Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status
Abstract Background Following its recent certification as malaria-free, imported infections now pose the greatest threat for maintaining this status in Sri Lanka. Imported infections may also introduce species that are uncommon or not previously endemic to these areas. We highlight in this case repo...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-04-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-017-2411-z |
| _version_ | 1818241845150351360 |
|---|---|
| author | Sharmini Gunawardena Rachel F. Daniels Thishan C. Yahathugoda Mirani V. Weerasooriya Katelyn Durfee Sarah K. Volkman Dyann F. Wirth Nadira D. Karunaweera |
| author_facet | Sharmini Gunawardena Rachel F. Daniels Thishan C. Yahathugoda Mirani V. Weerasooriya Katelyn Durfee Sarah K. Volkman Dyann F. Wirth Nadira D. Karunaweera |
| author_sort | Sharmini Gunawardena |
| collection | DOAJ |
| description | Abstract Background Following its recent certification as malaria-free, imported infections now pose the greatest threat for maintaining this status in Sri Lanka. Imported infections may also introduce species that are uncommon or not previously endemic to these areas. We highlight in this case report the increasing importance of less common malaria species such as Plasmodium ovale in elimination settings and discuss its relevance for the risk of malaria resurgence in the country. Case presentation A 41-year-old patient from southern Sri Lanka was diagnosed with malaria after 8 days of fever. Microscopy of blood smears revealed parasites morphologically similar to P. vivax and the rapid diagnostic test was indicative of non-P. falciparum malaria. He was treated with chloroquine over 3 days and primaquine for 14 days. He was negative for malaria at a one-year follow-up. Molecular testing performed subsequently confirmed that infection was caused by P. ovale curtisi. The patient gave a history of P. vivax malaria treated with chloroquine and primaquine. He also provided a history of travel to malaria endemic regions, including residing in Liberia from May 2012 to November 2013, throughout which he was on weekly malaria prophylaxis with mefloquine. He had also visited India on an eight-day Buddhist pilgrimage tour in September 2014 without malaria prophylaxis. Conclusions It is crucial that every case of malaria is investigated thoroughly and necessary measures taken to prevent re-introduction of malaria. Accurate molecular diagnostic techniques need to be established in Sri Lanka for the screening and diagnosis of all species of human malaria infections, especially those that may occur with low parasitemia and are likely to be undetected using the standard techniques currently in use. In addition, ascertaining whether an infection occurred through local transmission or by importation is critical in the implementation of an effective plan of action in the country. This new era emphasizes the global nature of regional malaria elimination. Increasing global surveillance and tool development are necessary in order to “fingerprint” parasites and identify their origin. |
| first_indexed | 2024-12-12T13:35:48Z |
| format | Article |
| id | doaj.art-dc9047b6b68d49099220b4a72f028e46 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T13:35:48Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-dc9047b6b68d49099220b4a72f028e462022-12-22T00:22:58ZengBMCBMC Infectious Diseases1471-23342017-04-011711610.1186/s12879-017-2411-zCase report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination statusSharmini Gunawardena0Rachel F. Daniels1Thishan C. Yahathugoda2Mirani V. Weerasooriya3Katelyn Durfee4Sarah K. Volkman5Dyann F. Wirth6Nadira D. Karunaweera7Department of Parasitology, Faculty of Medicine, University of ColomboDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthDepartment of Parasitology, Faculty of Medicine, University of RuhunaDepartment of Parasitology, Faculty of Medicine, University of RuhunaDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public HealthDepartment of Parasitology, Faculty of Medicine, University of ColomboAbstract Background Following its recent certification as malaria-free, imported infections now pose the greatest threat for maintaining this status in Sri Lanka. Imported infections may also introduce species that are uncommon or not previously endemic to these areas. We highlight in this case report the increasing importance of less common malaria species such as Plasmodium ovale in elimination settings and discuss its relevance for the risk of malaria resurgence in the country. Case presentation A 41-year-old patient from southern Sri Lanka was diagnosed with malaria after 8 days of fever. Microscopy of blood smears revealed parasites morphologically similar to P. vivax and the rapid diagnostic test was indicative of non-P. falciparum malaria. He was treated with chloroquine over 3 days and primaquine for 14 days. He was negative for malaria at a one-year follow-up. Molecular testing performed subsequently confirmed that infection was caused by P. ovale curtisi. The patient gave a history of P. vivax malaria treated with chloroquine and primaquine. He also provided a history of travel to malaria endemic regions, including residing in Liberia from May 2012 to November 2013, throughout which he was on weekly malaria prophylaxis with mefloquine. He had also visited India on an eight-day Buddhist pilgrimage tour in September 2014 without malaria prophylaxis. Conclusions It is crucial that every case of malaria is investigated thoroughly and necessary measures taken to prevent re-introduction of malaria. Accurate molecular diagnostic techniques need to be established in Sri Lanka for the screening and diagnosis of all species of human malaria infections, especially those that may occur with low parasitemia and are likely to be undetected using the standard techniques currently in use. In addition, ascertaining whether an infection occurred through local transmission or by importation is critical in the implementation of an effective plan of action in the country. This new era emphasizes the global nature of regional malaria elimination. Increasing global surveillance and tool development are necessary in order to “fingerprint” parasites and identify their origin.http://link.springer.com/article/10.1186/s12879-017-2411-zPlasmodium ovale curtisiElimination programMalariaSri Lanka |
| spellingShingle | Sharmini Gunawardena Rachel F. Daniels Thishan C. Yahathugoda Mirani V. Weerasooriya Katelyn Durfee Sarah K. Volkman Dyann F. Wirth Nadira D. Karunaweera Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status BMC Infectious Diseases Plasmodium ovale curtisi Elimination program Malaria Sri Lanka |
| title | Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status |
| title_full | Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status |
| title_fullStr | Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status |
| title_full_unstemmed | Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status |
| title_short | Case report of Plasmodium ovale curtisi malaria in Sri Lanka: relevance for the maintenance of elimination status |
| title_sort | case report of plasmodium ovale curtisi malaria in sri lanka relevance for the maintenance of elimination status |
| topic | Plasmodium ovale curtisi Elimination program Malaria Sri Lanka |
| url | http://link.springer.com/article/10.1186/s12879-017-2411-z |
| work_keys_str_mv | AT sharminigunawardena casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT rachelfdaniels casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT thishancyahathugoda casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT miranivweerasooriya casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT katelyndurfee casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT sarahkvolkman casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT dyannfwirth casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus AT nadiradkarunaweera casereportofplasmodiumovalecurtisimalariainsrilankarelevanceforthemaintenanceofeliminationstatus |