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Fulltext Prevalence of clinical malaria among an Orang Asli community in Malaysia

Kaur G

Southeast Asian J. Trop. Med. Public Health, 2009 Jul;40(4):665-73.
PMID: 19842399

An epidemiological cross-sectional study was undertaken to determine the prevalence of clinical malaria among the Orang Asli population of Raub, Pahang, Malaysia. The study was conducted on a representative sample of 520 Orang Asli. Malariometric and clinical measurements were taken. The overall parasitemic rate was 24.2% (95% CI 20.7-28.1). Twenty-three point four percent (95% CI 19.5-26.9) of respondents age two years and above were clinically febrile. The prevalence of fever, chills, perspiration and body aches during a one month period prior to the survey among the same group ranged between 4.2% (95% CI 2.7-6.4) and 13.5% (95% CI 10.6-16.7). Children 2-12 years old were more likely to present with fever, and symptoms of malaria than older children. Gender was not significantly associated with fever or any of the other malaria symptoms. Presence of clinical fever and history of malaria symptoms were all strongly associated with current infection. The association was significant even after controlling for age (adjusted OR 2.8-5.1, 95% CI 1.1-8.3). Orang Asli children significantly experienced greater morbidity due to malaria compared to adults. Control and treatment of malaria should focus on children, while further research should explore the effects of malaria morbidity on the quality of life of these children.

Matched MeSH terms: Parasitemia/epidemiology*
Fulltext Epidemiology of blood parasitic infections in the urban rat population in peninsular Malaysia

Alias SN, Sahimin N, Edah MA, Mohd-Zain SN

Trop Biomed, 2014 Jun;31(2):230-40.
PMID: 25134892 MyJurnal

A total of 719 wild rats were captured from four localities representing the west (Kuala Lumpur), east (Kuantan), north (Georgetown) and south (Malacca) to determine the diversity of blood protozoan from the urban wild rat population in peninsular Malaysia. Five rat species were recovered with Rattus rattus diardii being the most dominant species, followed by Rattus norvegicus, Rattus exulans, Rattus annandalei and Rattus argentiventer. Two blood protozoan species were found infecting the rodent population namely, Plasmodium sp. (42.1%) and Trypanosoma lewisi (25.0%). This study reports the presence of Plasmodium sp. for the first time in the rodent population in Malaysia. Two main intrinsic factors were identified affecting the parasitic infections. Trypanosoma lewisi infections were influenced by host age and sex with infections observed higher in male and juvenile rats meanwhile Plasmodium sp. infections were observed almost similar in both sexes. However, infections were higher in sub-adult rats.

Matched MeSH terms: Parasitemia/epidemiology
Malaria, arbovirus and hepatitis infections in Macaca fascicularis from Malaysia

Le Bras J, Larouze B, Geniteau M, Andrieu B, Dazza MC, Rodhain F

Lab. Anim., 1984 Jan;18(1):61-4.
PMID: 10628790

Naturally occurring malaria, arbovirus infection and hepatitis in monkeys can be a hazard for the investigator and might interfere with the outcome of experiments. 63 young adult Macaca fascicularis from Malaysia were screened for these infections. About 1 year after their arrival in France, parasitaemia due to Plasmodium spp., was present in 6.4% of the animals and specific antibodies in 55.5%. 19 of 35 initially positive monkeys were tested again 2 years later. Parasitaemia was found in 1 of 4 monkeys and antibodies in 11 of 19 monkeys which were initially positive. 9 of the monkeys initially tested had low titres of antibodies to the Flavivirus genus. All animals were negative for the hepatitis B surface antigen and anti-HBc. The prevalence of IgG antibodies against hepatitis A was 46.0%. The implications in terms of control are discussed.

Matched MeSH terms: Parasitemia/epidemiology
Fulltext Parasite biomass-related inflammation, endothelial activation, microvascular dysfunction and disease severity in vivax malaria

Barber BE, William T, Grigg MJ, Parameswaran U, Piera KA, Price RN, et al.

PLoS Pathog, 2015 Jan;11(1):e1004558.
PMID: 25569250 DOI: 10.1371/journal.ppat.1004558

Plasmodium vivax can cause severe malaria, however its pathogenesis is poorly understood. In contrast to P. falciparum, circulating vivax parasitemia is low, with minimal apparent sequestration in endothelium-lined microvasculature, and pathogenesis thought unrelated to parasite biomass. However, the relationships between vivax disease-severity and total parasite biomass, endothelial autocrine activation and microvascular dysfunction are unknown. We measured circulating parasitemia and markers of total parasite biomass (plasma parasite lactate dehydrogenase [pLDH] and PvLDH) in adults with severe (n = 9) and non-severe (n = 53) vivax malaria, and examined relationships with disease-severity, endothelial activation, and microvascular function. Healthy controls and adults with non-severe and severe falciparum malaria were enrolled for comparison. Median peripheral parasitemia, PvLDH and pLDH were 2.4-fold, 3.7-fold and 6.9-fold higher in severe compared to non-severe vivax malaria (p = 0.02, p = 0.02 and p = 0.015, respectively), suggesting that, as in falciparum malaria, peripheral P. vivax parasitemia underestimates total parasite biomass, particularly in severe disease. P. vivax schizonts were under-represented in peripheral blood. Severe vivax malaria was associated with increased angiopoietin-2 and impaired microvascular reactivity. Peripheral vivax parasitemia correlated with endothelial activation (angiopoietin-2, von-Willebrand-Factor [VWF], E-selectin), whereas markers of total vivax biomass correlated only with systemic inflammation (IL-6, IL-10). Activity of the VWF-cleaving-protease, ADAMTS13, was deficient in proportion to endothelial activation, IL-6, thrombocytopenia and vivax disease-severity, and associated with impaired microvascular reactivity in severe disease. Impaired microvascular reactivity correlated with lactate in severe vivax malaria. Findings suggest that tissue accumulation of P. vivax may occur, with the hidden biomass greatest in severe disease and capable of mediating systemic inflammatory pathology. The lack of association between total parasite biomass and endothelial activation is consistent with accumulation in parts of the circulation devoid of endothelium. Endothelial activation, associated with circulating parasites, and systemic inflammation may contribute to pathology in vivax malaria, with microvascular dysfunction likely contributing to impaired tissue perfusion.

