Clinical examination was remarkable for the presence of herpes labialis, but otherwise negative. In the period between the two P. He was discharged on 8 May, with negative blood smear and PCR for malaria. On follow-up he had normalization of blood examinations and up to January no more recurrences of malaria.
Microsatellite amplification was performed using specific primers previously described by Bruce et al. For amplification of Pmcsp gene, two internal primers were designed specifically and used to amplify the central repeat region of the gene Table 1. Comparison of the genetic diversity of P. Several cases were added by cross-referencing the articles cited in the retrieved case reports.
Articles in Chinese, Russian and Japanese languages were excluded. In each of two tested DNA samples, a single amplified product was observed on agarose gel for each analysed target, suggesting the presence of a single detectable isolate for each malaria episode. The result of the sequencing of PM11 and PM25 showed the amplification of non-specific bands, resulting in a cross-reaction with human DNA, and for this reason these two molecular markers were excluded by the present analysis.
Analysis of polymorphisms of the Pmcsp central repeat region resulted in the amplification of a DNA fragment of base pairs bps aminoacids in the isolate responsible of the first episode, with a repeat region characterized by two NDAG tetrapeptide repeat units followed by 51 NAAG tetrapeptide repeat units. Amino acid sequence alignment of a portion of repeat region of csp gene of P.
The sequence analysis of PM2 displayed two different size variants: P. However, both P. Nucleotide sequence alignment of PM2 microsatellite of P. Twenty-three case reports of P. However, it is plausible that very ancient case reports written in languages other than English were overlooked by this research by the fact that they are not included in modern databases. The oldest retrieved report about late P.
In the oldest cases recorded the diagnosis of P. No difference of gender was observed in the cases reported in the literature and the median age of patients was 59 years. A quartan fever paroxysm was reported in Malaria was acquired in Europe before its elimination in 7 cases, in sub-Saharan Africa in 11 cases, in Southeast Asia in 3 cases, and in Trinidad in the remaining case. The attack of malaria was precipitated by surgery in five patients splenectomy in 3 cases , and immunosuppressive therapy in 2 patients [ 5 , 6 , 7 , 15 , 17 , 19 , 21 ].
An episode of falciparum malaria preceded the recrudescence by P. Six patients had a documented episode of malariae malaria 4 weeks to 25 months before the diagnosis of recrudescence [ 26 , 27 , 28 , 29 , 30 , 31 ]. Splenomegaly was documented in 9 patients At the time of P. Chloroquine was the drug most frequently employed for treatment 12 patients, Plasmodium malariae is the most neglected among Plasmodium species responsible of human malaria, being frequently undetected due to the very low parasitaemia it causes.
Only recently a draft nuclear genome and a high-quality reference genome of P. Moreover, the existence among African apes and New World monkeys of two very similar species based on morphologic characteristics i.
Recurrences of P. Herein it is described a case of an Italian man who presented two symptomatic PCR-confirmed episodes of P. His medical history was notable for several previous episodes of malaria acquired during his frequent travels to sub-Saharan Africa, usually with self-treatment with quinine.
In the interval between the two observed episodes of malaria the patient denied any further stay in endemic areas except for a visit to Libya, a country considered malaria-free, thus giving the hypothesis of a recrudescence as the most plausible. Interestingly, genotyping of four P. In this context the possibility of a de-novo infection acquired in Libya cannot be discarded and the recent description in Italy by Martelli et al.
Alternatively, in the case of recrudescence, one can consider the possibility of chloroquine-resistance or inadequate drug concentration.
To the best of knowledge clinical chloroquine-resistant P. In the former study one patient had persistent parasitaemia on day 28 and two had persistent parasitaemia on day 8. However, Collins and Jeffery retrospectively analysed the curve of clearance of P. However, recurrence of P. More recently, Rutledge et al. Another possibility to be investigated as proposed for P. As far as the described patient, although the malaria infection was acquired in Africa where a single possible P.
However, given the long latency described for P. More recently, in a study aimed to investigate the biological basis of breakthrough P.
These investigators hypothesized again the possibility that P. Based on the life span of erythrocytes days and of hepatocytes — days , Richter et al.
Moreover, it is hard to explain how a dormant liver parasite is responsible of malaria transmitted by blood transfusion by an asymptomatic blood donor as long as 44 years after the last exposure in a malaria endemic area [ 45 , 46 , 47 ].
The interesting report by Rutledge and co-workers who showed that the recrudescent isolate in the patient they described was a single clone present at low density in the initial P. The review of the literature confirms the importance of immunity in controlling long-term latency of P. However, the precipitating event in several other cases remain unexplained [ 12 , 13 , 14 , 16 , 18 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Also intriguing is the ability of P.
It can be speculated that in view of the long pre-patent period of P. It is described a case of probable P. One-hundred and sixty-five years after its description P.
Several recent thorough reviews about P. Plasmodium malariae : parasite and disease. Malaria is a disease caused by a parasite. The parasite is spread to humans through the bites of infected mosquitoes. People who have malaria usually feel very sick with a high fever and shaking chills.
While the disease is uncommon in temperate climates, malaria is still common in tropical and subtropical countries. Each year nearly million people are infected with malaria, and more than , people die of the disease. To reduce malaria infections, world health programs distribute preventive drugs and insecticide-treated bed nets to protect people from mosquito bites.
The World Health Organization has recommended a malaria vaccine for use in children who live in countries with high numbers of malaria cases. Protective clothing, bed nets and insecticides can protect you while traveling. You also can take preventive medicine before, during and after a trip to a high-risk area. Many malaria parasites have developed resistance to common drugs used to treat the disease.
Some people who have malaria experience cycles of malaria "attacks. Malaria signs and symptoms typically begin within a few weeks after being bitten by an infected mosquito. However, some types of malaria parasites can lie dormant in your body for up to a year. Talk to your doctor if you experience a fever while living in or after traveling to a high-risk malaria region. If you have severe symptoms, seek emergency medical attention.
Malaria spreads when a mosquito becomes infected with the disease after biting an infected person, and the infected mosquito then bites a noninfected person. The malaria parasites enter that person's bloodstream and travel to the liver.
Question I am a year-old woman and I had malaria including cerebral malaria three times in my childhood. These bouts never last more than a day, but are debilitating at the time. Answer The answer is yes, malaria can return. I'm confused about malaria Malaria medication during pregnancy Malaria prevention during pregnancy Which antimalarial drug should we use in Zimbabwe? This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses.
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The authors are grateful to and would like to specifically thank the Medical Technology Laboratory Unit of Phop Phra Hospital for providing data, which was important for this study. The authors would also like to thank Mr. David C. Chang for English language editing of this article. This research was partially supported by the new strategic research P2P project, Walailak University, Thailand.
The funders had a role in the collection, analysis, and interpretation of the data. You can also search for this author in PubMed Google Scholar. MK and KU participated in the study design, data analysis, and writing of the paper. BP and NP participated in the data collection. VS and CP participated in the writing of the paper.
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Kotepui, M. Prevalence of malarial recurrence and hematological alteration following the initial drug regimen: a retrospective study in Western Thailand. BMC Public Health 19, Download citation.
Received : 15 March Accepted : 13 September Published : 15 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The hematological changes following the initial drug regimen has been poorly understood in Thailand. Results The results demonstrated that during years —, 95 out of patients 9. Conclusion This study indicated the high prevalence of malarial recurrence in Tak Province, Western Thailand, and its relationship to certain characteristics of individuals.
Background Plasmodium spp. Results The clinical and laboratory characteristics of patients are shown in Table 1.
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