymptomatic malaria was 10.17% which accounted for 47.36% of all cases of malaria infection. Malaria prevalence was higher in males compared to their female counterparts (29.85%), in those aged 21-25 years old (32.55%) and who were not using insecticide-treated bed nets (26.31%). Mean parasite density was the highest in males, 21-25 years old and bed nets users with 139 ± 346 parasites/μl, 132 ± 341 parasites/μl and 156 ± 476 parasites/μl respectively. None of the factors tested were found to be associated with an increased risk of malaria infection (pvalue> 0.05). Conclusion: This study has highlighted a potential high risk of TTM from student donors. In many endemic areas malaria diagnosis is overlooked thus increasing the risk of TTM and constraining its appraisal. This study fills the gaps a little in field of blood transfusion safety in our setting and we expect it will be helpful to adequately define policies in order to undermine the misperceptions about TTM such as screening malaria parasite and selection of potential donors in blood banks prior to the transfusion.

Role of Rapid diagnostic Tests for guiding therapy in partially treated malaria patients

Background: Malaria is one of the major public health problems worldwide. Diagnosis of malaria by microscopy and/ or rapid antigen detection test is the standard practice all over world. In endemic areas, many rely on clinical or self-diagnosis and start the antimalarial treatment without a definite microbiological diagnosis. These patients with incomplete treatment may pose a challenge to clinician and microbiologist alike. Methods: A total of 62 patients with history of incomplete treatment and clinically diagnosed as malaria were included in this study. Microbiological diagnosis of malaria is arried out by microscopy of the peripheral thin smear by giemsa stain and rapid antigen detection test (RDT). Results: All the blood samples were positive (62/62) by RDT, whereas 40 exhibited presence of malaria parasites by microscopy. 22 samples were negative for parasitic forms irrespective of the test band intensity in RDT. Conclusion: In developing countries like India, where malaria is endemic self-diagnosis and self-medication is a common practice. RDT found to be better tool for the confirmation of malaria diagnosis for the patients with incomplete antimalarial treatment history compared to microscopy. Key words: Self-medication, Anti-Malarial, Malaria, Diagnostic Tool

Prevalence of malaria parasites in adults and its determinants in malaria endemic area of Kisumu County, Kenya.

BackgroundThe prevalence of malaria parasites in adults in Africa is less well researched than in children. Therefore, a demographic surveillance site was used to conduct a household survey of adults in the malaria endemic area of Maseno division in Kisumu County near Lake Victoria.MethodsA random survey of 1,190 adults living in a demographic health surveillance site in a malaria endemic area of 70,805 population size was conducted, measuring presence of malaria parasites by slide microscopy. Data were analysed using STATA to calculate the prevalence of malaria and associated risk factors.ResultsThe adult prevalence of presence of malaria parasites in Maseno was 28% (95% CI: 25.4–31.0%). Gender was a significant sociodemographic risk factor in both univariate (OR 1.5, p = 0.005) and multivariate (OR 1.4, p = 0.019) analyses. Females were 50% more likely to have malaria than men.ConclusionsPresence of malaria parasites is common in the adult population of this endemic area, and the rate is greatly increased in women. The presence of such an adult pool of malaria parasites represents a key reservoir factor in transmission of parasites to children, and is relevant for plans to eradicate malaria.

ASSOCIATION BETWEEN ATYPICAL DEPOLARIZATION IN CELLDYN 00 AND THE PRESENCE OF PLASMODIUM SPP IN BLOOD IN Dr. SOETOMO HOSPITAL SURABAYA

