Prospective comparative multi-centre study on imported Plasmodium ovale wallikeri and Plasmodium ovale curtisi infections

TropNet Plasmodium ovale investigator group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Few previous retrospective studies suggest that Plasmodium ovale wallikeri seems to have a longer latency period and produces deeper thrombocytopaenia than Plasmodium ovale curtisi. Prospective studies were warranted to better assess interspecies differences. METHODS: Patients with imported P. ovale spp. infection diagnosed by thick or thin film, rapid diagnostic test (RDT) or polymerase chain reaction (PCR) were recruited between March 2014 and May 2017. All were confirmed by DNA isolation and classified as P. o. curtisi or P. o. wallikeri using partial sequencing of the ssrRNA gene. Epidemiological, analytical and clinical differences were analysed by statistical methods. RESULTS: A total of 79 samples (35 P. o. curtisi and 44 P. o. wallikeri) were correctly genotyped. Males predominate in wallikeri group (72.7%), whereas were 48.6% in curtisi group. Conversely, 74.3% of curtisi group were from patients of African ethnicity, whilst 52.3% of Caucasians were infected by P. o. wallikeri. After performing a multivariate analysis, more thrombocytopaenic patients (p = 0.022), a lower number of platelets (p = 0.015), a higher INR value (p = 0.041), and shorter latency in Caucasians (p = 0.034) were significantly seen in P. o. wallikeri. RDT sensitivity was 26.1% in P. o. curtisi and 42.4% in P. o. wallikeri. Nearly 20% of both species were diagnosed only by PCR. Total bilirubin over 3 mg/dL was found in three wallikeri cases. Two patients with curtisi infection had haemoglobin under 7 g/dL, one of them also with icterus. A wallikeri patient suffered from haemophagocytosis. Chemoprophylaxis failed in 14.8% and 35% of curtisi and wallikeri patients, respectively. All treated patients with various anti-malarials which included artesunate recovered. Diabetes mellitus was described in 5 patients (6.32%), 4 patients of wallikeri group and 1 curtisi. CONCLUSIONS: Imported P. o. wallikeri infection may be more frequent in males and Caucasians. Malaria caused by P. o. wallikeri produces more thrombocytopaenia, a higher INR and shorter latency in Caucasians and suggests a more pathogenic species. Severe cases can be seen in both species. Chemoprophylaxis seems less effective in P. ovale spp. infection than in P. falciparum, but any anti-malarial drug is effective as initial treatment. Diabetes mellitus could be a risk factor for P. ovale spp. infection.

Original languageEnglish
Number of pages1
JournalMalaria Journal
Volume17
Issue number1
DOIs
Publication statusPublished - Oct 30 2018

Fingerprint

Plasmodium ovale
Infection
International Normalized Ratio
Chemoprevention
Antimalarials
Routine Diagnostic Tests
Diabetes Mellitus
Polymerase Chain Reaction
Jaundice
Platelet Count
Bilirubin
Malaria
Hemoglobins
Multivariate Analysis
Retrospective Studies

Keywords

  • Antimalarials
  • Comparative study
  • Diabetes mellitus
  • INR
  • Plasmodium ovale curtisi
  • Plasmodium ovale wallikeri
  • Thrombocytopenia

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Prospective comparative multi-centre study on imported Plasmodium ovale wallikeri and Plasmodium ovale curtisi infections. / TropNet Plasmodium ovale investigator group.

In: Malaria Journal, Vol. 17, No. 1, 30.10.2018.

