Cerebral malaria is frequently associated with latent parasitemia among the semi-immune population of eastern Sudan
Open accessAbstract
The accurate diagnosis of malaria starts with clinical suspicion, confirmed by reliable laboratory results. A hospital-based study, described here, was carried out in a malaria mesoendemic area in eastern Sudan, where the inhabitants are semi-immune to malaria, and the fever threshold of parasitemia is not above the detection level of microscopy. Thus, we hypothesized that patients with symptoms highly suggestive of cerebral malaria (CM), but aparasitemic by microscopy, may have submicroscopic parasitemia. Patients in our malaria clinic were screened by microscopy, and 120 individuals were selected for the study, including febrile patients with and without microscopically detectable parasitemia, and apparently healthy individuals. In the two former groups there were patients with severe anemia and deep coma. Polymerase chain reaction (PCR) for parasite detection and ELISA tests for measuring serum antibody levels were carried out on all blood samples. A majority of the febrile patients who were parasite negative by microscopy showed the presence of a Plasmodium falciparum infection by PCR. The occurrence of P. falciparum infection with parasitemia below the detection level of microscopy was recognized more often in patients with CM symptoms than in those with severe malarial anemia (SMA), and in older rather than younger patients. Patients clinically suspected (CS) of having CM ((CS)CM) mostly were infected with a single clone, and a large proportion of them acquired antibodies (Abs) against merozoite surface protein (MSP) antigens (Ags). The therapeutic response to quinine treatment was comparable between patients with (CS)CM and CM. In conclusion, uniquely in this setting, CM can be associated with sub-patent parasitemia; thus, a diagnostic tool more sensitive than microscopy is needed.
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Low-density parasitemias serve as a reservoir for continued transmission of malaria and may contribute to negative health.
“These low-density parasitemias serve as a reservoir for continued transmission of the disease and may contribute to negative health. 9-11”
From What is the burden of submicroscopic malaria in pregnancy in central India? (2015) · cites this paper as [9]
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- Authors
- Giha, H. A., A-Elbasit, I. E., A-Elgadir, T. M. E., Adam, I., Berzins, K., ElGhazali, G., & Elbashir, M. I.
- Affiliations
- University of Khartoum (SD)
- Stockholm University (SE)
- Uppsala University (SE)
- Corresponding author
- Giha, Hayder A.
- Venue
- Microbes and Infection
- Publisher
- Elsevier BV
- Published
- 2005-08
- Volume
- 7
- Issue
- 11-12
- Pages
- 1196-1203
- ISSN
- 1286-4579 (ISSN-L)
- OpenAlex
- W1970846084
- Cited by
- 26
- References
- 34
- Citations by year
- 2024: 2 · 2022: 2 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 3
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (vor, 6727 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Microbes and Infection (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
- Keywords
- cerebral malaria, Plasmodium falciparum, malaria diagnosis, severe malarial anemia, Eastern Sudan
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Animals, Antibodies, Protozoan, Antigens, Protozoan, Child, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Female, Humans, Infant, Male, Middle Aged, Plasmodium falciparum, Sudan, Protozoan Proteins, DNA, Protozoan, Polymerase Chain Reaction, Malaria, Cerebral, Parasitemia, Endemic Diseases
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