Background: Malaria is a parasitic disease worldwide with a high morbidity and mortality. A rapid and accurate method is needed to detect the presence of malaria parasites in blood. A flagging system atypical depolarization (atypdep) in CBC results from Cell-Dyn 3200 has been related with malaria infection. Materials and Methods: An observational cross sectional approach with 48 samples obtained from inpatients of the Dr.Soetomo Hospital, Surabaya. Samples were screened by Cell-Dyn 3200 analyzer for atypdep flagging in CBC. Positive samples were later confirmed by microscope to detect malaria parasites. results: From 48 samples with atypdep flagging, 7 samples were malaria positive on peripheral blood smear (13.1%). Most frequent atypdep flagging was seen in malignancy (18.7%), and approximately 54.6% of the samples were not accompanied by fever symptoms. Lekositosis and anemia each were found in 20 samples (41.6%) and thrombocytopenia in 33.3%. conclusion: The presence of atypdep flagging in Cell-Dyn 3200 does not necessarily indicate the existence of malaria or it could be said that atypdep flagging is not always associated with presence of malaria infection. The usage of an atypdep flagging in non-endemic areas such as Surabaya is just an alert sign to evaluate malaria infection rather than a screening method to detect malaria.

Evaluation of the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT) in a malaria endemic area in Ghana, Africa.

BackgroundGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most widespread enzyme defect that can result in red cell breakdown under oxidative stress when exposed to certain medicines including antimalarials. We evaluated the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT) as a point-of-care tool for screening G6PD deficiency.MethodsA cross-sectional study was conducted among 206 randomly selected and consented participants from a group with known G6PD deficiency status between February 2013 and June 2013. A maximum of 1.6ml of capillary blood samples were used for G6PD deficiency screening using CareStart G6PD RDT and Trinity qualitative with Trinity quantitative methods as the “gold standard”. Samples were also screened for the presence of malaria parasites. Data entry and analysis were done using Microsoft Access 2010 and Stata Software version 12. Kintampo Health Research Centre Institutional Ethics Committee granted ethical approval.ResultsThe sensitivity (SE) and specificity (SP) of CareStart G6PD deficiency RDT was 100% and 72.1% compared to Trinity quantitative method respectively and was 98.9% and 96.2% compared to Trinity qualitative method. Malaria infection status had no significant (P=0.199) change on the performance of the G6PD RDT test kit compared to the “gold standard”.ConclusionsThe outcome of this study suggests that the diagnostic performance of the CareStart G6PD deficiency RDT kit was high and it is acceptable at determining the G6PD deficiency status in a high malaria endemic area in Ghana. The RDT kit presents as an attractive tool for point-of-care G6PD deficiency for rapid testing in areas with high temperatures and less expertise. The CareStart G6PD deficiency RDT kit could be used to screen malaria patients before administration of the fixed dose primaquine with artemisinin-based combination therapy.

Do ownership of mosquito nets, dwelling characteristics and mothers' socio-economic status influence malaria morbidity among children under the age of 5 in Cameroon?

This study analyzed the effect of the number of mosquito nets that are owned by households, dwelling characteristics and maternal demographic characteristics on malaria infections. The 2011 Demographic and Health Survey (DHS) data for children under 5 years of age were used. The children were subjected to haemoglobin test and rapid diagnostic test (RDT) to ascertain the presence of malaria parasites. Data were analyzed using probit regression method. It was found that 2.43% and 8.68% of the children were living in houses that were prone to landslide and flooding, respectively. Also, 19.93%, 17.08% and 16.26% of the children lived in houses without windows, with broken windows, and with a hole in the roof, respectively. Only 5.59% and 23.96% of the children lived in houses with window and door nets, respectively. Mosquito nets were owned by 64.03% of the households, where Adamawa Region had the lowest coverage (52.23%). Reasons for not owning mosquito nets by all the households included: lack of financial means (25.17%), using something else (1.80%) and not having many mosquitoes in the vicinity (5.53%). In the probit regression, variables that significantly reduced malaria infections among the children (p < 0.05) included: the number of mosquito nets, urban residence, improved toilet, ownership of a radio, residence in flood-prone area, mother's secondary education, mother's tertiary education and residence in areas with not many mosquitoes, while infections increased along with the household size, residence in areas prone to landslide, severe anaemia, moderate anaemia, mild anaemia and age of the children. Ownership of mosquito nets and dwelling characteristics are critical factors influencing infections with malaria. There is a need to ensure compliance with its use since there are disparities between access and actual usage. Also, addressing malaria problem in Cameroon should consider regional disparity in malaria incidence rates and more engagement of the media, among others, for appropriate sensitization.

