bluuebunny/crossref_metadata_2025 huggingface dataset:
RAPID ONSET OF TRANSMISSION-REDUCING ANTIBODIES IN JAVANESE MIGRANTS EXPOSED TO MALARIA IN PAPUA, INDONESIA
Authors: BOUSEMA J. TEUN , ROEFFEN WILL , VAN DER KOLK MIKE , DE VLAS SAKE J. , VAN DE VEGTE-BOLMER MARGA , BANGS MICHAEL J. , TEELEN KARINA , KURNIAWAN LILIANA , MAGUIRE JASON D. , BAIRD J. KEVIN , SAUERWEIN ROBERT W.
Published: September 2018

Transmission of Plasmodium falciparum malaria is initiated by sexual stages in the mosquito. Anti-Pfs48/45 and anti-Pfs230 sexual stage antibodies that are ingested together with parasites can reduce parasite development and subsequently malaria transmission. Acquisition of sexual stage immunity was studied in a cohort of 102 non-immune Javanese individuals migrating to hyperendemic Papua Indonesia. Seroprevalence of antibodies against Pfs48/45 and Pfs230 and functional transmission-reducing activity (TRA) were measured upon arrival and at 6, 12, and 24 months. Asexual parasitemia and gametocytemia were assessed every two weeks. The TRA and seroreactivity increased with the number of P. falciparum infections. The longitudinally sustained association between TRA and antibodies against Pfs48/45 (odds ratio [OR] = 3.74, 95% confidence interval [CI] = 1.51–9.29) and Pfs230 (OR = 3.72, 95% CI = 1.36–10.17) suggests that functional transmission reducing immunity is acquired after limited exposure to infection.
MOLECULAR DETECTION OF BARTONELLA QUINTANA, B. ELIZABETHAE, B. KOEHLERAE, B. DOSHIAE, B. TAYLORII, AND RICKETTSIA FELIS IN RODENT FLEAS COLLECTED IN KABUL, AFGHANISTAN
Authors: MARIÉ JEAN-LOU , FOURNIER PIERRE-ÉDOUARD , ROLAIN JEAN-MARC , BRIOLANT SÉBASTIEN , DAVOUST BERNARD , RAOULT DIDIER
Published: September 2018

The prevalences of Bartonella spp. and Rickettsia spp. were investigated using molecular methods in 77 rodent fleas collected in November 2002 by the French forces detachment in Kabul, Afghanistan. Overall, Bartonella DNA was detected in 15.5% of gerbil fleas and 40.5% of rat fleas, whereas Rickettsia felis was found in 9% of gerbil fleas. We described for the first time in this country Bartonella quintana, B. koehlerae, B. taylorii, and Rickettsia felis in fleas from the gerbil species Meriones lybicus, and B. elizabethae and B. doshiae in rat fleas. Of these, B. quintana, B. elizabethae, B. koehlerae, and R. felis are recognized human pathogens. These results emphasize the potential risk of flea-borne infections transmitted by rodents in this area, and suggest that preventive measures should be taken in the general framework of zoonoses management.
POLYGENIC DETECTION OF RICKETTSIA FELIS IN CAT FLEAS (CTENOCEPHALIDES FELIS) FROM ISRAEL
Authors: BAUER OMRI , BANETH GAD , ESHKOL TAMAR , SHAW SUSAN E. , HARRUS SHIMON
Published: September 2018

The presence of Rickettsia felis, an emerging bacterial pathogen, was investigated in 79 cat flea (Cteno-cephalides felis) pools from Israel (5 to 20 fleas each) by polymerase chain reaction (PCR) and sequencing of 5 different genes. Amplified targets included both metabolic (gltA and fusA) and surface antigen (ompA, ompB, and the 17-kDa antigen) genes. R. felis DNA was detected in 7.6% of the flea pools. Two genotypes similar in their housekeeping gene sequences but markedly different in their surface antigenic genetic milieus were characterized. This is the first detection of this flea-transmitted rickettsia within its vector in Israel and the Middle East. Although no clinical case has been reported in human beings in Israel to date, these findings suggest that this infection is prevalent in Israel.
FIRST MOLECULAR DETECTION OF RICKETTSIA FELIS IN FLEAS FROM ALGERIA
Authors: BITAM IDIR , PAROLA PHILIPPE , DE LA CRUZ KATHARINA DITTMAR , MATSUMOTO KOUTARO , BAZIZ BELKACEM , ROLAIN JEAN-MARC , BELKAID MILOUD , RAOULT DIDIER
Published: September 2018

Fleas collected in Algeria in the district of Oran between July and September 2003 were tested by polymerase chain reaction for the presence of Rickettsia spp. DNA using primers amplifying gltA and OmpA genes. Two gltA sequences identical to those of an emerging pathogen, Rickettsia felis, were detected including i) R. felis California 2 in Ctenocephalides canis from rodents and ii) R. felis RF2125 in Archeopsylla erinacei from hedgehogs.
LOW MULTIPLICATION RATES OF AFRICAN PLASMODIUM FALCIPARUM ISOLATES AND LACK OF ASSOCIATION OF MULTIPLICATION RATE AND RED BLOOD CELL SELECTIVITY WITH MALARIA VIRULENCE
Authors: DEANS ANNE-MARIE , LYKE KIRSTEN E. , THERA MAHAMADOU A. , PLOWE CHRISTOPHER V. , KONÉ ABDOULAYE , DOUMBO OGOBARA K. , KAI OSCAR , MARSH KEVIN , MACKINNON MARGARET J. , RAZA AHMED , ROWE J. ALEXANDRA
Published: September 2018

Two potential malaria virulence factors, parasite multiplication rate (PMR) and red blood cell selectivity (measured as selectivity index [SI]), were assessed in Plasmodium falciparum clinical isolates from Mali and Kenya. At both sites, PMRs were low (Kenya median = 2.2, n = 33; Mali median = 2.6, n = 61) and did not differ significantly between uncomplicated and severe malaria cases. Malian isolates from hyperparasitemic patients had significantly lower PMRs (median = 1.8, n = 19) than other Malian isolates (uncomplicated malaria median = 3.1, n = 23; severe malaria median = 2.8, n = 19; P = 0.03, by Kruskal-Wallis test). Selective invasion occurred at both sites (Kenya geometric mean SI = 1.9, n = 98; Mali geometric mean SI = 1.6, n = 104), and there was no significant association between the SI and malaria severity. Therefore, in contrast to previous results from Thailand, we found no association of PMR and SI with malaria severity in African children. This raises the possibility of differences in the mechanisms of malaria virulence between sub-Saharan Africa and Asia.
MALARIA CONTROL IN HENAN PROVINCE, PEOPLE’S REPUBLIC OF CHINA
Authors: XU BIAN-LI , SU YUN-PU , SHANG LE-YUAN , ZHANG HONG-WEI
Published: September 2018

