Malaria Control & Elimination

Merozoite surface protein 1 of (PfMSP-1) is a leading malaria vaccine candidate. However, extensive genetic diversity of this gene in field isolates of represents a major obstacle for the development of an effective vaccine against malaria. The present study was aimed at analysing genetic polymorphisms of K1, MAD20 and RO33 allelic types of MSP-1 block 2 among isolates from Sistan and Baluchestan, Iran. In this study a total of 94 infected persons from Sistan and Baluchistan Province of Iran, were included. Blood samples were collected from March 2011 to September 2012. Block 2 of the MSP-1 gene was genotyped by allele-specific nested polymerase chain reaction (PCR) after DNA extraction. Eighty-nine (94.7%) of the 94 samples were successfully amplified; 7 distinct MSP-1 genotypes were identified by size differences on agarose gels. MAD20 was the predominant MSP-1 allelic family identified in 46.1% (41/89) of the samples while RO33 family had the least frequency (7.9%). A total of 9/89 (10.1%) samples exhibited multiple infections with two alleles at PfMSP-1. The present study shows that the level of genetic diversity is relatively low in south-east of Iran and most of infections are composed of one clone, which is consistent with an area of low malaria transmission. These data are useful for malaria prevention and control in Iran.

 The SD Bioline malaria Ag- Pf/Pan performances were evaluated for malaria species detection in 215 febrile patients living in Gabon, using microscopy as gold standard. Malaria parasites were identified in 94 (43.7%) individuals by microscopy, and 104 (48.4%) patients tested positive by the RDT. The SD Bioline Ag-Pf/Pan global sensitivity was 96.8%. All the non-falciparum malaria species infections were correctly diagnosed by the rapid test. The specificity was of 89.3% and the false positive (FP) rate of 12.5%. The test sensitivity significantly increased with parasitaemia, being of 88.9% for parasite density below 100/ µL and 98.5% at density higher than 500 parasites/ µL (p<0.01). Among the patients with a negative blood smear, the proportion of FP results was 21.0% in those previously-treated with an antimalarial drug before the consultation, and 8.8% in individuals without self-medication. SD Bioline Ag-Pf/ Pan RDT represents a good alternative to microscopy for the diagnosis of Plasmodium spp infection.

 The burden of neonatal malaria was thought rare in the past because of presence of protective factors such as maternal antimalarial antibodies, lactoferrin, secretary IgA in human milk and HbF. In endemic areas for malaria, this group (neonates) needs to be more focused for such infection, as due to difficulty in diagnosis it may be representing only the tip of iceberg. In addition there is little information on the use of artimisinin-based combination therapy in neonates. This review aims to discuss all these aspects, focusing mainly on diagnosis and management of neonatal malaria. The final objective is to emphasize the need to establish management guideline of malaria in this neglected age group.