Prevalence and Determinants of Anaemia among Adolescent Girls in Secondary Schools in Yala Division Siaya District, Kenya

Approximately half of adolescent girls living in Sub-Saharan Africa are anemic. Anaemia is associated with lower physical work capacity, impaired cognitive functioning and lower school achievement among adolescents. This study was done to determine factors associated with the prevalence of anaemia among adolescent girls aged 14-18 years old within Yala division, Siaya District, Kenya. A mixed method multistage sampling was used to select 230 female students. Blood and stool samples were analysed for anaemia, malaria and worm infestation respectively. Questionnaires were used to assess intake of dietary iron. Results showed 26.5% , 41.3%, 7.4% prevalence anaemia (Hb <12.0 g/dl), malaria and ova of ascaris respectively. Factors that were significantly(P≤0.05) associated with anaemia were: the respondent’s age (OR 3.38 ), educational status of the fathers’, primary (OR=0.313) post-secondary (OR=0.343) inadequate daily dietary iron intake (OR=8.87), presence of malaria parasites (OR=3.68) and ova of ascaris (OR=11.94). The study concluded that anaemia is a public health problem among adolescents in this area. Interventions and strategies aimed at addressing effectively anemia in this population should therefore be targeted at the associated factors including parents especially fathers who should provide more bio available iron for the respondents in the diet.

Effect of Age on Prevalence of Malaria and Oxidative Stress in Children

Objective: To determine the effect of age on prevalence of malaria infection and oxidative stress in children. Study Design: One hundred and seventy children within the age range 0-5 years were recruited into this study from Specialist hospital, Ikare, Ondo state, Nigeria. The children were divided into three age range groups. The first group was within age range 0-1 year, the second group was within age range 2-3 years and the last group was within age range 4-5 years. The study considered those who were malaria positive only. Methodology: Five milliliters of blood was collected by venipuncture from each child and the blood was immediately transferred into ethylene diamine tetraacetic acid (EDTA) bottle. The plasma was separated from the whole blood and was used to determine the triglyceride, total plasma protein, malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione (GSH) levels. The whole blood was screened for the presence of malaria parasite. Results: The prevalence of malaria infection was significantly higher in the group within the age range 2-3 years than in other age ranges studied, but the parasite density was significantly higher (P<0.05) in the group within the age range 4-5 years than other age ranges studied. The parasite Original Research Article Akanbi; BMRJ, 8(1): 379-385, 2015; Article no.BMRJ.2015.130 380 density was significantly lower in the group within the age range 0-1 year than those within the age ranges 2-3 years and 4-5 years. There was a significant increase in total protein, SOD and GSH levels in the children within the age range 0-1 year as compared with other age groups studied. The triglyceride and MDA levels were significantly higher in age group 2-3 and 4-5 years than in the children within the age range 0-1 year. Conclusion: This study showed that the older children were more susceptible to malaria infection and oxidative stress as compared to those within the age range 0-1year, therefore, more attention should be given to these age groups.

Prevalence of Malaria and Associated Factors in Dilla Town and the Surrounding Rural Areas, Gedeo Zone, Southern Ethiopia

