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A large focus of naturally acquired Plasmodium knowlesi infections in human beings

About a fifth of malaria cases in 1999 for the Kapit division of Malaysian Borneo had routinely been identified by microscopy as Plasmodium malariae, although these infections appeared atypical and a nested PCR assay failed to identify P malariae DNA. We aimed to investigate whether such infections... Full description

Journal Title: The Lancet (British edition) 2004, Vol.363 (9414), p.1017-1024
Main Author: Singh, Balbir
Other Authors: Sung, Lee Kim , Matusop, Asmad , Radhakrishnan, Anand , Shamsul, Sunita SG , Cox-Singh, Janet , Thomas, Alan , Conway, David J
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
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recordid: cdi_proquest_miscellaneous_71785105
title: A large focus of naturally acquired Plasmodium knowlesi infections in human beings
format: Article
creator:
  • Singh, Balbir
  • Sung, Lee Kim
  • Matusop, Asmad
  • Radhakrishnan, Anand
  • Shamsul, Sunita SG
  • Cox-Singh, Janet
  • Thomas, Alan
  • Conway, David J
subjects:
  • Abridged Index Medicus
  • Adult
  • Animals
  • Biological and medical sciences
  • Chloroquine - therapeutic use
  • Diagnosis
  • DNA, Protozoan - isolation & purification
  • Erythrocytes - parasitology
  • General aspects
  • Human protozoal diseases
  • Humans
  • Infectious diseases
  • Macaca - parasitology
  • Malaria
  • Malaria - epidemiology
  • Malaria - parasitology
  • Malaria - transmission
  • Malaysia - epidemiology
  • Medical sciences
  • Monkey Diseases - parasitology
  • Monkey Diseases - transmission
  • Parasitic diseases
  • Plasmodium knowlesi - genetics
  • Plasmodium knowlesi - isolation & purification
  • Plasmodium malariae - genetics
  • Plasmodium malariae - isolation & purification
  • Polymerase Chain Reaction
  • Primaquine - therapeutic use
  • Protozoal diseases
  • Protozoan diseases
  • Reports
  • Zoonoses - epidemiology
  • Zoonoses - parasitology
  • Zoonoses - transmission
ispartof: The Lancet (British edition), 2004, Vol.363 (9414), p.1017-1024
description: About a fifth of malaria cases in 1999 for the Kapit division of Malaysian Borneo had routinely been identified by microscopy as Plasmodium malariae, although these infections appeared atypical and a nested PCR assay failed to identify P malariae DNA. We aimed to investigate whether such infections could be attributable to a variant form of P malariae or a newly emergent Plasmodium species. We took blood samples from 208 people with malaria in the Kapit division between March, 2000, and November, 2002. The small subunit ribosomal RNA and the circumsporozoite protein genes were sequenced for eight isolates that had been microscopically identified as P malariae. All blood samples were characterised with a genus-specific and species-specific nested PCR assay together with newly designed P knowlesi-specific primers. All DNA sequences were phylogenetically indistinguishable from those of P knowlesi, a malaria parasite of long-tailed macaque monkeys, but were significantly different from other malaria parasite species. By PCR assay, 120 (58%) of 208 people with malaria tested positive for P knowlesi, whereas none was positive for P malariae. P knowlesi parasites in human erythrocytes were difficult to distinguish from P malariae by microscopy. Most of the P knowlesi infections were in adults and we did not note any clustering of cases within communities. P knowlesi infections were successfully treated with chloroquine and primaquine. Naturally acquired P knowlesi infections, misdiagnosed by microscopy mainly as P malariae, accounted for over half of all malaria cases in our study. Morphological similarities between P knowlesi and P malariae necessitate the use of molecular methods for correct identification. Further work is needed to determine whether human P knowlesi infections in the Kapit division are acquired from macaque monkeys or whether a host switch to human beings has occurred.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionAbout a fifth of malaria cases in 1999 for the Kapit division of Malaysian Borneo had routinely been identified by microscopy as Plasmodium malariae, although these infections appeared atypical and a nested PCR assay failed to identify P malariae DNA. We aimed to investigate whether such infections could be attributable to a variant form of P malariae or a newly emergent Plasmodium species. We took blood samples from 208 people with malaria in the Kapit division between March, 2000, and November, 2002. The small subunit ribosomal RNA and the circumsporozoite protein genes were sequenced for eight isolates that had been microscopically identified as P malariae. All blood samples were characterised with a genus-specific and species-specific nested PCR assay together with newly designed P knowlesi-specific primers. All DNA sequences were phylogenetically indistinguishable from those of P knowlesi, a malaria parasite of long-tailed macaque monkeys, but were significantly different from other malaria parasite species. By PCR assay, 120 (58%) of 208 people with malaria tested positive for P knowlesi, whereas none was positive for P malariae. P knowlesi parasites in human erythrocytes were difficult to distinguish from P malariae by microscopy. Most of the P knowlesi infections were in adults and we did not note any clustering of cases within communities. P knowlesi infections were successfully treated with chloroquine and primaquine. Naturally acquired P knowlesi infections, misdiagnosed by microscopy mainly as P malariae, accounted for over half of all malaria cases in our study. Morphological similarities between P knowlesi and P malariae necessitate the use of molecular methods for correct identification. Further work is needed to determine whether human P knowlesi infections in the Kapit division are acquired from macaque monkeys or whether a host switch to human beings has occurred.
