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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11-12
pubmed:dateCreated
2005-10-24
pubmed:abstractText
The accurate diagnosis of malaria starts with clinical suspicion, confirmed by reliable laboratory results. A hospital-based study, described here, was carried out in a malaria mesoendemic area in eastern Sudan, where the inhabitants are semi-immune to malaria, and the fever threshold of parasitemia is not above the detection level of microscopy. Thus, we hypothesized that patients with symptoms highly suggestive of cerebral malaria (CM), but aparasitemic by microscopy, may have submicroscopic parasitemia. Patients in our malaria clinic were screened by microscopy, and 120 individuals were selected for the study, including febrile patients with and without microscopically detectable parasitemia, and apparently healthy individuals. In the two former groups there were patients with severe anemia and deep coma. Polymerase chain reaction (PCR) for parasite detection and ELISA tests for measuring serum antibody levels were carried out on all blood samples. A majority of the febrile patients who were parasite negative by microscopy showed the presence of a Plasmodium falciparum infection by PCR. The occurrence of P. falciparum infection with parasitemia below the detection level of microscopy was recognized more often in patients with CM symptoms than in those with severe malarial anemia (SMA), and in older rather than younger patients. Patients clinically suspected (CS) of having CM ((CS)CM) mostly were infected with a single clone, and a large proportion of them acquired antibodies (Abs) against merozoite surface protein (MSP) antigens (Ags). The therapeutic response to quinine treatment was comparable between patients with (CS)CM and CM. In conclusion, uniquely in this setting, CM can be associated with sub-patent parasitemia; thus, a diagnostic tool more sensitive than microscopy is needed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1286-4579
pubmed:author
pubmed:issnType
Print
pubmed:volume
7
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1196-203
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:15994107-Adolescent, pubmed-meshheading:15994107-Adult, pubmed-meshheading:15994107-Age Factors, pubmed-meshheading:15994107-Aged, pubmed-meshheading:15994107-Animals, pubmed-meshheading:15994107-Antibodies, Protozoan, pubmed-meshheading:15994107-Antigens, Protozoan, pubmed-meshheading:15994107-Child, pubmed-meshheading:15994107-Child, Preschool, pubmed-meshheading:15994107-DNA, Protozoan, pubmed-meshheading:15994107-Endemic Diseases, pubmed-meshheading:15994107-Enzyme-Linked Immunosorbent Assay, pubmed-meshheading:15994107-Female, pubmed-meshheading:15994107-Humans, pubmed-meshheading:15994107-Infant, pubmed-meshheading:15994107-Malaria, Cerebral, pubmed-meshheading:15994107-Male, pubmed-meshheading:15994107-Middle Aged, pubmed-meshheading:15994107-Parasitemia, pubmed-meshheading:15994107-Plasmodium falciparum, pubmed-meshheading:15994107-Polymerase Chain Reaction, pubmed-meshheading:15994107-Protozoan Proteins, pubmed-meshheading:15994107-Sudan
pubmed:articleTitle
Cerebral malaria is frequently associated with latent parasitemia among the semi-immune population of eastern Sudan.
pubmed:affiliation
Malaria Research Center (MalRC), Department of Biochemistry, Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan. gehaha2002@yahoo.com
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't