Research output: Contribution to journalArticle

@article{4dcfb1ef6eee494daf0c6ceb3d44dcad,
title = "Prospective comparative multi-centre study on imported Plasmodium ovale wallikeri and Plasmodium ovale curtisi infections",
abstract = "BACKGROUND: Few previous retrospective studies suggest that Plasmodium ovale wallikeri seems to have a longer latency period and produces deeper thrombocytopaenia than Plasmodium ovale curtisi. Prospective studies were warranted to better assess interspecies differences. METHODS: Patients with imported P. ovale spp. infection diagnosed by thick or thin film, rapid diagnostic test (RDT) or polymerase chain reaction (PCR) were recruited between March 2014 and May 2017. All were confirmed by DNA isolation and classified as P. o. curtisi or P. o. wallikeri using partial sequencing of the ssrRNA gene. Epidemiological, analytical and clinical differences were analysed by statistical methods. RESULTS: A total of 79 samples (35 P. o. curtisi and 44 P. o. wallikeri) were correctly genotyped. Males predominate in wallikeri group (72.7{\%}), whereas were 48.6{\%} in curtisi group. Conversely, 74.3{\%} of curtisi group were from patients of African ethnicity, whilst 52.3{\%} of Caucasians were infected by P. o. wallikeri. After performing a multivariate analysis, more thrombocytopaenic patients (p = 0.022), a lower number of platelets (p = 0.015), a higher INR value (p = 0.041), and shorter latency in Caucasians (p = 0.034) were significantly seen in P. o. wallikeri. RDT sensitivity was 26.1{\%} in P. o. curtisi and 42.4{\%} in P. o. wallikeri. Nearly 20{\%} of both species were diagnosed only by PCR. Total bilirubin over 3 mg/dL was found in three wallikeri cases. Two patients with curtisi infection had haemoglobin under 7 g/dL, one of them also with icterus. A wallikeri patient suffered from haemophagocytosis. Chemoprophylaxis failed in 14.8{\%} and 35{\%} of curtisi and wallikeri patients, respectively. All treated patients with various anti-malarials which included artesunate recovered. Diabetes mellitus was described in 5 patients (6.32{\%}), 4 patients of wallikeri group and 1 curtisi. CONCLUSIONS: Imported P. o. wallikeri infection may be more frequent in males and Caucasians. Malaria caused by P. o. wallikeri produces more thrombocytopaenia, a higher INR and shorter latency in Caucasians and suggests a more pathogenic species. Severe cases can be seen in both species. Chemoprophylaxis seems less effective in P. ovale spp. infection than in P. falciparum, but any anti-malarial drug is effective as initial treatment. Diabetes mellitus could be a risk factor for P. ovale spp. infection.",
keywords = "Antimalarials, Comparative study, Diabetes mellitus, INR, Plasmodium ovale curtisi, Plasmodium ovale wallikeri, Thrombocytopenia",
author = "{TropNet Plasmodium ovale investigator group} and Gerardo Rojo-Marcos and Rubio-Mu{\~n}oz, {Jos{\'e} Miguel} and Andrea Angheben and Stephane Jaureguiberry and Silvia Garc{\'i}a-Bujalance and Tomasoni, {Lina Rachele} and Natalia Rodr{\'i}guez-Valero and Ruiz-Giard{\'i}n, {Jos{\'e} Manuel} and Joaqu{\'i}n Salas-Coronas and Juan Cuadros-Gonz{\'a}lez and Magdalena Garc{\'i}a-Rodr{\'i}guez and Israel Molina-Romero and Rogelio L{\'o}pez-V{\'e}lez and Federico Gobbi and Mar{\'i}a Calder{\'o}n-Moreno and Esteban Martin-Echevarr{\'i}a and Matilde El{\'i}a-L{\'o}pez and Jos{\'e} Llovo-Taboada",
year = "2018",
month = "10",
day = "30",
doi = "10.1186/s12936-018-2544-6",
language = "English",
volume = "17",
journal = "Malaria Journal",
issn = "1475-2875",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Prospective comparative multi-centre study on imported Plasmodium ovale wallikeri and Plasmodium ovale curtisi infections