We analyzed malaria prevalence and evaluated the effect of malaria control measures in Henan Province, People’s Republic of China between 1993 and 2004. Data relating to malaria epidemics, malaria control measures and their effects, and vector surveillance between 1993 and 2004 were collected and analyzed. Mean malaria incidence during this period was 2.96/100,000. After integrated vector control measures and appropriate treatment of malaria cases were carried out, the number of malaria cases in Henan Province decreased from 4,815 in 2000 to 2,112 in 2004. The parasite-positive rate and the density of Anopheles anthropophagus were also reduced. Malaria control measures were effective and malaria incidence decreased in Henan. However, there are still more cases in this province than in 1992. Local malaria outbreaks and epidemics have occurred in areas where Anopheles anthropophagus and An. sinensis are present. Thus, malaria control measures should be strengthened.
DIAGNOSIS OF MALARIA BY MAGNETIC DEPOSITION MICROSCOPY
Authors: ZIMMERMAN PETER A. , THOMSON JODI M. , FUJIOKA HISASHI , COLLINS WILLIAM E. , ZBOROWSKI MACIEJ
Published: September 2018

Although malaria contributes to a significant public health burden, malaria diagnosis relies heavily on either non-specific clinical symptoms or blood smear microscopy methods developed in the 1930s. These approaches severely misrepresent the number of infected individuals and the reservoir of parasites in malaria-endemic communities and undermine efforts to control disease. Limitations of conventional microscopy-based diagnosis center on time required to examine slides, time required to attain expertise sufficient to diagnose infection accurately, and attrition from the limited number of existing malaria microscopy experts. Earlier studies described magnetic properties of Plasmodium falciparum but did not refine methods to diagnosis infection by all four human malaria parasite species. Here, following specific technical procedures, we show that it is possible to concentrate all four human malaria parasite species, at least 40-fold, on microscope slides using very inexpensive magnets through an approach termed magnetic deposition microscopy. This approach delivered greater sensitivity than a thick smear preparation while maintaining the clarity of a thin smear to simplify species-specific diagnosis. Because the magnetic force necessary to concentrate parasites on the slide is focused at a precise position relative to the magnet surface, it is possible to examine a specific region of the slide for parasitized cells and avoid the time-consuming process of scanning the entire slide surface. These results provide insight regarding new strategies for performing malaria blood smear microscopy.
STABILITY OF INTERFERON-γ AND INTERLEUKIN-10 RESPONSES TO PLASMODIUM FALCIPARUM LIVER STAGE ANTIGEN-1 AND THROMBOSPONDIN-RELATED ADHESIVE PROTEIN IN RESIDENTS OF A MALARIA HOLOENDEMIC AREA
Authors: MOORMANN ANN M. , JOHN CHANDY C. , SUMBA PETER ODADA , TISCH DANIEL , EMBURY PAULA , KAZURA JAMES W.
Published: September 2018

The stability of anti-malarial immunity will influence the interpretation of immunologic endpoints during malaria vaccine trials conducted in endemic areas. Therefore, we evaluated cytokine responses to Plasmodium falciparum liver stage antigen-1 (LSA-1) and thrombospondin-related adhesive protein (TRAP) by Kenyans from a holoendemic area at a 9-month interval. The proportion of adults with interferon-γ (IFN-γ) responses to 9-mer LSA-1 peptides was similar at both time-points, whereas responses from children decreased (P < 0.05). Response to the longer, 23-mer LSA-1 peptide was variable, decreasing in adults and children over time (P < 0.02 and P < 0.001, respectively). The proportion of children with IFN-γ responses to either antigen at the second time-point was significantly lower than that of adults, yet more adults responded to 9-mer TRAP peptides (P < 0.02). In contrast, the proportion of interleukin-10 responses to LSA-1 and TRAP was similar at both time-points for both age groups. Most noteworthy was that even when the repeat cross-sectional frequency of cytokine responses was the same, these responses were not generated by the same individuals. This suggests that cytokine responses to LSA-1 and TRAP are transient under natural exposure conditions.
CLONING OF THE BABESIA GIBSONI CYTOCHROME B GENE AND ISOLATION OF THREE SINGLE NUCLEOTIDE POLYMORPHISMS FROM PARASITES PRESENT AFTER ATOVAQUONE TREATMENT
Authors: MATSUU AYA , MIYAMOTO KAYOKO , IKADAI HIROMI , OKANO SHOZO , HIGUCHI SEIICHI
Published: September 2018

We determined the nucleotide sequence of the Babesia gibsoni cytochrome b (cytb) gene. DNA was extracted from B. gibsoni isolated from Aomori Prefecture, Japan, and 1,288 basepairs of the cytb gene, including 1,071 basepairs of the open reading frame, were sequenced. The cytb gene of B. gibsoni obtained from three dogs that had been experimentally infected with B. gibsoni and treated with atovaquone was also sequenced. The B. gibsoni cytb gene obtained from all three atovaquone-treated dogs contained a single polymorphism resulting in an amino acid change in one of the putative ubiquinone-binding sites of Plasmodium falciparum. This polymorphism was homologous to mutations in other apicomplexan protozoa that exhibit resistance to atovaquone. Two other single polymorphisms were identified in parasites isolated from two of the dogs. These results indicate that single nucleotide polymorphisms in the sequence for mitochondrial cytb gene may be associated with decreased susceptibility of Babesia species to atovaquone.
RISK FACTORS FOR DEATH IN ACQUIRED IMMUNODEFICIENCY SYNDROME–ASSOCIATED DISSEMINATED HISTOPLASMOSIS
Authors: DE FRANCESCO DAHER ELIZABETH , DE SOUSA BARROS FERNANDO ANTONIO , DA SILVA JÚNIOR GERALDO BEZERRA , TAKEDA CHRISTIANNE FERNANDES VALENTE , MOTA ROSA MARIA SALANI , FERREIRA MARÚSIA THOMAZ , MARTINS JULIETA CUNHA , OLIVEIRA SORAYA ALVES JACINTO , GUTIÉRREZ-ADRIANZÉN OSWALDO AUGUSTO
Published: September 2018