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subjectAbridged Index Medicus ; Adult ; Animals ; Biological and medical sciences ; Chloroquine - therapeutic use ; Diagnosis ; DNA, Protozoan - isolation & purification ; Erythrocytes - parasitology ; General aspects ; Human protozoal diseases ; Humans ; Infectious diseases ; Macaca - parasitology ; Malaria ; Malaria - epidemiology ; Malaria - parasitology ; Malaria - transmission ; Malaysia - epidemiology ; Medical sciences ; Monkey Diseases - parasitology ; Monkey Diseases - transmission ; Parasitic diseases ; Plasmodium knowlesi - genetics ; Plasmodium knowlesi - isolation & purification ; Plasmodium malariae - genetics ; Plasmodium malariae - isolation & purification ; Polymerase Chain Reaction ; Primaquine - therapeutic use ; Protozoal diseases ; Protozoan diseases ; Reports ; Zoonoses - epidemiology ; Zoonoses - parasitology ; Zoonoses - transmission
ispartofThe Lancet (British edition), 2004, Vol.363 (9414), p.1017-1024
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6Thomas, Alan
7Conway, David J
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descriptionAbout a fifth of malaria cases in 1999 for the Kapit division of Malaysian Borneo had routinely been identified by microscopy as Plasmodium malariae, although these infections appeared atypical and a nested PCR assay failed to identify P malariae DNA. We aimed to investigate whether such infections could be attributable to a variant form of P malariae or a newly emergent Plasmodium species. We took blood samples from 208 people with malaria in the Kapit division between March, 2000, and November, 2002. The small subunit ribosomal RNA and the circumsporozoite protein genes were sequenced for eight isolates that had been microscopically identified as P malariae. All blood samples were characterised with a genus-specific and species-specific nested PCR assay together with newly designed P knowlesi-specific primers. All DNA sequences were phylogenetically indistinguishable from those of P knowlesi, a malaria parasite of long-tailed macaque monkeys, but were significantly different from other malaria parasite species. By PCR assay, 120 (58%) of 208 people with malaria tested positive for P knowlesi, whereas none was positive for P malariae. P knowlesi parasites in human erythrocytes were difficult to distinguish from P malariae by microscopy. Most of the P knowlesi infections were in adults and we did not note any clustering of cases within communities. P knowlesi infections were successfully treated with chloroquine and primaquine. Naturally acquired P knowlesi infections, misdiagnosed by microscopy mainly as P malariae, accounted for over half of all malaria cases in our study. Morphological similarities between P knowlesi and P malariae necessitate the use of molecular methods for correct identification. Further work is needed to determine whether human P knowlesi infections in the Kapit division are acquired from macaque monkeys or whether a host switch to human beings has occurred.
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5Diagnosis
6DNA, Protozoan - isolation & purification
7Erythrocytes - parasitology
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26Polymerase Chain Reaction
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28Protozoal diseases
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titleA large focus of naturally acquired Plasmodium knowlesi infections in human beings
authorSingh, Balbir ; Sung, Lee Kim ; Matusop, Asmad ; Radhakrishnan, Anand ; Shamsul, Sunita SG ; Cox-Singh, Janet ; Thomas, Alan ; Conway, David J
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abstractAbout a fifth of malaria cases in 1999 for the Kapit division of Malaysian Borneo had routinely been identified by microscopy as Plasmodium malariae, although these infections appeared atypical and a nested PCR assay failed to identify P malariae DNA. We aimed to investigate whether such infections could be attributable to a variant form of P malariae or a newly emergent Plasmodium species. We took blood samples from 208 people with malaria in the Kapit division between March, 2000, and November, 2002. The small subunit ribosomal RNA and the circumsporozoite protein genes were sequenced for eight isolates that had been microscopically identified as P malariae. All blood samples were characterised with a genus-specific and species-specific nested PCR assay together with newly designed P knowlesi-specific primers. All DNA sequences were phylogenetically indistinguishable from those of P knowlesi, a malaria parasite of long-tailed macaque monkeys, but were significantly different from other malaria parasite species. By PCR assay, 120 (58%) of 208 people with malaria tested positive for P knowlesi, whereas none was positive for P malariae. P knowlesi parasites in human erythrocytes were difficult to distinguish from P malariae by microscopy. Most of the P knowlesi infections were in adults and we did not note any clustering of cases within communities. P knowlesi infections were successfully treated with chloroquine and primaquine. Naturally acquired P knowlesi infections, misdiagnosed by microscopy mainly as P malariae, accounted for over half of all malaria cases in our study. Morphological similarities between P knowlesi and P malariae necessitate the use of molecular methods for correct identification. Further work is needed to determine whether human P knowlesi infections in the Kapit division are acquired from macaque monkeys or whether a host switch to human beings has occurred.
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pmid15051281
doi10.1016/S0140-6736(04)15836-4