Although progress in the fight against malaria, about 75% of the land and 60% of the population is exposed to malaria in Ethiopia. The aim of this study was to assess the prevalence and associated factors of malaria in Dilla town and surrounding rural areas, Southern Ethiopia. Institution based, cross sectional study was employed from October 01 to December 29, 2014 in health facilities. A stratified sampling technique was carried out to select representative individuals. A pre-tested structured questionnaire and blood film examination format (n=350) were used as data collection tools. Peripheral blood samples were collected and the presence of malaria parasites was observed microscopically on thick and thin blood smears. Personal data were collected through the householdbased questionnaires. Finally, data were entered and analyzed using SPSS version 20.0. The overall prevalence of malaria in the study area was 16.0% with higher infection rate in the surrounding area (53.6%) and amongst the age group of 15-24 years (35.7%). The predominant Plasmodium species detected was P. vivax (62.5%) followed by P. falciparum (26.8%) and mixed malaria infection of both species (10.7%). Chi-square result revealed that residing in houses with mud block walls and unavailability of insecticide treated bed nets were found to be significantly associated with the risk of getting malaria parasites (p<0.05). Individuals living in nearby stagnant water were found to be two times more likely to get malaria parasites than those who were far away from these risky areas (OR=2.01, 95% CI: 1.50-3.85). Houses that had been sprayed with insecticide in the past 6 months were protected against malaria infection (OR=2.45, 95% CI: 2.20-3.99). In conclusion, the prevalence of malaria reported in the current study was higher than reports in many areas of the country despite its reduction from year to year.

Prevalence of placenta Plasmodium parasitemia and pregnancy outcome in asymptomatic patients at delivery in a university teaching hospital in Nigeria.

Malaria is an important public health issue in pregnancy association with poor fetal and maternal outcome, especially in malaria endemic area like Nigeria. The objective was to determine the prevalence of placental malaria in asymptomatic women in labor and to compare the fetal and maternal outcome between affected and unaffected women. A prospective cross-sectional study of 210 women who delivered at a tertiary health facility in Nigeria. Participants' peripheral venous blood, cord blood, and placental blood samples were examined microscopically for the presence of malaria parasite. Data collected were analyzed using SPSS version 16. Prevalence of placental malaria was 65.2%. Nulliparity was significantly associated with placental malaria (χ² = 21.32, P = 0.0000039, odds ratio [OR] =5.6). Poor compliance to intermittent preventive therapy was significantly associated with placental malaria (χ² = 16.67, P = 0.00004). The mean gestational age at delivery was 38.57 ± 1.7 weeks and 12.85% of women had preterm delivery. Sixty-seven (31.9%) women had anemia and malaria parasitemia was significantly associated with anemia (χ² = 8.34, P = 0.0039, OR = 2.6). Fourteen (6.67%) babies had low birth weight, but placental malaria was not significantly associated with low birth weight (χ² = 0.03, P = 0.87). There is a high prevalence of placental malaria in the study population. Nulliparity, poor drug compliance, and maternal anemia were associated with placental malaria.

The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women.

To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population. Cross-sectional study in which Hb, ferritin, transferrin receptor (sTfR), C-reactive protein, α-1 acid glycoprotein, hepcidin, malaria, hookworm infestation, syphilis and Helicobacter pylori infection were assessed. Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda. HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation. The prevalence of anaemia was 29·1 %. Fe deficiency was 40·4 % and 14·6 % based on ferritin 8·3 μg/ml. The prevalence of Fe-deficiency anaemia was 9·3 % based on ferritin 8·3 μg/ml. Hepcidin concentration was positively correlated with ferritin concentration (n 151, r=0·578, P1 g/l and/or C-reactive protein >5 mg/l. Malaria parasitaemia (OR=6·85; 95 % CI 1·25, 37·41, P=0·026) and Fe deficiency defined using sTfR (OR=5·58; 95 % CI 1·26, 24·80, P=0·024) were independently and positively associated with anaemia. Population-attributable risk factors for anaemia for raised C-reactive protein, Fe deficiency defined by sTfR >8·3 μg/ml and presence of malaria parasites were 41·6 (95 % CI 11·1, 72·2) %, 13·5 (95 % CI 2·0, 25·0) % and 12·0 (95 % CI 1·4, 22·6) %, respectively. Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester.

