Mixed Plasmodium falciparum infections and its clinical implications in four areas of the Brazilian Amazon region.
The aim of this study was to assess the prevalence pattern of mixed-Plasmodium falciparum malaria infections in Brazil by molecular diagnosis and to address its clinically important features. DNA was extracted from 115 thick blood film P. falciparum human blood positive samples using the phenol-chloroform method, followed by a semi-nested PCR protocol with species-specific primers. Seventy-three percent of P. falciparum single infections and 26.95% of mixed infections were found. Amongst mixed infections, the majority was double infection (96.77%). Our results suggest that the prevalence of one species over the other can be important on weakening P. falciparum malaria clinical symptoms. We confirm that P. falciparum co-infections frequently occur in Brazilian malaria endemic areas, with underestimated diagnosis. The results point to the need of improving microscopy or changing for another accurate diagnosis technique to differentiate among human malaria species, as this is essential to choose the best treatment and control measure for malaria. More investigations are necessary in order to clarify the role of mixed-infections in the severity of P. falciparum disease.
Lorenzetti
Alexandre
A
Centro de Investigação de Microrganismos, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, Avenida Brigadeiro Faria Lima 5416, 15090-000 São José do Rio Preto, São Paulo, Brazil.
Fornazari
Patrícia Aparecida
PA
Bonini-Domingos
Ana Carolina
AC
de Souza Rodrigues Penhalbel
Roberta
R
Fugikaha
Erika
E
Bonini-Domingos
Cláudia Regina
CR
Fraga
Valéria Daltibari
VD
Conceição
Luciana Moran
LM
Rossit
Andréa Regina Baptista
AR
Cavasini
Carlos Eugênio
CE
Couto
Vanja Suely Calvosa D'Almeida
VS
Machado
Ricardo Luiz Dantas
RL
D000293:Adolescent; D000328:Adult; D000818:Animals; D001769:Blood / Q000469:parasitology; D001938:Brazil / Q000453:epidemiology; D017931:DNA Primers / Q000235:genetics; D016054:DNA, Protozoan / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods
D017931:DNA Primers; D016054:DNA, Protozoan