Matched MeSH terms: Parasitemia/epidemiology
Fulltext Malaria endemicity in an Orang Asli community in Pahang, Malaysia

Gurpreet K

Trop Biomed, 2009 Apr;26(1):57-66.
PMID: 19696728 MyJurnal

An epidemiological cross-sectional study was undertaken to determine the endemicity of malaria among the Orang Asli population of Raub, Pahang. Malaria endemicity was measured in terms of the prevalence of parasitaemia and splenomegaly. A total of 520 Orang Asli were examined. The point prevalence of malaria was 24.2% (95% CI 20.7-25.1), with Plasmodium falciparum (67.5%) being the predominant species. Children < 12 years were at least 3.7 times more likely to be parasitaemic compared to those older. The prevalence of malaria among children 2-<10 years was 38.1% (95% CI 31.6-50.0). Spleen rate among children 2-<10 years old was 22.3% (95% CI 17.1-28.3). The average enlarged spleen size was 1.2. These findings classify the study area as being mesoendemic. Malaria control activities among the Orang Asli should focus on protecting vulnerable subgroups like young children. Measuring the level of malaria endemicity at regular intervals is fundamental in evaluating the effectiveness of malaria control programs.

Matched MeSH terms: Parasitemia/epidemiology*
Fulltext A survey of parasitic infection on small ruminant farms in Kinta and Hilir Perak districts, Perak, Malaysia

Chandrawathani P, Nurulaini R, Adnan M, Premalaatha B, Khadijah S, Jamnah O, et al.

Trop Biomed, 2009 Apr;26(1):11-5.
PMID: 19696722 MyJurnal

This paper reports the occurrence of helminth and protozoan infections on small ruminants from eight farms situated in Kinta and Perak Tengah district, Perak. The results of this survey indicate that helminthiasis and coccidiosis is rampant in sheep and goat farms. Several anthelmintics have been used for the control of helminths. The smallholders depended on health and extention services from the State Veterinary Department. This survey is part of an ongoing programme by the Department of Veterinary Services to upgrade services and report the current status of parasitic diseases in the state.

Matched MeSH terms: Parasitemia/epidemiology*
Fulltext Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia

Jiram AI, Ooi CH, Rubio JM, Hisam S, Karnan G, Sukor NM, et al.

Malar J, 2019 May 02;18(1):156.
PMID: 31046769 DOI: 10.1186/s12936-019-2786-y

BACKGROUND: Malaysia has declared its aim to eliminate malaria with a goal of achieving zero local transmission by the year 2020. However, targeting the human reservoir of infection, including those with asymptomatic infection is required to achieve malaria elimination. Diagnosing asymptomatic malaria is not as straightforward due to the obvious lack of clinical manifestations and often subpatent level of parasites. Accurate diagnosis of malaria is important for providing realistic estimates of malaria burden and preventing misinformed interventions. Low levels of parasitaemia acts as silent reservoir of transmission thus remains infectious to susceptible mosquito vectors. Hence, the aim of this study is to investigate the prevalence of asymptomatic submicroscopic malaria (SMM) in the District of Belaga, Sarawak.
METHODS: In 2013, a total of 1744 dried blood spots (DBS) were obtained from residents of 8 longhouses who appeared healthy. Subsequently, 251 venous blood samples were collected from residents of 2 localities in 2014 based on the highest number of submicroscopic cases from prior findings. Thin and thick blood films were prepared from blood obtained from all participants in this study. Microscopic examination were carried out on all samples and a nested and nested multiplex PCR were performed on samples collected in 2013 and 2014 respectively.
RESULTS: No malaria parasites were detected in all the Giemsa-stained blood films. However, of the 1744 samples, 29 (1.7%) were positive for Plasmodium vivax by PCR. Additionally, of the 251 samples, the most prevalent mono-infection detected by PCR was Plasmodium falciparum 50 (20%), followed by P. vivax 39 (16%), P. knowlesi 9 (4%), and mixed infections 20 (8%).
CONCLUSIONS: This research findings conclude evidence of Plasmodium by PCR, among samples previously undetectable by routine blood film microscopic examination, in local ethnic minority who are clinically healthy. SMM in Belaga district is attributed not only to P. vivax, but also to P. falciparum and P. knowlesi. In complementing efforts of programme managers, there is a need to increase surveillance for SMM nationwide to estimate the degree of SMM that warrant measures to block new transmission of malaria.

Matched MeSH terms: Parasitemia/epidemiology