We performed a retrospective study of 164 human immunodeficiency virus (HIV)–infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] = 3.9, P = 0.001), neurologic manifestations (OR = 5.8, ; P = 0.001), hemoglobin level < 8.0g/dL (OR = 2.7, P = 0.004), urea level 2 times the normal upper limit (OR = 5.0, P < 0.001), creatinine level > 1.5 mg/dL (OR = 2.9, P = 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR = 3.1, P = 0.01), respiratory insufficiency (OR = 9.7, P < 0.001), sepsis (OR = 20.2, P < 0.001), and acute renal failure (OR = 2.5, P = 0.011). A hemoglobin level < 8.0 g/dL (OR = 3.8, P = 0.008), an AST level ≥ 2.5 times the normal limit (OR = 1.0, P = 0.007), acute renal failure (OR = 2.96, P = 0.015), and respiratory insufficiency (OR = 12.2, P = 0.01) were independent risk factors for death.
PREDICTING DENSITY OF IXODES PACIFICUS NYMPHS IN DENSE WOODLANDS IN MENDOCINO COUNTY, CALIFORNIA, BASED ON GEOGRAPHIC INFORMATION SYSTEMS AND REMOTE SENSING VERSUS FIELD-DERIVED DATA
Authors: EISEN REBECCA J. , EISEN LARS , LANE ROBERT S.
Published: September 2018

Ixodes pacificus nymphs are the primary vectors to humans of Borrelia burgdorferi, the etiologic agent of Lyme disease, in California. We used a supervised classification model, based on remote sensing (RS) data from multi-seasonal Landsat TM 5 images, to identify the key habitat in Mendocino County where humans are exposed to I. pacificus nymphs (woodlands carpeted with leaf litter). The model, based on the normalized difference vegetation index (NDVI), brightness, and wetness, separated the nymphal risk habitat (52.6% of the county) from other habitat types with > 93% user and producer accuracies. Next, we determined the density of questing nymphs in 62 woodland-leaf areas located throughout Mendocino County and created forward-stepwise regression models explaining the variation in nymphal density based on traits attainable by a lay-person in the field (e.g., tree species present, deer signs; r2 = 0.43, P < 0.0001), or geographic information systems (GIS)/RS-based environmental data (r2 = 0.50, P < 0.0001). The GIS/RS model, using July NDVI, November greenness, a coastal influence category, May solar insolation, November hours of sunlight, and dominant hydrologic grouping as input variables, was 22% more accurate in predicting nymphal density at 16 validation sites (r2 = 0.72) than the field-derived data model (r2 = 0.50). The habitat classification and GIS/RS models were combined to create a continuous nymphal density surface for the entirety of Mendocino County. This risk surface showed that 11.9% of the county was classified as habitat posing at least moderate risk of human exposure to nymphs (> 6.4 nymphs per 100 m2). Furthermore, high-risk areas (> 10.5 nymphs per 100 m2; 1.7% of the county) tended to cluster in the central interior and most heavily populated region of Mendocino County, but were rare in the proximity of coastal population centers.
PCR-BASED ASSAY TO SURVEY FOR KNOCKDOWN RESISTANCE TO PYRETHROID ACARICIDES IN HUMAN SCABIES MITES (SARCOPTES SCABIEI VAR HOMINIS)
Authors: PASAY CIELO , WALTON SHELLEY , FISCHER KATJA , HOLT DEBORAH , MCCARTHY JAMES
Published: September 2018

Permethrin, in the form of a topical cream, is being increasingly used for community-based programs to control endemic scabies. The development of resistance has reduced the use of pyrethroids for the control of many arthropods of economic and health importance. The best recognized form of pyrethroid resistance, known as knockdown resistance or kdr, has been linked to specific mutations in the target of these agents, the para-homologous voltage-sensitive sodium channel gene (Vssc). To develop tools to study resistance to pyrethroid acaricides, we cloned 3711 and 6151 bp, respectively, of cDNA and genomic fragments of the Vssc gene from scabies mite, Sarcoptes scabiei. The sequence encompasses the major polymorphic amino acid residues associated with pyrethroid resistance. A polymerase chain reaction–based strategy has been developed that enables genotyping individual scabies mites. This will facilitate early detection and monitoring of pyrethroid resistance in scabies mite populations under drug selection pressure.
PATHOGENESIS OF WEST NILE VIRUS INFECTION IN DOGS TREATED WITH GLUCOCORTICOIDS
Authors: BOWEN RICHARD A. , ROUGE MELISSA M. , SIGER LEONARDO , MINKE JULES M. , NORDGREN ROBERT , KARACA KEMAL , JOHNSON JEREMY
Published: September 2018

Control and glucocorticoid-treated dogs were infected with West Nile virus (WNV) through the bites of infected mosquitoes to study the effect of a commonly used immunomodulator on the magnitude and duration of viremia and on development of clinical disease. All dogs became viremic after challenge. The peak viremia and integrated magnitude of viremia were approximately 40 and 50 times higher, respectively, in the five dogs treated with methyl-prednisolone for 1 month compared with untreated dogs. None of the five control or treated dogs developed signs of clinical disease, nor was histopathologic evidence of neuroinvasion observed in any case. Neutralizing antibodies to WNV were produced in all dogs, with no apparent effect of glucocorticoid treatment. Considering the dramatic effect of glucocorticoid treatment on magnitude of viremia, it is likely that this therapy had suppressive effects on some aspect of innate immunity or T cell function.
ARE PLASMODIUM FALCIPARUM PARASITES PRESENT IN PERIPHERAL BLOOD GENETICALLY THE SAME AS THOSE SEQUESTERED IN THE TISSUES?
Authors: DEMBO EDSON G. , PHIRI HAPPY T. , MONTGOMERY JACQUI , MOLYNEUX MALCOLM E. , ROGERSON STEPHEN J.
Published: September 2018

