Molecular monitoring of the diversity of human pathogenic malaria species in blood donations on Bioko Island, Equatorial Guinea
Molecular monitoring of the diversity of human pathogenic malaria species in blood donations on Bioko Island, Equatorial Guinea
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DOI：
10.1186/s12936-019-2639-8
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发表时间：
2019-01-15
期刊：
影响因子：
3
通讯作者：
Daubenberger, Claudia
中科院分区：
文献类型：
--
作者：
Schindler, Tobias;Robaina, Tamy;Daubenberger, Claudia
研究背景疟疾可以通过输血在人与人之间传播，是世界范围内大多数输血传播的传染病。在撒哈拉以南非洲，据估计，近四分之一的献血含有疟疾寄生虫。由于快速诊断检测和厚血涂片显微镜检查对低密度寄生虫病缺乏敏感性，特别是在无症状的成人中，评估输血传播疟疾问题的最可靠方法是基于核酸的分子方法，如定量聚合酶链反应。该研究旨在确定赤道几内亚马拉博献血者中亚显微疟原虫感染的患病率。MethodsBetween July and August 2017，共收集了200份来自马拉博血库献血者的个体血液样本，并通过快速诊断测试和厚血涂片显微镜进行筛查。结果与快速诊断试验的6.5%（13/200）和显微镜检查的2.0%（4/200）相比，定量聚合酶链反应分析的恶性疟原虫阳性献血者的比例明显较高（26%，52/200）。恶性疟原虫阳性献血的密度范围为0.06至3707.0个寄生虫/μ L，其中79.6%低于100个寄生虫/μ L，因此无法通过非分子疟疾诊断试验检测到。基于qPCR的种属鉴定显示恶性疟原虫是导致88.1%（52/59）的阳性献血者的主要种属，其次是三日疟原虫（15.3%，9/59）和卵形疟原虫（3.4%，2/59.ConclusionsThis study confirmed that in malaria endemic settings，sub-patent malaria infections among blood donators are prevalent.在从生活在马拉博的健康供体采集的血液中，鉴定出恶性疟原虫、三日疟原虫和卵形疟原虫寄生虫。目前广泛使用的疟疾诊断工具已经错过了超过75%的含有恶性疟原虫的献血，证明了定量聚合酶链反应可靠地检测低密度恶性疟原虫感染的价值。由于疟疾流行国家的分子诊断方法仍然有限，生活在疟疾流行国家的受血者应按照世卫组织的建议接受治疗。
BackgroundMalaria can be transmitted by blood transfusion from human to human and it is responsible for the majority of transfusion-transmitted infectious diseases worldwide. In sub-Saharan Africa, it had been estimated that almost a quarter of blood donations contain malaria parasites. Since rapid diagnostic tests and thick blood smear microscopy lack sensitivity for low density parasitaemia, particularly in asymptomatic adults, the most reliable method to assess the problem of transfusion-transmitted malaria are nucleic acid-based molecular approaches such as quantitative polymerase chain reaction. The study was undertaken to determine the prevalence of sub-microscopic malaria parasite infection among blood donors in Malabo, Equatorial Guinea.MethodsBetween July and August 2017, a total of 200 individual blood samples from blood donors at the Malabo Blood Bank were collected and screened by rapid diagnostic tests and thick blood smear microscopy. Retrospectively, the same samples were analysed for the presence of undetected, low-density malaria parasites using quantitative polymerase chain reaction.ResultsIn comparison to 6.5% (13/200) by rapid diagnostic test and 2.0% (4/200) by microscopy, the proportion of Plasmodium falciparum positive blood donations analysed by quantitative polymerase chain reaction was significantly higher (26%, 52/200). Densities of P. falciparum positive blood donations were ranging from 0.06 to 3707.0 parasites/mu L with 79.6% below 100 parasites/mu L and therefore not detectable by non-molecular malaria diagnostic tests. qPCR based species identification revealed that P. falciparum was the dominating species responsible for 88.1% (52/59) of positive blood donations, followed by Plasmodium malariae (15.3%, 9/59) and Plasmodium ovale (3.4%, 2/59).ConclusionsThis study confirms that in malaria endemic settings, sub-patent malaria infections among blood donors are prevalent. In blood collected from healthy donors living in Malabo, P. falciparum, P. malariae and P. ovale parasites were identified. Currently widely used malaria diagnostic tools have missed more than 75% of P. falciparum containing blood donations, demonstrating the value of quantitative polymerase chain reaction to reliably detect low density P. falciparum infections. Since the availability of molecular diagnostic methods in malaria endemic countries is still limited, the blood recipients living in malaria endemic countries should be treated following WHO recommendations.