title: Rare quadruple malaria infection in Irian Jaya Indonesia.
abstract: We report an exceptional finding from a blood slide collected in a remote area in the western half of New Guinea Island (Irian Jaya Province, Indonesia). One adolescent patient was found patently coinfected with all 4 known human malaria species, Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale. Diagnostic erythrocytic stages of all 4 species were clearly seen in the peripheral blood. A nested polymerase chain reaction, using species-specific primer pairs to detect DNA, helped substantiate this finding. Previous reports from Africa, Thailand, and New Guinea have detected all 4 species in a population but not simultaneously in an individual with a patent, microscopically detectable infection. We believe this quadruple infection represents the first reported natural case of all 4 human malaria parasites observed concurrently in the peripheral blood from a single Giemsa-stained slide.
authors.affiliation: U.S. Naval Medical Research Unit No. 2 (NAMRU-2), Kompleks P2M/PLP, JI. Percetakan Negara No. 29, Jakarta, Indonesia.
authors.lastname: Purnomo
authors.forename: A
authors.initials: A
authors.lastname: Solihin
authors.forename: E
authors.initials: E
authors.lastname: Gomez-Saladin
authors.forename: M J
authors.initials: MJ
authors.lastname: Bangs
mesh_terms: D000818:Animals; D002675:Child, Preschool; D015331:Cohort Studies; D017931:DNA Primers / Q000737:chemistry; D016054:DNA, Protozoan / Q000032:analysis; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology*; D008297:Male; D018512:Parasitemia / Q000469:parasitology; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification; D010965:Plasmodium malariae / Q000235:genetics / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D013045:Species Specificity
chemical_list: D017931:DNA Primers; D016054:DNA, Protozoan