Since quinine does not inhibit the growth of Plasmodium falciparum ring stages or mature schizonts, parasites may continue to emerge from sequestration sites after starting treatment. We used polymerase chain reaction amplification of P. falciparum merozoite surface protein 1 (MSP-1) and MSP-2 alleles to distinguish genotypes infecting 58 children with severe malaria. To examine changes in parasite populations in peripheral blood over time, we compared changes in number and spectrum of genotypes in samples on admission to a hospital to those obtained up to 24 hours later. Thirty-four children lost genotypes, 21 retained genotypes, and 3 gained an extra P. falciparum genotype at one locus but not the other. The lack of novel genotypes emerging suggests that among children with severe malaria the dominant clones sequestered in deep organs are usually the same as those in peripheral circulation.
PREGNANCY OUTCOMES ASSOCIATED WITH PLASMODIUM VIVAX MALARIA IN NORTHEASTERN VENEZUELA
Authors: RODRIGUEZ-MORALES ALFONSO J. , SANCHEZ ELIA , VARGAS MIGUEL , PICCOLO CARMELINA , COLINA ROSA , ARRIA MELISSA , FRANCO-PAREDES CARLOS
Published: September 2018

Although Plasmodium vivax is increasingly recognized as an important cause of morbidity in pregnancy in low malaria–transmission areas of Asia, little is know about the epidemiologic and clinical profiles of P. vivax in pregnant women in Latin America. We describe the clinical features and pregnancy outcomes in a series of 12 cases of P. vivax malaria in pregnant women complicated in some by miscarriage or preterm deliveries and in others with significant degrees of anemia and thrombocytopenia in a population where P. vivax is endemic in northeastern Venezuela.
POPULATION STRUCTURE OF THE MALARIA VECTOR ANOPHELES DARLINGI IN A MALARIA-ENDEMIC REGION OF EASTERN AMAZONIAN BRAZIL
Authors: CONN JAN E. , VINEIS JOSEPH H. , BOLLBACK JONATHAN P. , ONYABE DAVID Y. , WILKERSON RICHARD C. , PÓVOA MARINETE M.
Published: September 2018

Anopheles darlingi is the primary malaria vector in Latin America, and is especially important in Amazonian Brazil. Historically, control efforts have been focused on indoor house spraying using a variety of insecticides, but since the mid-1990s there has been a shift to patient treatment and focal insecticide fogging. Anopheles darlingi was believed to have been significantly reduced in a gold-mining community, Peixoto de Azevedo (in Mato Grosso State), in the early 1990s by insecticide use during a severe malaria epidemic. In contrast, although An. darlingi was eradicated from some districts of the city of Belem (the capital of Para State) in 1968 to reduce malaria, populations around the water protection area in the eastern district were treated only briefly. To investigate the population structure of An. darlingi including evidence for a population bottleneck in Peixoto, we analyzed eight microsatellite loci of 256 individuals from seven locations in Brazil: three in Amapa State, three in Para State, and one in Mato Grosso State. Allelic diversity and mean expected heterozygosity were high for all populations (mean number alleles/locus and HE were 13.5 and 0.834, respectively) and did not differ significantly between locations. Significant heterozygote deficits were associated with linkage disequilibrium, most likely due to either the Wahlund effect or selection. We found no evidence for a population bottleneck in Peixoto, possibly because the reduction was not extreme enough to be detected. Overall estimates of long-term Ne varied from 92.4 individuals under the linkage disequilibrium model to ∞ under the heterozygote excess model. Fixation indices and analysis of molecular variance demonstrated significant differentiation between locations north and south of the Amazon River, suggesting a degree of genetic isolation between them, attributed to isolation by distance.
ECOLOGY OF THE LEISHMANIA SPECIES IN THE GUIANAN ECOREGION COMPLEX
Authors: ROTUREAU BRICE
Published: September 2018

In the Guianan ecoregion complex, at least seven Leishmania species belonging to both the L. (Leishmania) Saf’ janova, 1982 and L. (Viannia) Lainson and Shaw, 1987 sub-genera are causative agents of American visceral leishmaniasis, mucocutaneous leishmaniasis, and cutaneous leishmaniases, including localized and diffuse forms. They are mostly sylvatic species subjugated to their own specific Lutzomyia sand fly vectors and to particular wild mammalian reservoir hosts of the dense rain forest. Originally implicated strictly in wild zoonoses and developing in forested ecotopes, Leishmania show a particular adaptive plasticity to face environmental modifications following deforestation and anthropization. This review presents the different pathogenic complexes of these parasites, emphasizes their implication in human diseases, and considers the influence of humans on their ecology.
HUMAN INTESTINAL CAPILLARIASIS (CAPILLARIA PHILIPPINENSIS) IN TAIWAN
Authors: LU LI-HUA , LIN MAU-ROUNG , CHOI WAI-MAU , HWANG KAO-PIN , HSU YUNG-HSIANG , BAIR MING-JONG , LIU JEAN-DEAN , WANG TSANG-EN , LIU TSANG-PAI , CHUNG WEN-CHENG
Published: September 2018

Capillaria philippinensis was first reported in 1963 in the Philippines. Major outbreaks have occurred in the Philippines and Thailand. This article reviews the known 30 intestinal capillariasis cases in Taiwan from January 1983 to December 2003. The infected cases were diagnosed each year with the exception of 1984 and 2002, making Taiwan a capillaria-prevalent area. Two Taiwanese aboriginal tribes, the Ami and Paiwan, presented a high prevalence. The males and elderly also had a high infection rate. Nine cases were diagnosed by histopathological biopsied specimens. About half of the 30 cases denied having consumed raw or undercooked fish. All cases recovered to health after receiving medication, with no deaths or recurrences.
SCHISTOSOMA MANSONI, NEMATODE INFECTIONS, AND PROGRESSION TO ACTIVE TUBERCULOSIS AMONG HIV-1–INFECTED UGANDANS
Authors: BROWN MICHAEL , MIIRO GEORGE , NKURUNZIZA PETER , WATERA CHRISTINE , QUIGLEY MARIA A. , DUNNE DAVID W. , WHITWORTH JAMES A. G. , ELLIOTT ALISON M.
Published: September 2018

