J Korean Med Sci.  2006 Oct;21(5):932-935. 10.3346/jkms.2006.21.5.932.

A Case of Imported Plasmodium ovale malaria

• Han TH
• Kim BN
• Seong HK

• KMID: 1781918
• DOI: http://doi.org/10.3346/jkms.2006.21.5.932

Abstract

There have been reports in Korea of imported malaria cases of four Plasmodium species, but there has been no report of imported Plasmodium ovale malaria confirmed by molecular biological methods. We report an imported case of that was confirmed by Wright-Giemsa-stained peripheral blood smear and nested polymerase chain reaction targeting the small subunit ribosomal RNA gene. The amplified DNA was sequenced and compared with other registered P. ovale isolates. The isolate in this study was a member of the classic type group. The patient was a 44-yr-old male who had worked as a woodcutter in Cote d'Ivoire in tropical West Africa. He was treated with hydroxychloroquine and primaquine and discharged following improvement. In conclusion, P. ovale should be considered as an etiology in the imported malaria in Korea, because the number of travelers to P. ovale endemic regions has recently increased.

Keyword

Plasmodium ovale; Malaria; Polymerase Chain Reaction

MeSH Terms

Sequence Analysis, DNA
Polymerase Chain Reaction
Plasmodium ovale/*genetics
Male
Malaria/*diagnosis/etiology
Humans
Genes, rRNA
Adult

Figure

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  Fig. 1 Wright-Giemsa-stained peripheral blood smear (magnification, ×1,000). (A) a ring form in an enlarged red blood cell with fimbriated margin, (B) a schizont with eight merozoites distributed like a daisy-head, (C) a microgametocyte with eccentric and dispersed chromatin, (D) a macrogametocyte with eccentric and condensed chromatin.

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  Fig. 2 Plasmodium species-specific nested PCR. Lanes 1 and 5 show a DNA ladder marker (Bioneer, Daejeon, Korea). The Plasmodium genus can be identified from the presence of first-round amplification product (-1,000 bp, lane 2 and 6). Plasmodium species can be identified from the presence of second-round amplification products specific for P. falciparum (205 bp, lane 3), P. vivax (120 bp, lane 4), P. malariae (144 bp), and P. ovale (788 bp, lane 10) respectively. Only P. ovale DNA was detected from the patient's blood. Abbreviation: P, genus Plasmodium; Pv, P. vivax; Pf, P. falciparum; Pm, P. malariae; Po, P. ovale.

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  Fig. 3 Phylogenetic tree based on the small subunit ribosomal RNA genes of Plasmodium species including four registered P. ovale isolates (Nigerian I/CDC, Papua New Guinea, MAL/MAI, and CAG/Cameroon.) and P. ovale isolate (SM04-119, DQ104413) of this study. SM04-119 is more similar to the isolates of Nigerian I/CDC and Papua New Guinea than those of MAL/MAI and CAG/Cameroon.

Reference

1. Win TT, Jalloh A, Tantular IS, Tsuboi T, Ferreira MU, Kimura M, Kawamoto F. Molecular analysis of Plasmodium ovale variants. Emerg Infect Dis. 2004. 10:1235–1240.

2. Win TT, Lin K, Mizuno S, Zhou M, Liu Q, Ferreira MU, Tantular IS, Kojima S, Ishii A, Kawamoto F. Wide distribution of Plasmodium ovale in Myanmar. Trop Med Int Health. 2002. 7:231–239.

3. Kawamoto F, Liu Q, Ferreira MU, Tantular IS. How prevalent are Plasmodium ovale and P. malariae in East Asia? Parasitol Today. 1999. 15:422–426.

4. Faye FB, Spiegel A, Tall A, Sokhna C, Fontenille D, Rogier C, Trape JF. Diagnostic criteria and risk factors for Plasmodium ovale malaria. J Infect Dis. 2002. 186:690–695.

5. Mehlotra RK, Lorry K, Kastens W, Miller SM, Alpers MP, Bockarie M, Kazura JW, Zimmerman PA. Random distribution of mixed-species malaria infections in Papua New Guinea. Am J Trop Med Hyg. 2000. 62:225–231.

6. Lee SY, Ko TS, Chi HS, Park YS. Four cases of the imported falciparum malaria in children. J Korean Pediatr Soc. 1997. 40:249–254.

7. Shin KS, Kim JS, Ryu SW, Suh IB, Lim CS. A case of Plasmodium vivax infection diagnosed after treatment of imported falciparum malaria. Korean J Clin Pathol. 2001. 21:360–364.

8. Soh CT, Lee KT, Im KI, Min DY, Ahn MH, Kim JJ, Yong TS. Current status of malaria in Korea. Yonsei Rep Trop Med. 1985. 16:11–18.

9. Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol. 1993. 61:315–320.

10. Warhurst DC, Williams JE. Laboratory diagnosis of malaria. J Clin Pathol. 1996. 49:533–538.

11. Richie TL. Interactions between malaria parasites infecting the same vertebrate host. Parasitology. 1988. 96:607–639.

12. May J, Mockenhaupt FP, Ademowo OG, Falusi AG, Olumese PE, Bienzle U, Meyer CG. High rate of mixed and subpatent malarial infections in southwest Nigeria. Am J Trop Med Hyg. 1999. 61:339–343.

13. Qari SH, Shi YP, Pieniazek NJ, Collins WE, Lal AA. Phylogenetic relationship among the malaria parasites based on small subunit rRNA gene sequences: monophyletic nature of the human malaria parasite, Plasmodium falciparum. Mol Phylogenet Evol. 1996. 6:157–165.

14. Nzeyimana I, Henry MC, Dossou-Yovo J, Doannio JM, Diawara L, Carnevale P. The epidemiology of malaria in the southwestern forests of the Ivory Coast (Tai region). Bull Soc Pathol Exot. 2002. 95:89–94.

15. Rubio JM, Post RJ, van Leeuwen WM, Henry MC, Lindergard G, Hommel M. Alternative polymerase chain reaction method to identify Plasmodium species in human blood samples: the semi-nested multiplex malaria PCR (SnM-PCR). Trans R Soc Trop Med Hyg. 2002. 96:199–204.