Haematological alterations in malaria-infected refugees in South Africa

Background Though malaria in South Africa has been reduced dramatically in endemic areas, little is known about haematological changes associated with malaria infection among refugee populations that live in the cities. Aim The aim of the study was to describe haematological alterations among malaria-infected refugees in South Africa. Materials and methods A cross-sectional study was conducted in 2013 at a refugee centre located in Durban, South Africa. The blood samples of 102 adult African refugees were screened for presence of malaria parasites using rapid diagnostic tests and microscopy. Haematological profiles were compared with standard normal values. The haematological alterations of both malaria infected and non-malaria infected participants were also compared. Results Amongst the 102 participants, malaria infection was detected in 15.7% participants. The mean absolute haemoglobin (Hb) level was reduced in 16.3% of the malaria positive patients (9.2 g/dl) with an extremely low packed cell volume (PCV) of 28.3%. All other haematological parameters were similar for malaria infected and noninfected although slightly elevated in the former group. Conclusions Anaemia was more common among participants with malaria infections than among non-infected participants. Other haematological alterations were detected in both malaria infected and uninfected participants, suggesting that infections other than malaria may be present. More research on a large sample is needed and should cover other areas and infections.

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology.

BackgroundIn Brazil, malaria is endemic in the Amazon River basin and non-endemic in the extra-Amazon region, which includes areas of São Paulo state. In this state, a number of autochthonous cases of malaria occur annually, and the prevalence of subclinical infection is unknown. Asymptomatic infections may remain undetected, maintaining transmission of the pathogen, including by blood transfusion. In these report it has been described subclinical Plasmodium infection in blood donors from a blood transfusion centre in São Paulo, Brazil.MethodsIn this cross-sectional study, representative samples of blood were obtained from 1,108 healthy blood donors at the Fundação Pró-Sangue Hemocentro de São Paulo, the main blood transfusion centre in São Paulo. Malaria exposure was defined by the home region (exposed: forest region; non-exposed: non-forest region). Real-time PCR was used to detect Plasmodium falciparum and Plasmodium vivax. Subclinical malaria cases were geo-referenced.ResultsEighty-four (7.41%) blood donors tested positive for Plasmodium; 57 of these were infected by P. falciparum, 25 by P. vivax, and 2 by both. The prevalence of P. falciparum and P. vivax was 5.14 and 2.26, respectively. The overall prevalence ratio (PR) was 3.23 (95% confidence interval (CI) 2.03, 5.13); P. falciparum PR was 16.11 (95% CI 5.87, 44.21) and P. vivax PR was 0.47 (95% CI 0.2, 1.12). Plasmodium falciparum subclinical malaria infection in the Atlantic Forest domain was present in the mountain regions while P. vivax infection was observed in cities from forest-surrounded areas.ConclusionsThe presence of Plasmodium in healthy blood donors from a region known as non-endemic, which is important in the context of transfusion biosafety, was described. Infected recipients may become asymptomatic carriers and a reservoir for parasites, maintaining their transmission. Furthermore, P. falciparum PR was positively associated with the forest environment, and P. vivax was associated with forest fragmentation.

Evaluation of leptin, interleukin–1 beta and tumor necrosis factor alpha in serum of malaria patients as prognostic markers of treatment outcome

To analyze serum leptin levels in patients with malaria falciparum and compare them with healthy controls and correlate with development and outcome of malaria infection. Sixty cases of malaria falciparum were included in this study as patients. Thirty healthy individuals of comparable age, racial and body mass index were taken as controls. All patients were diagnosed by clinical picture and the presence of malaria parasites in blood film. Estimation of liver function test, kidney function test, complete blood count, fasting blood sugar, fasting serum insulin, pro-inflammatory cytokine tumor necrosis factor alpha (TNFα) and interleukin 1 (IL1), estimation of morning serum leptin and calculation of body mass index (kg/m(2)) were done in both groups on the day of admission, on discharge and 7 d after discharge. At admission, leptin levels were significantly higher in patients group than in control while fasting serum insulin levels were not significantly different between the two groups. There were significant increases as regard to TNFα and IL1 in malaria patients. Significant differences were observed between the control and the patient group for leptin, TNFα and IL1 at the time of admission and discharge. After discharge for 7 d, a significant decline in serum leptin levels, TNFα and IL1 in the patients group was observed as compared with time of admission and time of discharge, a positive correlation between serum leptin levels and TNFα and IL1. Leptin hormone level might play an important role in development and outcome of malaria infection.