Rates of tuberculosis (TB) in Africa are highest among people infected with HIV. Searching for additional risk factors in a cohort of HIV-infected Ugandan adults, we previously found that a type 2 cytokine bias and eosinophilia were associated with progression to active TB. A possible role for helminth infection was assessed in this study. We analyzed TB incidence in 462 members of this cohort who were screened for filarial infections, gastrointestinal nematodes, and schistosomiasis. Progression to TB was not associated with gastrointestinal nematodes (rate ratio [RR], 1.18; confidence intervals [CIs], 0.66–2.10) or Mansonella perstans (RR, 0.42; CI, 0.13–1.34). A weak association between Schistosoma mansoni infection and TB was found (RR, 1.42; CI, 0.86–2.34); after adjusting for potential explanatory variables and using more stringent diagnostic criteria, the association was strengthened (RR, 2.31; 1.00–5.33). This analysis suggests an effect of S. mansoni infection on progression to active TB among HIV-1–infected Ugandans.
PRESCRIPTION AND ADMINISTRATION OF A 14-DAY REGIMEN OF ZINC TREATMENT FOR CHILDHOOD DIARRHEA IN MALI
Authors: WINCH PETER J. , GILROY KATE E. , DOUMBIA SEYDOU , PATTERSON AMY E. , DAOU ZANA , COULIBALY SEYON , SWEDBERG ERIC , BLACK ROBERT E. , FONTAINE OLIVIER
Published: September 2018

We evaluated prescription and correct dosing of a 14-day course of dispersible zinc tablets prescribed to young children with diarrhea by community and facility workers in rural, southern Mali, West Africa. One hundred twenty-three children were followed at home on days 3 and 14 after being prescribed zinc. The age-appropriate dose of zinc was dispensed in 94% of cases. Ninety-five percent of mothers dissolved the tablet in a small amount of water and gave it with a spoon. Only eight caretakers reported problems with zinc administration: either vomiting or refusal to take the tablets. Sixty-four percent of children received the full 14-day course of treatment, and more than 89% of children were given at least a 10-day course of zinc treatment. The levels of correct administration were very good but might be lower under non-research conditions.
INCIDENCE, ETIOLOGY, AND IMPACT OF DIARRHEA AMONG LONG-TERM TRAVELERS (US MILITARY AND SIMILAR POPULATIONS): A SYSTEMATIC REVIEW
Authors: RIDDLE MARK S. , SANDERS JOHN W. , PUTNAM SHANNON D. , TRIBBLE DAVID R.
Published: September 2018

To determine regional estimates of pathogen-specific prevalence and incidence, as well as, describe morbidity associated with diarrhea among deployed US military and similar populations, a systematic review was conducted for publications between January 1990 to June 2005. Point estimates and confidence intervals of pathogen prevalence and travelers’ diarrhea incidence were combined in a random effects model and assessed for heterogeneity. In total, 262 studies were identified for potential inclusion, of which 52 fulfilled inclusion criteria. Overall, 38% were from the Middle East, 29% from Southeast Asia, 27% from Latin America/Caribbean, and 6% from sub-Saharan Africa. Median duration of travel was 1.5 months (interquartile range, 1–3 months). Enterotoxigenic Escherichia coli (ETEC), Campylobacter, and Shigella were identified as causing 38–45% of diarrhea, with regional and population differences. Incidence based on self-report was higher than studies using passive surveillance or clinic-based methods (29 versus 7 versus 6 episodes per 100 person-months, respectively) without regional differences.
RECOVERY AND USE OF PLASMODIUM DNA FROM MALARIA RAPID DIAGNOSTIC TESTS
Authors: VERON VINCENT , CARME BERNARD
Published: September 2018

The purpose of this study was to show that individual malaria rapid diagnosis tests (MRDTs) could also be used to isolate Plasmodium DNA for genetic studies. We extracted and amplified Plasmodium DNA using two commercial MRDT kits. Phenol/chloroform extraction followed by a nested polymerse chain reaction (PCR) can be used to identify Plasmodium falciparum and Plasmodium vivax from MRDTs. The PCR on MRDT-isolated DNA was more sensitive than antigen capture by MRDT. Satisfactory results were also obtained if older MRDT tests were used, even after long periods of storage at ambient temperature, with no special preservation.
HAPTOGLOBIN LEVELS ARE ASSOCIATED WITH HAPTOGLOBIN GENOTYPE AND α+-THALASSEMIA IN A MALARIA-ENDEMIC AREA
Authors: IMRIE HEATHER , FOWKES FREYA J.I. , MICHON PASCAL , TAVUL LIVINGSTONE , HUME JENNIFER C.C. , PIPER KAREN P. , REEDER JOHN C. , DAY KAREN P.
Published: September 2018

Haptoglobin (Hp) is an acute phase protein that removes free hemoglobin (Hb) released during hemolysis. Hp has also been shown to be toxic for malaria parasites. α+-Thalassemia is a hemoglobinopathy that results in subclinical hemolytic anemia. α+-Thassemia homozygosity confers protection against severe malarial disease by an as yet unidentified mechanism. Hp levels were measured in a serial cross-sectional survey of children in Madang Province, Papua New Guinea (PNG). Hp levels were related to age, Hp genotype, Hb levels, parasitemia, splenomegaly, and α+-thalassemia genotype. Surprisingly, children who were homozygous for α+ -thalassemia had significantly higher levels of Hp than did heterozygotes, after controlling for relevant confounders. We suggest that this is the result of either reduced mean cell Hb associated with α+ -thalassemia homozygosity or an elevated IL-6–dependent acute phase response.
REDUCTION IN INFECTION WITH PLASMODIUM FALCIPARUM ONE YEAR AFTER THE INTRODUCTION OF MALARIA CONTROL INTERVENTIONS ON BIOKO ISLAND, EQUATORIAL GUINEA
Authors: KLEINSCHMIDT IMMO , SHARP BRIAN , BENAVENTE LUIS E. , SCHWABE CHRIS , TORREZ MIGUEL , KUKLINSKI JAIME , MORRIS NATASHIA , RAMAN JAISHREE , CARTER JOSEPH
Published: September 2018

The Bioko Island Malaria Control Project was initiated in 2003 to substantially reduce malaria on the island of Bioko in Equatorial Guinea. The intervention consisted of generalized indoor residual spraying during the first year of the project. Case management and related measures were introduced during the second year. Two large household and parasitemia surveys of children 2 to < 15 years of age were carried out in 2004 and 2005, respectively, to assess the effect of the intervention after the first year. Patient records were collected retrospectively from one district hospital and analyzed for a comparison of pre-intervention and post-intervention periods. Overall mean prevalence of P. falciparum infection reduced from 46% (95% confidence interval [CI] = 40–51%) at baseline in 2004 to 31% (95% CI = 24–40%) in 2005 (P < 0.001). When the 12-month pre-intervention period was compared with the 12-month post-intervention period, there was a modest but statistically significant reduction in the number of malaria cases among hospital patients.
HIV INFECTION AMONG COMMERCIAL SEX WORKERS AND INJECTING DRUG USERS IN THE CZECH REPUBLIC
Authors: BRUCKOVA MARIE , BAUTISTA CHRISTIAN T. , GRAHAM ROSS R. , MALY MAREK , VANDASOVA JANA , PRESL JIRI , SUMEGH LASZLO , CHAPMAN GAIL D. , CARR JEAN K. , SANCHEZ JOSE L. , EARHART KENNETH C.
Published: September 2018

