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–chl...

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Bibliographic Details
Published in:	Acta tropica Vol. 107; no. 1; pp. 8 - 12
Main Authors:	Lorenzetti, Alexandre, Fornazari, Patrícia Aparecida, Bonini-Domingos, Ana Carolina, de Souza Rodrigues Penhalbel, Roberta, Fugikaha, Érika, Bonini-Domingos, Cláudia Regina, Fraga, Valéria Daltibari, Conceição, Luciana Moran, Rossit, Andréa Regina Baptista, Cavasini, Carlos Eugênio, Couto, Vanja Suely Calvosa D’Almeida, Machado, Ricardo Luiz Dantas
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier B.V 2008 Elsevier
Subjects:	Adolescent Adult Animals Biological and medical sciences Blood - parasitology Brazil - epidemiology Brazilian Amazon region Clinical aspects DNA Primers - genetics DNA, Protozoan - genetics DNA, Protozoan - isolation & purification Female General aspects Human protozoal diseases Humans Infectious diseases Malaria Malaria - epidemiology Malaria - parasitology Malaria - physiopathology Male Medical sciences Middle Aged Mixed infection Parasitic diseases Plasmodium - classification Plasmodium - genetics Plasmodium - isolation & purification Plasmodium falciparum Polymerase Chain Reaction - methods Protozoal diseases South America Brazil America Plasmodium falciparum Clinical aspects Mixed infection Brazilian Amazon region Protozoa Apicomplexa Protozoal disease Brazilian Amazon région Malaria Parasitosis Infection Symptomatology Treatment Tropical medicine
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-706X 1873-6254
DOI:	10.1016/j.actatropica.2008.03.012