Literature review on malaria parasitemia
Species-specific LAMP assays for all five human malaria species have been developed and were highly sensitive and specific. Point-of-care molecular tools for rapid malaria diagnosis have also been reported. A lab-on-chip PCR diagnostic platform for malaria, the Accutas system, can detect five species of human malaria with high sensitivity Although molecular methods are the most efficacious in diagnosing P.
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An ideal molecular diagnostic test for point-of-care diagnosis of all five human malaria species that is cost-effective and suitable for the resource-limited setting is yet to be developed. Due to its short asexual cycle of 24 h, infection with P. In guidelines for the treatment of malaria, WHO recommends that adults and children with uncomplicated knowlesi malaria be treated with artemisinin-based combination therapy ACT except for pregnant women in their first trimester or chloroquine. However, the latter is not recommended in areas with chloroquine-resistant Plasmodium species.
Whereas in severe malaria, WHO suggests the administration of parenteral artesunate for at least 24 h followed by ACT in both adults and children. Since the history of P. A prospective observational study in adults demonstrated that chloroquine together with primaquine was successful in treating uncomplicated knowlesi malaria. However, the clearance of parasite and fever was notably faster in those receiving artesunate—mefloquine combination therapy. An ex vivo drug sensitivity assay using clinical P. In studying the drug resistance mutations, Tiyagi et al found that the orthologs for known P.
Nevertheless, there was no evidence of selective drug pressure in humans. Although current state of P. Genetic polymorphism studies not only guide malaria vaccine design 73 but also help us understand the population history and structure of a parasite and thus its adaptive potential.
Hitherto, proteins of P. At the same time, the mutations are deleterious to the parasite and the P. Whole genome sequencing of P. Table 1 Selection pressure on proteins of P. Assuming that these sequenced proteins from various sources human and macaque are representative of the gene pool in macaques, the high genetic diversity and deviation of selection pressure on these proteins from those of P. These genetic diversity studies also uncovered the existence of multiple P. It began with the observation of consistent dimorphisms two distinct groups in many of the studied proteins originating from humans and macaques.
The two major sympatric clusters are associated with the long-tailed or pig-tailed macaque, and one cluster consisted of isolates from Peninsular Malaysia. This led Ahmed et al to postulate that the negative selection on this gene could be the driving force in the evolution and separation of the protein into three clusters. The data show that genetic divergence of P. The genomic diversity seen in P. When studying the adaptation of P. In vitro adaptation from macaque erythrocyte to human erythrocyte shows that there is a gradual increase in human erythrocyte invasion efficiency.
Hence, P. Currently, we know very little of the differences in characteristics and pathogenesis of the three subpopulations of P. Isolation and investigation of these three subpopulations will be needed to shed more light on these. More importantly, we do not know if human to human transmission happens naturally. The genetic diversity in MSP1 and apical membrane antigen 1 AMA1 observed among isolates of humans than those from monkeys in Thailand and non-human isolates of Malaysia suggests that it is possible.
In , P. Several P. An important parasite adhesin, the reticulocyte binding-like RBL family, is found to be involved in host cell erythrocyte receptor binding to facilitate merozoite invasion. NBPXa is one of the members in P. Erythrocyte binding-like EBL family is another group that mediates interaction with host cell erythrocyte receptors.
Tryptophan-rich antigens TRAgs are involved in rosetting formation and merozoite invasion, thereby contributing to disease severity.
This monoclonal antibody is found to be cross-strain reactive as it targets on a non-polymorphic epitope. The lack of polymorphism suggests that P. Proteins that demonstrated different mechanisms in parasite metabolic pathways from those found in human host are also of particular interest.
Garg et al have carried out a study on P. Structural, biochemical properties, and inhibition profile of PkPMTs were evaluated using X-ray crystallography, enzyme kinetics, and mutant gene expression studies. These findings suggest that PkPMTs are suitable targets for chemotherapy, and the data from this study could further contribute to a better design of more selective antimalarial drugs against P. In infected erythrocytes, P. These pathway-related proteins could be used as malaria intervention targets as the disruption of the protein export structures would then interfere with the exposition of virulent ligands at the surface of infected erythrocytes.
Despite higher physiological similarity between human and primate compared to other animal models, vaccine studies of P. Taking into account that majority of P. There remains a clear risk of continuous P. Further research into the way these risk factors associate with each other and further spatial mapping and geographic monitoring of P.
WHO recommends to perform parasite-specific diagnosis in malaria-suspected patients before treatment to prevent unnecessary drug wastage and to halt antimalarial drug resistance. In-depth population genetic studies for both human and primate isolates are needed to shed light on possible human-to-human transmission of P. Knowlesi malaria cases have been showing an upward trend in Malaysian Borneo for the past decade and is also forecasted to increase. Experimental studies on the vectors that transmit this parasite and knowing the distribution of vectors harboring this parasite will also lend credence to solving this issue.
Rapid development in genome editing tools such as clustered regularly interspaced short palindromic repeats highly increase the efficiency to engineer the genome. However, efforts for malaria control and elimination in certain Southeast Asia countries, such as Malaysia, are greatly impeded by the uncontrollable passage of P. In conclusion, different strategies and interventions are needed to prevent P. Effective vaccines are in need to control, if not eliminate the parasite.
White NJ. Plasmodium knowlesi: the fifth human malaria parasite. Clin Infect Dis. Singh B, Daneshvar C. Human infections and detection of Plasmodium knowlesi. Clin Microbiol Rev. Ministry of Health. Annual Report Ministry of Health Malaysia: Ministry of Health; —70, 95— High proportion of knowlesi malaria in recent malaria cases in Malaysia. Malar J.
Abeysinghe R. Outcomes from the evidence review group on Plasmodium knowlesi. A study of monkey-malaria, and its experimental transmission to man a preliminary report. Indian Med Gaz.
The malaria parasites of the pig-tailed macaque, Macaca nemestrina Linnaeus , in Malaya. Indian J Malariol. Malaria parasites of the Malayan leaf monkeys of the genus Presbytis. Medl J Malaya.
Wharton R, Eyles DE. Anopheles hackeri , a vector of Plasmodium knowlesi in Malaya. Natural transmission of Plasmodium knowlesi to humans by Anopheles latens in Sarawak, Malaysia. Seasonal and spatial dynamics of the primary vector of Plasmodium knowlesi within a major transmission focus in Sabah, Malaysia. Co-infections of Plasmodium knowlesi, P. Emerg Infect Dis. Plasmodium knowlesi malaria an emerging public health problem in Hulu Selangor, Selangor, Malaysia — : epidemiologic and entomologic analysis. Parasit Vectors.
[Full text] Plasmodium knowlesi malaria: current research perspectives | IDR
Kantele A, Jokiranta TS. Review of cases with the emerging fifth human malaria parasite, Plasmodium knowlesi. Plasmodium knowlesi : reservoir hosts and tracking the emergence in humans and macaques. PLoS Pathog.