Biomedical subjects

Pratap Singhasivanon

Publications and source records attributed to Pratap Singhasivanon.

42 records · Page 3Linked to original sources

PubMed2003

Effects of mefloquine usage on genetic polymorphism of Plasmodium falciparum in Thai-Myanmarese border.

We studied the polymorphism of msp-1, which encodes a major surface protein on the merozoite, isolated from blood samples from western Thailand in 1999. Our study area was a low-transmission area for malaria, where mefloquine has been used as an antimalarial drug since 1994. Forty-nine patients were confirmed to have contracted falciparum malaria twice within 24 weeks. The number of detected haplotypes in 49 patients was 89 at the first diagnosis and 68 at the second diagnosis. The mean number of haplotypes per patient significantly decreased from 1.82 to 1.39 but the frequency distributions of msp-1 haplotypes did not change significantly with the use of mefloquine. Our study strongly suggests that the antigenic diversity of Plasmodium falciparum is retained during mefloquine therapy in low-transmission areas.

Age Distribution↗

PubMed2003

Mekong malaria. II. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.

In an expansion of the first Mekong Malaria monograph published in 1999, this second monograph updates the malaria database in the countries comprising the Mekong region of Southeast Asia. The update adds another 3 years' information to cover cumulative data from the 6 Mekong countries (Cambodia, China/Yunnan, Lao PDR, Myanmar, Thailand, Viet Nam) for the six-year period 1999-2001. The objective is to generate a more comprehensive regional perspective in what is a global epicenter of drug resistant falciparum malaria, in order to improve malaria control on a regional basis in the context of social and economic change. The further application of geographical information systems (GIS) to the analysis has underscored the overall asymmetry of disease patterns in the region, with increased emphasis on population mobility in disease spread. Of great importance is the continuing expansion of resistance of P. falciparum to antimalarial drugs in common use and the increasing employment of differing drug combinations as a result. The variation in drug policy among the 6 countries still represents a major obstacle to the institution of region-wide restrictions on drug misuse. An important step forward has been the establishment of 36 sentinel sites throughout the 6 countries, with the objective of standardizing the drug monitoring process; while not all sentinel sites are fully operational yet, the initial implementation has already given encouraging results in relation to disease monitoring. Some decreases in malaria mortality have been recorded. The disease patterns delineated by GIS are particularly instructive when focused on inter-country distribution, which is where more local collaborative effort can be made to rationalize resource utilization and policy development. Placing disease data in the context of socio-economic trends within and between countries serves to further identify the needs and the potential for placing emphasis on resource rationalization on a regional basis. Despite the difficulties, the 6-year time frame represented in this monograph gives confidence that the now well established collaboration is becoming a major factor in improving malaria control on a regional basis and hopefully redressing to a substantial degree the key problem of spread of drug resistance regionally and eventually globally.

Animals↗

PubMed2002

Relationship between reactive nitrogen intermediates and total immunoglobulin E, soluble CD21 and soluble CD23: comparison between cerebral malaria and nonsevere malaria.

To search for evidence of a protective role of the CD23/NO pathway against cerebral malaria, concentrations of reactive nitrogen intermediates (RNI) and sCD21, total immunoglobulin (Ig)E and sCD23 were compared between 17 cases of cerebral malaria and 33 controls. The geometric mean of sCD23 concentration was higher among cerebral malaria cases than among controls (optical density 2643/1495, P = 0.01). The ratio between sCD21 and sCD23 was significantly lower in cerebral malaria cases than in controls (0.67 +/- 0.02 versus 0.77 +/- 0.02, respectively, P = 0.009). Multiple linear regression analysis showed that, among cerebral malaria cases, there was a clear correlation between RNI and both IgE (P = 0.007) and sCD21 (P < 0.0001). Among controls, there was a strong negative correlation between RNI and sCD23 concentrations (r = -0.61, P < 0.0001). However, multivariate analysis unmasked the fact that, in controls, there was also a positive correlation between RNI and IgE (P = 0.045). Logistic regression showed that increased RNI concentrations were associated with a cerebral malaria adjusted odds ratio of 1.05 per unit increase [95% confidence interval (CI) 1.006-1.1, P = 0.02] and that an increased ratio between sCD21 and sCD23 was associated with protection from cerebral malaria (adjusted OR = 0.00001 per unit increase (95% CI 0-0.03, P = 0.005). These different immunological profiles suggest that, among controls, the CD23/NO pathway was chronically stimulated whereas, in cerebral malaria, its stimulation was acute, which could explain why some patients developed cerebral malaria and others did not.

Animals↗

PubMed2002

Decreased hemoglobin concentrations, hyperparasitemia, and severe malaria are associated with increased Plasmodium falciparum gametocyte carriage.

To determine factors influencing gametocyte carriage, a cross-sectional study was conducted among 512 patients admitted for Plasmodium falciparum malaria. After adjustments for potential confounders, hemoglobin concentrations were lower in gametocyte carriers 10.5 (+/-2.5) than in patients without gametocytes 12.5 (+/-2.3) (P < 0.0001). Hemoglobin concentrations were negatively correlated with peak gametocyte counts (Spearman's p = -0.37, P < 0.0001) and gametocyte carriage durations (Spearman's p = -(0.30, P < 0.0001). Adjustments for the duration of the malaria episode and other potential confounders did not alter the association (P < 0.0001). After adjustment for potential confounders, the median asexual parasitemia was higher in patients with gametocytes than in patients without gametocytes (P = 0.003). Severe malaria cases were more likely to have gametocytes (65%) than malaria with hyperparasitemia (38%) or mild malaria (31%) (P = 0.0001). These findings suggest that events surrounding anemia and tissue hypoxia stimulate Plasmodium falciparum gametocytogenesis.

Adolescent↗

PubMed2002

Helminth infections are associated with protection from cerebral malaria and increased nitrogen derivatives concentrations in Thailand.

Following a study showing an association between Ascaris and protection from cerebral malaria, we hypothesized helminths may have induced protection through immunoglobulin E (IgE) and the CD23/NO pathway. We compared the prevalence of helminth infections in 67 cerebral malaria patients and 217 hyperparasitemic controls with no complications. For 24 cerebral malaria cases and 56 controls, we compared reactive nitrogen intermediates (RNI) concentrations and their correlations to total IgE and sCD23 concentrations in helminth-infected and noninfected patients. We observed a dose-dependent association between helminth infections and protection from cerebral malaria (adjusted odds ratio [OR] = 0.36, 95% CI = 0.19-0.7, P = 0.002, linear trend P = 0.0007). Helminth-infected controls had higher RNI concentrations than those without helminths: 72 OD +/- 19 SD and 57 OD +/- 20 SD, respectively (P = 0.006). Logistic regression, including interaction terms between RNI and sCD23, showed that an increase of RNI could be both protective and pathogenic depending on the concentration of sCD23. Helminths increasing both the CD23 receptor and its ligand may have a role in the establishment of malaria tolerance through the CD23/NO pathway.

Animals↗

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Beyond deworming.

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Anthelmintics↗