AU - TropNet Plasmodium ovale investigator group

AU - Rojo-Marcos, Gerardo

AU - Rubio-Muñoz, José Miguel

AU - Angheben, Andrea

AU - Jaureguiberry, Stephane

AU - García-Bujalance, Silvia

AU - Tomasoni, Lina Rachele

AU - Rodríguez-Valero, Natalia

AU - Ruiz-Giardín, José Manuel

AU - Salas-Coronas, Joaquín

AU - Cuadros-González, Juan

AU - García-Rodríguez, Magdalena

AU - Molina-Romero, Israel

AU - López-Vélez, Rogelio

AU - Gobbi, Federico

AU - Calderón-Moreno, María

AU - Martin-Echevarría, Esteban

AU - Elía-López, Matilde

AU - Llovo-Taboada, José

PY - 2018/10/30

Y1 - 2018/10/30

N2 - BACKGROUND: Few previous retrospective studies suggest that Plasmodium ovale wallikeri seems to have a longer latency period and produces deeper thrombocytopaenia than Plasmodium ovale curtisi. Prospective studies were warranted to better assess interspecies differences. METHODS: Patients with imported P. ovale spp. infection diagnosed by thick or thin film, rapid diagnostic test (RDT) or polymerase chain reaction (PCR) were recruited between March 2014 and May 2017. All were confirmed by DNA isolation and classified as P. o. curtisi or P. o. wallikeri using partial sequencing of the ssrRNA gene. Epidemiological, analytical and clinical differences were analysed by statistical methods. RESULTS: A total of 79 samples (35 P. o. curtisi and 44 P. o. wallikeri) were correctly genotyped. Males predominate in wallikeri group (72.7%), whereas were 48.6% in curtisi group. Conversely, 74.3% of curtisi group were from patients of African ethnicity, whilst 52.3% of Caucasians were infected by P. o. wallikeri. After performing a multivariate analysis, more thrombocytopaenic patients (p = 0.022), a lower number of platelets (p = 0.015), a higher INR value (p = 0.041), and shorter latency in Caucasians (p = 0.034) were significantly seen in P. o. wallikeri. RDT sensitivity was 26.1% in P. o. curtisi and 42.4% in P. o. wallikeri. Nearly 20% of both species were diagnosed only by PCR. Total bilirubin over 3 mg/dL was found in three wallikeri cases. Two patients with curtisi infection had haemoglobin under 7 g/dL, one of them also with icterus. A wallikeri patient suffered from haemophagocytosis. Chemoprophylaxis failed in 14.8% and 35% of curtisi and wallikeri patients, respectively. All treated patients with various anti-malarials which included artesunate recovered. Diabetes mellitus was described in 5 patients (6.32%), 4 patients of wallikeri group and 1 curtisi. CONCLUSIONS: Imported P. o. wallikeri infection may be more frequent in males and Caucasians. Malaria caused by P. o. wallikeri produces more thrombocytopaenia, a higher INR and shorter latency in Caucasians and suggests a more pathogenic species. Severe cases can be seen in both species. Chemoprophylaxis seems less effective in P. ovale spp. infection than in P. falciparum, but any anti-malarial drug is effective as initial treatment. Diabetes mellitus could be a risk factor for P. ovale spp. infection.

AB - BACKGROUND: Few previous retrospective studies suggest that Plasmodium ovale wallikeri seems to have a longer latency period and produces deeper thrombocytopaenia than Plasmodium ovale curtisi. Prospective studies were warranted to better assess interspecies differences. METHODS: Patients with imported P. ovale spp. infection diagnosed by thick or thin film, rapid diagnostic test (RDT) or polymerase chain reaction (PCR) were recruited between March 2014 and May 2017. All were confirmed by DNA isolation and classified as P. o. curtisi or P. o. wallikeri using partial sequencing of the ssrRNA gene. Epidemiological, analytical and clinical differences were analysed by statistical methods. RESULTS: A total of 79 samples (35 P. o. curtisi and 44 P. o. wallikeri) were correctly genotyped. Males predominate in wallikeri group (72.7%), whereas were 48.6% in curtisi group. Conversely, 74.3% of curtisi group were from patients of African ethnicity, whilst 52.3% of Caucasians were infected by P. o. wallikeri. After performing a multivariate analysis, more thrombocytopaenic patients (p = 0.022), a lower number of platelets (p = 0.015), a higher INR value (p = 0.041), and shorter latency in Caucasians (p = 0.034) were significantly seen in P. o. wallikeri. RDT sensitivity was 26.1% in P. o. curtisi and 42.4% in P. o. wallikeri. Nearly 20% of both species were diagnosed only by PCR. Total bilirubin over 3 mg/dL was found in three wallikeri cases. Two patients with curtisi infection had haemoglobin under 7 g/dL, one of them also with icterus. A wallikeri patient suffered from haemophagocytosis. Chemoprophylaxis failed in 14.8% and 35% of curtisi and wallikeri patients, respectively. All treated patients with various anti-malarials which included artesunate recovered. Diabetes mellitus was described in 5 patients (6.32%), 4 patients of wallikeri group and 1 curtisi. CONCLUSIONS: Imported P. o. wallikeri infection may be more frequent in males and Caucasians. Malaria caused by P. o. wallikeri produces more thrombocytopaenia, a higher INR and shorter latency in Caucasians and suggests a more pathogenic species. Severe cases can be seen in both species. Chemoprophylaxis seems less effective in P. ovale spp. infection than in P. falciparum, but any anti-malarial drug is effective as initial treatment. Diabetes mellitus could be a risk factor for P. ovale spp. infection.

KW - Antimalarials

KW - Comparative study

KW - Diabetes mellitus

KW - INR

KW - Plasmodium ovale curtisi

KW - Plasmodium ovale wallikeri

KW - Thrombocytopenia

UR - http://www.scopus.com/inward/record.url?scp=85055627372&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055627372&partnerID=8YFLogxK

U2 - 10.1186/s12936-018-2544-6

DO - 10.1186/s12936-018-2544-6

M3 - Article

C2 - 30376868

AN - SCOPUS:85055627372

VL - 17

JO - Malaria Journal

JF - Malaria Journal

SN - 1475-2875

IS - 1

ER -