Prevalence of the Sickle Cell Trait in Gabon: A nationwide study

Sickle Cell Disease (SCD) is an important cause of death in young children in Africa, which the World Health Organization has declared a public health priority. Although SCD has been studied at the continental scale and at the local scale, a picture of its distribution at the scale of an African country has never been given. The aim of this study is to provide such a picture for the Republic of Gabon, a country where precisely the epidemiology of SCD has been poorly investigated. To this effect, 4250 blood samples from persons older than 15 were collected between June 2005 and September 2008 in 210 randomly selected villages from the nine administrative provinces of Gabon. Two methods were used to screen Sickle Cell Trait (SCT) carriers: isoelectric focusing (IEF) and high-performance liquid chromatography (HPLC). SCT prevalence in Gabon was 21.1% (895/4249). SCT prevalence was significantly larger for the Bantu population (21.7%, n=860/3959) than for the Pygmy population (12.1%, n=35/290), (p=0.00013). In addition, the presence of Plasmodium sp. was assessed via thick blood examination. Age was positively associated with SCT prevalence (odds-ratio for an increase of 10years in age=1.063, p=0.020). Sex was not associated with SCT prevalence. The study reveals the absence of homozygous sickle-cell patients, and marked differences in SCT prevalence between the Gabonese provinces, and also between population groups (Bantu vs Pygmy). These findings could be used by the public health authorities to allocate medical resources and target prevention campaigns.

Critical values in Hematology

Critical values are life-threatening results that require immediate notification to the patient's healthcare provider. Accreditation bodies require laboratories to establish critical values. A survey of Ontario laboratories was conducted to determine current practice for critical values in hematology. The survey was sent to 182 participants questioning sources for establishing critical values, levels, review frequency, delta checks, and reporting. The survey was completed by laboratory managers, supervisors, technical specialists, senior technologists, and bench technologists working in hematology. The majority of participating laboratories have established critical values limits for hemoglobin, leukocyte counts, and platelet counts. Most laboratories also include the presence of malaria parasites and blast cells. Some laboratories reported the presence of plasma cells, sickle cells, schistocytes, and spherocytes as critical values. Multiple sources are used for establishing a critical value policy. There was variability for the frequency of critical values review. Rules may differ for a first-time patient sample vs. a repeat patient sample. Delta checks are seldom used to determine whether a result should be called a critical value. Most participants require the individual taking the critical result(s) to read back and confirm that they are directly involved with the patient's care. There is a lack of consensus for critical values reporting in hematology. As critical value reporting is crucial for patient safety, standardization of this practice would be beneficial.

Avian malaria is associated with increased reproductive investment in the blue tit

Haemosporidians causing avian malaria are very common parasites among bird species. Their negative effects have been repeatedly reported in terms of deterioration in survival prospects or reproductive success. However, a positive association between blood parasites and avian fitness has also been reported. Here, we studied a relationship between presence of malaria parasites and reproductive performance of the host, a hole‐breeding passerine – the blue titCyanistes caeruleus. Since the malaria parasites might affect their hosts differently depending on environmental conditions, we performed brood size manipulation experiment to differentiate parental reproductive effort and study the potential interaction between infection status and brood rearing conditions on reproductive performance. We found individuals infected with malaria parasites to breed later in the season in comparison with uninfected birds, but no differences were detected in clutch size. Interestingly, infected parents produced heavier and larger offspring with stronger reaction to phytohemagglutinin. More importantly, we found a significant interaction between infection status and brood size manipulation in offspring tarsus length and reaction to phytohemagglutinin: presence of parasites had stronger positive effect among birds caring for experimentally enlarged broods. Our results might be interpreted either in the light of the parasite‐mediated selection or terminal investment hypothesis.