1/4. The potential utility of the Semi-Nested Multiplex PCR technique for the diagnosis and investigation of congenital malaria.We report three cases of congenital malaria involving two malarial immune mothers living in spain. Diagnostic PCR and Genotyping PCR for merozoite surface proteins 1 and 2 were essential to show that mothers and new-borns had different Plasmodium population parasites at the moment of the delivery, and that the infection was acquired earlier in gestation by transplacental transmission. In the first case the Plasmodium species founded in both, mother and child were different. Malaria in the twins showed a mixed infection (P. falciparum plus P. malariae) while the mother presented a P. falciparum infection. These facts were confirmed studying the polymorphisms for MSP1 and MSP2. blood samples of the newborns were analyzed an half hour after delivery excluding the possibility of re-infection by mosquito bite and indicating a vertical transmission during pregnancy.- - - - - - - - - - ranking = 1keywords = mixed infection (Clic here for more details about this article) |
2/4. plasmodium malariae--a report of three cases.Kasaragod District of Kerala state has never reported cases of plasmodium malariae. During September 1999-March 2000 a total of 52 slides were reported as positive for P. vivax, P. falciparum and mixed infection. The expert team cross-checked these positive slides and three were found positive for P. malariae which were reported as P. vivax. All these had similar clinical features and were either imported cases from endemic areas or local population who visited endemic areas or by persons who came in as construction workers.- - - - - - - - - - ranking = 1keywords = mixed infection (Clic here for more details about this article) |
3/4. Malaria surveillance--united states, 2004.PROBLEM/CONDITION: Malaria in humans is caused by any of four species of intraerythrocytic protozoa of the genus Plasmodium (i.e., P. falciparum, P. vivax, P. ovale, or P. malariae). These parasites are transmitted by the bite of an infective female anopheles sp. mosquito. The majority of malaria infections in the united states occur among persons who have traveled to areas with ongoing malaria transmission. In the united states, cases can occur through exposure to infected blood products, congenital transmission, or local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. PERIOD COVERED: This report summarizes cases in persons with onset of illness in 2004 and summarizes trends during previous years. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood film are mandated to be reported to local and state health departments by health-care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS). Data from NMSS serve as the basis for this report. RESULTS: CDC received reports of 1,324 cases of malaria, including four fatal cases, with an onset of symptoms in 2004 among persons in the united states or one of its territories. This number represents an increase of 3.6% from the 1,278 cases reported for 2003. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 49.6%, 23.8%, 3.6%, and 2.0% of cases, respectively. Seventeen patients (1.3% of total) were infected by two or more species. The infecting species was unreported or undetermined in 262 (19.8%) cases. Compared with 2003, the number of reported malaria cases acquired in the americas (n = 173) increased 17.7%, whereas the number of cases acquired in asia (n = 172) and africa (n = 809) decreased 2.8% and 3.7%, respectively. Of 775 U.S. civilians who acquired malaria abroad, only 160 (20.6%) reported that they had followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Four patients became infected in the united states; three cases were attributed to congenital transmission and one to laboratory-related mosquitoborne transmission. Four deaths were attributed to malaria, including two caused by P. falciparum, one by P. vivax, and one by a mixed infection with P. falciparum and P. malariae. INTERPRETATION: The 3.6% increase in malaria cases in 2004, compared with 2003, resulted primarily from an increase in the number of cases acquired in the americas but was offset by a decrease in the number of cases acquired in africa and asia. This limited increase might reflect local changes in disease transmission, increased travel to regions in which malaria is endemic, or fluctuations in reporting to state and local health departments. These changes likely reflect expected variation in annual reporting and should not be interpreted as indicating a longer-term trend. In the majority of reported cases, U.S. civilians who acquired infection abroad had not adhered to a chemoprophylaxis regimen that was appropriate for the country in which they acquired malaria. public health ACTIONS: Additional investigations were conducted for the four fatal cases and four infections acquired in the united states. persons traveling to a malarious area should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel and use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently has a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should include a blood-film test for malaria. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention can be obtained from CDC at http://www.cdc.gov/travel or by calling the Malaria Hotline at telephone 770-488-7788. Recommendations concerning malaria treatment can be obtained at http://www.cdc.gov/malaria/diagnosis_treatment/treatment.htm or by calling the Malaria Hotline.- - - - - - - - - - ranking = 1keywords = mixed infection (Clic here for more details about this article) |
4/4. Is the malaria diagnosis expensive?Malaria remains the most important of the tropical diseases, widespread throughout the tropics, but also occurring in many temperate regions. The disease causes a heavy toll of illness and death, among children in endemic areas. It also poses a risk to business travellers, tourists and immigrants and imported cases of malaria are increasingly seen in non-endemic areas. We discuss here how microscopical diagnosis is essential for identifying Plasmodium species responsible of the infection and discarding possible mixed infections. Thus, a correct treatment can be administered in 30 min, avoiding secondary stays and saving important amounts of money. Problems of drug resistance have to be distinguished from those arising due to erroneous diagnosis.- - - - - - - - - - ranking = 1keywords = mixed infection (Clic here for more details about this article) |