Cryptic Plasmodium ovale concurrent with mixed Plasmodium falciparum and Plasmodium malariae infection in two children from Central African Republic.
Cryptic Plasmodium ovale concurrent with mixed Plasmodium falciparum and Plasmodium malariae infection in two children from Central African Republic.
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DOI：
10.1186/s12936-017-1979-5
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发表时间：
2017-08-15
期刊：
影响因子：
3
通讯作者：
Gargala G
中科院分区：
文献类型：
--
作者：
Bichara C;Flahaut P;Costa D;Bienvenu AL;Picot S;Gargala G
由于特定地区通常存在多种疟疾寄生虫，因此在这些地区感染的人类中更有可能发生一种以上疟原虫的混合感染。在许多混合感染中，隐性物种的寄生虫密度可能较低，并且在临床实践中常常未被识别。最近从中非共和国领养的两名儿童（3 岁和 6 岁）因间歇性发烧入院。吉姆萨染色的薄血涂片显示，两名儿童入院时均感染了恶性疟原虫和三日疟原虫。他们都接受了阿托伐醌-氯胍组合治疗 3 天。第 7 天，薄血涂片检查仍呈阴性，但在第 28 天，女孩和她兄弟的薄血涂片分别显示三日疟原虫滋养体和卵形疟原虫呈阳性。第 1 天和第 28 天收集的样本进行实时 PCR，显示两名儿童入院时的血液样本中存在三种寄生虫（恶性疟原虫、三日疟原虫和卵形疟原虫），而第 28 天时仅存在卵形疟原虫。治疗后 28 天的随访结果在这两名患者的血液中检测到了第三种寄生虫，表明存在隐性共感染，并且在治疗后一种隐性寄生虫的出现延迟。治疗。同时感染的疟疾物种可能会相互抑制，其中恶性疟原虫往往会主导其他物种。这些观察结果提供了更多证据，表明输入性疟疾的治疗建议应考虑疟原虫并发或隐性感染的风险。临床医生和生物学家应意识到隐性物种混合感染的频率被低估，以及第 28 天患者随访的重要性。未来的指南应进一步阐明混合感染的治疗以及使用基于青蒿素的组合治疗恶性疟原虫和非恶性疟原虫物种的兴趣。
Since several malaria parasite species are usually present in a particular area, co-infections with more than one species of Plasmodium are more likely to occur in humans infected in these areas. In many mixed infections, parasite densities of the cryptic species may be low and often not recognized in clinical practice. Two children (3 and 6 years old) adopted recently from Central African Republic were admitted to hospital because of intermittent fever. Thin blood smears stained with Giemsa showed Plasmodium falciparum and Plasmodium malariae co-infection for both children at admission. They were both treated with atovaquone-proguanil combination for 3 days. At day 7, both thin blood smears examination remained negative but at day 28, thin blood smear was positive for P. malariae trophozoites and for Plasmodium ovale for the girl and her brother, respectively. Samples collected at day 1 and day 28 were submitted to real-time PCR showing the presence of the three parasite species (P. falciparum, P malariae and P. ovale) in admission blood samples from the two children and only P. ovale at day 28. Twenty-eight days follow-up after treatment led to detection of a third parasite species in the blood of these two patients suggesting covert co-infection and a delayed appearance of one cryptic species following treatment. Concurrently infecting malaria species could be mutually suppressive, with P. falciparum tending to dominate other species. These observations provide more evidence that recommendations for treatment of imported malaria should take into account the risk of concurrent or cryptic infection with Plasmodium species. Clinicians and biologists should be aware of the underestimated frequency of mixed infections with cryptic species and of the importance of patient follow-up at day 28. Future guidelines should shed more light on the treatment of mixed infection and on the interest of using artemisinin-based combinations for falciparum and non-falciparum species.
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影响因子：
9.6
作者：
Snounou, G
通讯作者：
Snounou, G
影响因子：
2.9
作者：
Nolder D;Oguike MC;Maxwell-Scott H;Niyazi HA;Smith V;Chiodini PL;Sutherland CJ
通讯作者：
Sutherland CJ
DOI：
10.2307/4582611
发表时间：
1938-01-01
期刊：
Public Health Reports Washington
影响因子：
--
作者：
Mayne, B.;Young, M. D.
通讯作者：
Young, M. D.
影响因子：
2.1
作者：
FONTENILLE, D;LEPERS, JP;COULANGES, P
通讯作者：
COULANGES, P
影响因子：
6.4
作者：
Sutherland, Colin J.;Tanomsing, Naowarat;Polley, Spencer D.
通讯作者：
Polley, Spencer D.