Since the first HIV case was diagnosed in the Czech Republic in 1985, there is a lack of information regarding the epidemiology of HIV infection in most high-risk groups. To determine the prevalence of, and risk factors for, HIV among female and male commercial sex workers (FCSW and MCSW, respectively) and injecting drug users (IDUs), cross-sectional studies were conducted in the cities of Cheb, Usti nad Labem, Ostrava, and Prague of the Czech Republic. A total of 1,277 subjects were enrolled, which included 585 FCSWs, 230 MCSWs, and 462 IDUs. The HIV prevalences were 0.7% (95% CI: 0.2–1.7%), 0.9% (95% CI: 0.1–3.1%), and 0.2% (95% CI: 0.005–1.2%) among FCSWs, MCSWs, and IDUs, respectively. Although low HIV prevalences were found, ongoing sentinel surveillance studies, which address modifiable behavioral and biologic risk factors among high-risk groups, are necessary to guide strategies to stem the tide of the epidemic in this country.
LEISHMANIA AMAZONENSIS INFECTIONS IN ORYZOMYS ACRITUS AND ORYZOMYS NITIDUS FROM BOLIVIA
Authors: KERR SARA F. , EMMONS LOUISE H. , MELBY PETER C. , LIU CHANG , PEREZ LUIS E. , VILLEGAS MARIA , MIRANDA ROBERT
Published: September 2018

Three of thirteen Oryzomys acritus, Emmons and Patton 2005 (Rodentia: Muridae: Sigmodontinae) and 3 of 17 Oryzomys nitidus, Thomas 1884, collected from Noël Kempff National Park, Bolivia, from 2002 to 2005, tested positive for Leishmania (Leishmania) amazonensis or L. (L.) mexicana and negative for Leishmania (Viannia) spp. using the polymerase chain reaction (PCR). Based on previous records of L. (L.) amazonensis in humans, rodents, and sand flies from Bolivia, and the geographic distributions of L. (L.) amazonensis and L. (L.) mexicana, it was concluded that the Oryzomys were infected with L. (L.) amazonensis. These results identify two additional species of Oryzomys as hosts of L. (L.) amazonensis, and identify an ecological region of Bolivia where L. (L.) amazonensis is enzootic.
SUCCESSFUL TREATMENT OF BLACK-GRAIN MYCETOMA WITH VORICONAZOLE
Authors: LOULERGUE PIERRE , HOT ARNAUD , DANNAOUI ERIC , DALLOT ALEXIANE , POIRÉE SYLVAIN , DUPONT BERTRAND , LORTHOLARY OLIVIER
Published: September 2018

Fungal mycetoma (or eumycetoma) are endemic diseases in tropical areas that have economic effects because of their chronic and disabling evolution. Classic treatments include surgery and antifungal drugs, but these have multiple side effects. We report a case of black-grain fungal mycetoma successfully treated with voriconazole without side effects. The duration of the treatment remains unclear, but must be prolonged because of the frequency of relapses.
ORAL REHYDRATION SOLUTION TO PREVENT NEPHROTOXICITY OF AMPHOTERICIN B
Authors: ECHEVARRIA JUAN , SEAS CARLOS , CRUZ MARIA , CHÁVEZ ELAINE , CAMPOS MIGUEL , CIEZA JAVIER , GOTUZZO EDUARDO , LLANOS ALEJANDRO
Published: September 2018

Treatment with amphotericin B deoxycholate (AB) is associated with dose-related nephrotoxicity. We conducted an open and randomized trial to evaluate the efficacy of an oral rehydration solution (ORS) to prevent nephrotoxicity of AB, compared with an intravenous saline solution (SS). Adult patients with mucosal leishmaniasis in whom AB was indicated received either three liters or ORS or one liter of SS. Renal function tests were performed at baseline and during treatment. Forty-eight patients were included (ORS = 25, SS = 23). No difference was observed in serum creatinine, creatinine clearance, serum urea, and serum sodium values during treatment, but serum potassium values were lower in the SS group than in the ORS group (P < 0.03). Treatment was more temporarily discontinued in the SS group than in the ORS group (7 patients versus 1 patient, P = 0.02). We conclude that ORS is comparable to SS in preventing glomerular damage of AB, but more effective in preventing hypokalemia.
CHARACTERIZATION OF SEPIK AND ENTEBBE BAT VIRUSES CLOSELY RELATED TO YELLOW FEVER VIRUS
Authors: KUNO GORO , CHANG GWONG-JEN J.
Published: September 2018

Yellow fever virus has a special place in medical history as the first animal virus isolated and as the prototype virus in the genus Flavivirus, which contains many serious human pathogens. Only recently, its closely related viruses within the group were identified phylogenetically. In this study, we obtained complete or near complete genome sequences of two viruses most closely related to yellow fever virus: Sepik virus of Papua New Guinea and Entebbe bat virus of Africa. Based on full-genomic characterization and genomic traits among related viruses, we identified Sepik virus to be most closely related to yellow fever virus and analyzed the pattern of repeat and conserved sequence motifs in the 3′-noncoding region among the members of yellow fever virus cluster. We also discuss the geographic dispersal as a part of ecological traits of this lineage of flaviviruses.
IMPORTED PLASMODIUM FALCIPARUM MALARIA: ARE PATIENTS ORIGINATING FROM DISEASE-ENDEMIC AREAS LESS LIKELY TO DEVELOP SEVERE DISEASE? A PROSPECTIVE, OBSERVATIONAL STUDY
Authors: JENNINGS RICHARD M. , DE SOUZA J. BRIAN , TODD JIM E. , ARMSTRONG MARGARET , FLANAGAN KATIE L. , RILEY ELEANOR M. , DOHERTY JUSTIN F.
Published: September 2018

