Prospective Clinical and Molecular Evaluation of Potential Plasmodium ovale curtisi and wallikeri Relapses in a High-transmission Setting

TY - JOUR

T1 - Prospective Clinical and Molecular Evaluation of Potential Plasmodium ovale curtisi and wallikeri Relapses in a High-transmission Setting

AU - Groger, Mirjam

AU - Veletzky, Luzia

AU - Lalremruata, Albert

AU - Cattaneo, Chiara

AU - Mischlinger, Johannes

AU - Manego Zoleko, Rella

AU - Kim, Johanna

AU - Klicpera, Anna

AU - Meyer, Elias L

AU - Blessborn, Daniel

AU - Winterberg, Markus

AU - Adegnika, Ayola A

AU - Agnandji, Selidji T

AU - Kremsner, Peter G

AU - Mordmüller, Benjamin

AU - Mombo-Ngoma, Ghyslain

AU - Fuehrer, Hans-Peter

AU - Ramharter, Michael

N1 - © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

PY - 2019/11/27

Y1 - 2019/11/27

N2 - BACKGROUND: Plasmodium ovale curtisi and wallikeri are perceived as relapsing malarial parasites. Contrary to Plasmodium vivax, direct evidence for this hypothesis is scarce. The aim of this prospective study was to characterize the reappearance patterns of ovale parasites.METHODS: P. ovale spp. infected patients were treated with artemether-lumefantrine and followed biweekly for up to 1 year for the detection of reappearing parasitemia. Molecular analysis of reappearing isolates was performed to identify homologous isolates by genotyping and to define cases of relapse following predefined criteria.RESULTS: At inclusion, 26 participants were positive for P. ovale curtisi and/or P. ovale wallikeri. The median duration of follow-up was 35 weeks. Reappearance of the same P. ovale species was observed in 46% of participants; 61% of P. ovale curtisi and 19% of P. ovale wallikeri infection-free intervals were estimated to end with reappearance by week 32. Based on the predefined criteria, 23% of participants were identified with 1 or 2 relapses, all induced by P. ovale curtisi.CONCLUSION: These findings are in line with the currently accepted relapse theory inasmuch as the reappearance of P. ovale curtisi strains following initial blood clearance was conclusively demonstrated. Interestingly, no relapse of P. ovale wallikeri was observed.

AB - BACKGROUND: Plasmodium ovale curtisi and wallikeri are perceived as relapsing malarial parasites. Contrary to Plasmodium vivax, direct evidence for this hypothesis is scarce. The aim of this prospective study was to characterize the reappearance patterns of ovale parasites.METHODS: P. ovale spp. infected patients were treated with artemether-lumefantrine and followed biweekly for up to 1 year for the detection of reappearing parasitemia. Molecular analysis of reappearing isolates was performed to identify homologous isolates by genotyping and to define cases of relapse following predefined criteria.RESULTS: At inclusion, 26 participants were positive for P. ovale curtisi and/or P. ovale wallikeri. The median duration of follow-up was 35 weeks. Reappearance of the same P. ovale species was observed in 46% of participants; 61% of P. ovale curtisi and 19% of P. ovale wallikeri infection-free intervals were estimated to end with reappearance by week 32. Based on the predefined criteria, 23% of participants were identified with 1 or 2 relapses, all induced by P. ovale curtisi.CONCLUSION: These findings are in line with the currently accepted relapse theory inasmuch as the reappearance of P. ovale curtisi strains following initial blood clearance was conclusively demonstrated. Interestingly, no relapse of P. ovale wallikeri was observed.

U2 - 10.1093/cid/ciz131

DO - 10.1093/cid/ciz131

M3 - SCORING: Journal article

C2 - 31066448

VL - 69

SP - 2119

EP - 2126

JO - CLIN INFECT DIS

JF - CLIN INFECT DIS

SN - 1058-4838

IS - 12

ER -