Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

Malaria Journal

Research

Maria Anice M Sallum¹  Gabriel Z Laporta²  Aline M Monteiro³  Pedro E Dorlhiac-Llacer³  Linah A Fukuya³  Debora Levy⁴  Sérgio P Bydlowski⁴  Luciana MF Maselli⁵  Claudio T Daniel-Ribeiro⁶  Maria F Ferreira-da-Cruz⁶ 

[1] Departament of Epidemiology, Faculdade de Saúde Pública, Universidade de São Paulo, 01246-904, São Paulo, SP, Brazil;Departament of Epidemiology, Faculdade de Saúde Pública, Universidade de São Paulo, 01246-904, São Paulo, SP, Brazil;Laboratório de Informática Médica (LIM01), University of São Paulo School of Medicine, 01246-903, São Paulo, SP, Brazil;Division of Hematology, Hospital das Clínicas from the University of Sao Paulo School of Medicine, 05403-000, São Paulo, SP, Brazil;Laboratory of Genetics and Molecular Hematology (LIM31), University of Sao Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 155 – 1st floor - room 43, 05403-000, São Paulo, SP, Brazil;Laboratory of Genetics and Molecular Hematology (LIM31), University of Sao Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 155 – 1st floor - room 43, 05403-000, São Paulo, SP, Brazil;Fundação Pró-Sangue Hemocentro de São Paulo, 05403-000, São Paulo, SP, Brazil;Malaria Research Laboratory, Instituto Osvaldo Cruz, 21045-900, Rio de Janeiro, RJ, Brazil;

关键词: Plasmodium falciparum;    Plasmodium vivax;    S;    Blood center;    Transfusion;    Prevalence ratio;    Dynamics of malaria transmission;   

DOI  :  10.1186/1475-2875-13-224

 received in 2014-04-29, accepted in 2014-06-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundIn Brazil, malaria is endemic in the Amazon River basin and non-endemic in the extra-Amazon region, which includes areas of São Paulo state. In this state, a number of autochthonous cases of malaria occur annually, and the prevalence of subclinical infection is unknown. Asymptomatic infections may remain undetected, maintaining transmission of the pathogen, including by blood transfusion. In these report it has been described subclinical Plasmodium infection in blood donors from a blood transfusion centre in São Paulo, Brazil.MethodsIn this cross-sectional study, representative samples of blood were obtained from 1,108 healthy blood donors at the Fundação Pró-Sangue Hemocentro de São Paulo, the main blood transfusion centre in São Paulo. Malaria exposure was defined by the home region (exposed: forest region; non-exposed: non-forest region). Real-time PCR was used to detect Plasmodium falciparum and Plasmodium vivax. Subclinical malaria cases were geo-referenced.ResultsEighty-four (7.41%) blood donors tested positive for Plasmodium; 57 of these were infected by P. falciparum, 25 by P. vivax, and 2 by both. The prevalence of P. falciparum and P. vivax was 5.14 and 2.26, respectively. The overall prevalence ratio (PR) was 3.23 (95% confidence interval (CI) 2.03, 5.13); P. falciparum PR was 16.11 (95% CI 5.87, 44.21) and P. vivax PR was 0.47 (95% CI 0.2, 1.12). Plasmodium falciparum subclinical malaria infection in the Atlantic Forest domain was present in the mountain regions while P. vivax infection was observed in cities from forest-surrounded areas.ConclusionsThe presence of Plasmodium in healthy blood donors from a region known as non-endemic, which is important in the context of transfusion biosafety, was described. Infected recipients may become asymptomatic carriers and a reservoir for parasites, maintaining their transmission. Furthermore, P. falciparum PR was positively associated with the forest environment, and P. vivax was associated with forest fragmentation.

【 授权许可】

Unknown   
© Maselli et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.