Just more than 2,000 cases of Plasmodium falciparum malaria are reported in the United Kingdom annually, with a mortality rate of approximately 1%. Some studies suggest that patients with malaria who originate from disease-endemic areas are less likely to develop severe disease; such patients are often treated at home. We have prospectively examined 99 patients with imported P. falciparum malaria and categorized them according to severity as defined by World Health Organization criteria. There was no significant difference between those who developed severe disease and those who did not in terms of their ethnicity, residence in a malaria-endemic area, or history of previous episodes of malaria. To assume a patient has clinical immunity to malaria simply because they originate from or have lived for a long time in a malaria-endemic area may be inappropriate and unsafe.
RE-INGESTION OF PLASMODIUM BERGHEI SPOROZOITES AFTER DELIVERY INTO THE HOST BY MOSQUITOES
Authors: KEBAIER CHAHNAZ , VANDERBERG JEROME P.
Published: September 2018

Malaria-infected mosquitoes feeding on a mammalian host inject sporozoites into the skin to induce a malaria infection. The numbers of sporozoites ultimately able to reach the liver may be important determinants of the characteristics of the ensuing blood infection. Because feeding mosquitoes not only inject sporozoites into the host but concomitantly ingest blood to obtain their bloodmeal, some sporozoites are re-ingested by the feeding mosquito. We studied transmission of fluorescent Plasmodium berghei sporozoites injected into mice by Anopheles stephensi mosquitoes and found that the numbers of sporozoites re-ingested by mosquitoes are comparable to numbers previously reported to be delivered directly into mice. Thus, re-ingestion of sporozoites likely plays a significant role in transmission dynamics of malaria by mosquitoes, and may account for the failure of some sporozoite-infected mosquitoes to induce a blood infection.
EVALUATION OF THREE RAPID TESTS FOR DIAGNOSIS OF P. FALCIPARUM AND P. VIVAX MALARIA IN COLOMBIA
Authors: VAN DEN BROEK INGRID , HILL OLIVIA , GORDILLO FABIOLA , ANGARITA BIBIANA , HAMADE PRUDENCE , COUNIHAN HELEN , GUTHMANN JEAN-PAUL
Published: September 2018

The diagnostic capacity of three malaria rapid diagnostic tests (RDTs), NOW-Malaria-ICT, OptiMAL-IT, and Paracheck-Pf, was evaluated against expert microscopy in Colombia. We tested 896 patients, of whom microscopy confirmed 139 P. falciparum, 279 P. vivax, and 13 mixed P.f/P.v infections and 465 negatives. Paracheck-Pf and NOW-malaria-ICT were more accurate in detecting P. falciparum (sensitivities 90.8% and 90.1%, respectively) in comparison with Optimal-IT (83.6%). NOW showed an acceptable Pf detection rate at low densities (< 500/μL), but resulted in a higher proportion of false positives. For P. vivax diagnosis, Optimal-IT had a higher sensitivity than NOW (91.0% and 81.4%, respectively). The choice between the two Pf/Pv detecting RDTs balances P. falciparum and P. vivax detection rates. Considering some degree of P. falciparum overtreatment and failure to detect all P. vivax cases as more acceptable than missing some cases of P. falciparum, we recommend careful implementation of NOW-malaria-ICT in areas where microscopy is lacking. The price is however still a constraint.
HIGH EFFICACY OF TWO ARTEMISININ-BASED COMBINATIONS (ARTESUNATE + AMODIAQUINE AND ARTEMETHER + LUMEFANTRINE) IN CAALA, CENTRAL ANGOLA
Authors: GUTHMANN JEAN-PAUL , COHUET SANDRA , RIGUTTO CHRISTINE , FORTES FILOMENO , SARAIVA NILTON , KIGULI JAMES , KYOMUHENDO JULIET , FRANCIS MAX , NOËL FRÉDÉRIC , MULEMBA MARYLINE , BALKAN SUNA
Published: September 2018

In April 2004, 137 children 6–59 months of age with uncomplicated Plasmodium falciparum (Pf) malaria (Caala, Central Angola) were randomized to receive either artemether-lumefantrine (Coartem) or artesunate + amodiaquine (ASAQ). After 28 days of follow-up, there were 2/61 (3.2%) recurrent parasitemias in the Coartem group and 4/64 (6.2%) in the ASAQ group (P = 0.72), all classified as re-infections after PCR genotyping (cure rate = 100% [95%CI: 94–100] in both groups). Only one patient (ASAQ group) had gametocytes on day 28 versus five (Coartem) and three (ASAQ) at baseline. Compared with baseline, anemia was significantly improved after 28 days of follow-up in both groups (Coartem: from 54.1% to 13.4%; ASAQ: from 53.1% to 15.9%). Our findings are in favor of a high efficacy of both combinations in Caala. Now that Coartem has been chosen as the new first-line anti-malarial, the challenge is to insure that this drug is available and adequately used.
MOLECULAR MARKERS ASSOCIATED WITH PLASMODIUM FALCIPARUM RESISTANCE TO SULFADOXINE-PYRIMETHAMINE IN THE DEMOCRATIC REPUBLIC OF CONGO
Authors: COHUET SANDRA , BONNET MARYLINE , VAN HERP MICHEL , VAN OVERMEIR CHANTAL , D’ALESSANDRO UMBERTO , GUTHMANN JEAN-PAUL
Published: September 2018

Sulfadoxine-pyrimethamine (SP) is the first line antimalarial treatment in the Democratic Republic of Congo. Using polymerase chain reaction, we assessed the prevalence of mutations in the dihydrofolate reductase (dhfr) (codons 108, 51, 59) and dihydropteroate synthase (dhps) (codons 437, 540) genes of Plasmodium falciparum, which have been associated with resistance to pyrimethamine and sulfadoxine, respectively. Four hundred seventy-four patients were sampled in Kilwa (N = 138), Kisangani (N = 112), Boende (N = 106), and Basankusu (N = 118). The proportion of triple mutations dhfr varied between sites but was always > 50%. The proportion of dhps double mutations was < 20%, with some sites as low as 0.9%. A quintuple mutation was present in 12.8% (16/125) samples in Kilwa; 11.9% (13/109) in Kisangani, 2.9% (3/102) in Boende, and 0.9% (1/112) in Basankusu. These results suggest high resistance to pyrimethamine alone or combined with sulfadoxine. Adding artesunate to SP does not seem a valid alternative to the current monotherapy.
ASSOCIATION BETWEEN MUTATIONS IN PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER AND P. FALCIPARUM MULTIDRUG RESISTANCE 1 GENES AND IN VIVO AMODIAQUINE RESISTANCE IN P. FALCIPARUM MALARIA–INFECTED CHILDREN IN NIGERIA
Authors: HAPPI C. T. , GBOTOSHO G. O. , FOLARIN O. A. , BOLAJI O. M. , SOWUNMI A. , KYLE D. E. , MILHOUS W. , WIRTH D. F. , ODUOLA A. M. J.
Published: September 2018

