Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia
Abstract Background Malaysia has declared its aim to eliminate malaria with a goal of achieving zero local transmission by the year 2020. However, targeting the human reservoir of infection, including those with asymptomatic infection is required to achieve malaria elimination. Diagnosing asymptomat...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-019-2786-y |
| _version_ | 1819026339957571584 |
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| author | Adela Ida Jiram Choo Huck Ooi José Miguel Rubio Shamilah Hisam Govindarajoo Karnan Nurnadiah Mohd Sukor Mohd Mafie Artic Nor Parina Ismail Nor Wahida Alias |
| author_facet | Adela Ida Jiram Choo Huck Ooi José Miguel Rubio Shamilah Hisam Govindarajoo Karnan Nurnadiah Mohd Sukor Mohd Mafie Artic Nor Parina Ismail Nor Wahida Alias |
| author_sort | Adela Ida Jiram |
| collection | DOAJ |
| description | Abstract Background Malaysia has declared its aim to eliminate malaria with a goal of achieving zero local transmission by the year 2020. However, targeting the human reservoir of infection, including those with asymptomatic infection is required to achieve malaria elimination. Diagnosing asymptomatic malaria is not as straightforward due to the obvious lack of clinical manifestations and often subpatent level of parasites. Accurate diagnosis of malaria is important for providing realistic estimates of malaria burden and preventing misinformed interventions. Low levels of parasitaemia acts as silent reservoir of transmission thus remains infectious to susceptible mosquito vectors. Hence, the aim of this study is to investigate the prevalence of asymptomatic submicroscopic malaria (SMM) in the District of Belaga, Sarawak. Methods In 2013, a total of 1744 dried blood spots (DBS) were obtained from residents of 8 longhouses who appeared healthy. Subsequently, 251 venous blood samples were collected from residents of 2 localities in 2014 based on the highest number of submicroscopic cases from prior findings. Thin and thick blood films were prepared from blood obtained from all participants in this study. Microscopic examination were carried out on all samples and a nested and nested multiplex PCR were performed on samples collected in 2013 and 2014 respectively. Results No malaria parasites were detected in all the Giemsa-stained blood films. However, of the 1744 samples, 29 (1.7%) were positive for Plasmodium vivax by PCR. Additionally, of the 251 samples, the most prevalent mono-infection detected by PCR was Plasmodium falciparum 50 (20%), followed by P. vivax 39 (16%), P. knowlesi 9 (4%), and mixed infections 20 (8%). Conclusions This research findings conclude evidence of Plasmodium by PCR, among samples previously undetectable by routine blood film microscopic examination, in local ethnic minority who are clinically healthy. SMM in Belaga district is attributed not only to P. vivax, but also to P. falciparum and P. knowlesi. In complementing efforts of programme managers, there is a need to increase surveillance for SMM nationwide to estimate the degree of SMM that warrant measures to block new transmission of malaria. |
| first_indexed | 2024-12-21T05:25:01Z |
| format | Article |
| id | doaj.art-61817d263e6b44b2b7bdbabd3e7598e7 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-21T05:25:01Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-61817d263e6b44b2b7bdbabd3e7598e72022-12-21T19:14:43ZengBMCMalaria Journal1475-28752019-05-0118111210.1186/s12936-019-2786-yEvidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, MalaysiaAdela Ida Jiram0Choo Huck Ooi1José Miguel Rubio2Shamilah Hisam3Govindarajoo Karnan4Nurnadiah Mohd Sukor5Mohd Mafie Artic6Nor Parina Ismail7Nor Wahida Alias8Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaVector Borne Diseases Section, Sarawak Health Department, Ministry of Health MalaysiaMalaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology, Instituto de Salud Carlos III (ISCIII)Parasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaParasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaParasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaParasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaParasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaParasitology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Ministry of Health MalaysiaAbstract Background Malaysia has declared its aim to eliminate malaria with a goal of achieving zero local transmission by the year 2020. However, targeting the human reservoir of infection, including those with asymptomatic infection is required to achieve malaria elimination. Diagnosing asymptomatic malaria is not as straightforward due to the obvious lack of clinical manifestations and often subpatent level of parasites. Accurate diagnosis of malaria is important for providing realistic estimates of malaria burden and preventing misinformed interventions. Low levels of parasitaemia acts as silent reservoir of transmission thus remains infectious to susceptible mosquito vectors. Hence, the aim of this study is to investigate the prevalence of asymptomatic submicroscopic malaria (SMM) in the District of Belaga, Sarawak. Methods In 2013, a total of 1744 dried blood spots (DBS) were obtained from residents of 8 longhouses who appeared healthy. Subsequently, 251 venous blood samples were collected from residents of 2 localities in 2014 based on the highest number of submicroscopic cases from prior findings. Thin and thick blood films were prepared from blood obtained from all participants in this study. Microscopic examination were carried out on all samples and a nested and nested multiplex PCR were performed on samples collected in 2013 and 2014 respectively. Results No malaria parasites were detected in all the Giemsa-stained blood films. However, of the 1744 samples, 29 (1.7%) were positive for Plasmodium vivax by PCR. Additionally, of the 251 samples, the most prevalent mono-infection detected by PCR was Plasmodium falciparum 50 (20%), followed by P. vivax 39 (16%), P. knowlesi 9 (4%), and mixed infections 20 (8%). Conclusions This research findings conclude evidence of Plasmodium by PCR, among samples previously undetectable by routine blood film microscopic examination, in local ethnic minority who are clinically healthy. SMM in Belaga district is attributed not only to P. vivax, but also to P. falciparum and P. knowlesi. In complementing efforts of programme managers, there is a need to increase surveillance for SMM nationwide to estimate the degree of SMM that warrant measures to block new transmission of malaria.http://link.springer.com/article/10.1186/s12936-019-2786-ySubmicroscopicMalariaAsymptomaticBelagaSarawakLow transmission |
| spellingShingle | Adela Ida Jiram Choo Huck Ooi José Miguel Rubio Shamilah Hisam Govindarajoo Karnan Nurnadiah Mohd Sukor Mohd Mafie Artic Nor Parina Ismail Nor Wahida Alias Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia Malaria Journal Submicroscopic Malaria Asymptomatic Belaga Sarawak Low transmission |
| title | Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia |
| title_full | Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia |
| title_fullStr | Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia |
| title_full_unstemmed | Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia |
| title_short | Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia |
| title_sort | evidence of asymptomatic submicroscopic malaria in low transmission areas in belaga district kapit division sarawak malaysia |
| topic | Submicroscopic Malaria Asymptomatic Belaga Sarawak Low transmission |
| url | http://link.springer.com/article/10.1186/s12936-019-2786-y |
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