This study investigated the association between Plasmodium falciparum chloroquine resistance transporter (pfcrt) T76 and P. falciparum multidrug resistance gene 1 (pfmdr1) Y86 alleles and in vivo amodiaquine (AQ) resistance, as well as the clearance of parasites harboring these two alleles in children treated with AQ in southwest Nigeria. One hundred one children with acute uncomplicated P. falciparum malaria infections were treated with the standard dosage of AQ and followed-up for 28 days. Blood samples were collected on filter paper samples at enrollment and during follow-up for identification of parasite genotypes and pfcrt and pfmdr1 mutations using polymerase chain reaction and restriction fragment length polymorphism approaches. Parasitologic assessment of response to treatment showed that 87% and 13% (RI) of patients were cured and failed treatment, respectively. Although infections in patients were polyclonal (as determined by merozoite surface protein 2 genotyping), the presence of both mutants pfcrtT76 and pfmdr1Y86 alleles in parasites is associated with in vivo AQ resistance (odds ratio = 7.58, 95% confidence interval = 1.58–36.25, P = 0.006) and is selected by the drug in children who failed AQ treatment. Treatment failure with the combination of mutant pfcrtT76 and pfmdr1Y86 alleles as well as the ability of patients to clear these resistant parasites is dependent on age, suggesting a critical role of host immunity in clearing AQ-resistant P. falciparum. The combination of mutant pfcrtT76 and pfmdr1Y86 alleles may be useful markers for monitoring the development and spread of AQ resistance, when combining this drug with other antimalarials for treatment of malaria in Africa.
TRANSMISSION OF HEPATITIS C VIRUS BETWEEN PARENTS AND CHILDREN
Authors: MOHAMED MOSTAFA K. , MAGDER LAURENCE S. , ABDEL-HAMID MOHAMED , EL-DALY MAY , MIKHAIL NABIEL N. , ABDEL-AZIZ FATMA , MEDHAT AHMED , THIERS VALERIE , STRICKLAND G. THOMAS
Published: September 2018

Egyptian children with infected parents are at high risk of infection with hepatitis C (HCV). Analysis of data collected during surveys of rural communities show children whose parents had antibodies to HCV (anti-HCV) were at higher risk for having anti-HCV than children whose parents did not. The association was greater with mothers than fathers and when the parent had HCV RNA. For instance, 87 (14%) of 612 children had anti-HCV whose mothers had HCV RNA compared with 28 (7%) of 401 whose mothers only had anti-HCV and 79 (2.6%) of 3,086 whose mothers were seronegative. These associations persisted after controlling for age, parenteral exposures, and serologic status of the other parent. Sequencing isolates from 13 families with parent(s) and children having HCV RNA showed 10 of 18 had genetically similar viruses. These findings suggest Egyptian children are at high risk of being infected with HCV by their parents and identification of the transmission routes would allow for preventive measures.
PHASE 1 SAFETY AND IMMUNOGENICITY TRIAL OF MALARIA VACCINE RTS,S/AS02A IN ADULTS IN A HYPERENDEMIC REGION OF WESTERN KENYA
Authors: STOUTE JOSÉ A. , HEPPNER D. GRAY , MASON CARL J. , SIANGLA JORAM , OPOLLO MALACHI O. , KESTER KENT E. , VIGNERON LAURENCE , VOSS GERALD , WALTER MICHAEL J. , TORNIEPORTH NADIA , COHEN JOE D. , BALLOU W. RIPLEY
Published: September 2018

We conducted a phase 1 trial of candidate malaria vaccine RTS,S/AS02A in western Kenya to determine its safety and immunogenicity in healthy adults in an area hyperendemic for malaria. Twenty adults were enrolled and received RTS,S/AS02A (50 μg of RTS,S in 0.5 mL of AS02A) by intramuscular injection on a 0-, 28-, and 178-day schedule. All 60 scheduled immunizations were given, and 18 of 20 volunteers completed the last study visit on day 210. The vaccine was safe and well-tolerated. There were no vaccine-related severe adverse events. The most common solicited adverse events associated with immunization were injection site pain and headache. The geometric mean concentration of antibodies to circumsporozoite protein was 1.9 μg/mL at baseline and it increased 2–4 weeks after each dose to 16, 17.8, and 36.6 μg/mL, respectively. These safety and immunogenicity data from adults in hyperendemic Kenya are comparable to data reported earlier from two trials in west African adults in hypo-endemic and meso-endemic areas of The Gambia. We conclude that in this small study, RTS,S/AS02A is safe and similarly immunogenic in malaria-exposed African adults of different ethnicity in different transmission settings.
ROLE OF TYPE I/II SCAVENGER RECEPTORS IN MALARIAL INFECTION IN C57BL/6J MICE
Authors: INOUE MAI , XUAN XUENAN , FUJISAKI KOZO , IGARASHI IKUO , SUZUKI HIROSHI
Published: September 2018

Although it is well known that SR-A I/II plays a significant role in host defense against bacterial and viral infection, the contribution of SR-A I/II to protozoan infection is not well understood. Thus, we examined the possible role of SR-A I/II against murine malarial infection, such as Plasmodium. berghei and P. yoelli, by using SR-A I/II knockout mice with a C57BL/6J genetic background. When SR-A I/II knockout mice were infected with P. berghei NK65 or P. yoelli 17X, their survival rates were not significantly different from wild-type animals. In terms of the kinetics of parasitemia, hematocrit values and the number of white blood cells, there were no significant differences between the genotypes in P. berghei NK65 or P. yoelli 17X infection. Taken together with the findings in our previous report, the SR-A I/II functional contribution to host defense in malarial infection does not seem to be widely extended, and the effect of SR-A I/II seem in collaboration with other, as yet unidentified, gene(s).