Contributions
Abstract: PB2041
Type: Publication Only
Background
Rising evidence of artemisin resistant malaria in Indian subcontinent and South America has prompted researchers to search for alternative antimalarials. In the last few decades, few reports and subsequent in vitro results have emerged showing dependence of malarial parasites, particularly Pl. falciparum on RBC tyrosine kinases for its maturation and egress. As there were no clinical data to support the hypothesis, we conducted a case control study with patients of CML-CP on fixed dose Imatinib as cases and a representative healthy population as control
Aims
- To find the prevalence of asymptomatic malarial parasitemia in patients of CML-CP on Imatinib and compare with the prevalence in healthy blood donors
- To internally validate the results of positive RDT samples with PCR in both cases and controls
Methods
A standard questionnaire and Rapid Diagnostic Test (RDT) for plasmodium antigens from the blood of cases attending CML clinic were used as study tools. 191 CML patients on Imatinib 400mg/d for a minimum period of 1 year were analysed
Results
Out of 54 febrile episodes during the study period, one patient had vivax malaria. RDT testing on non-febrile participants revealed two samples positive for dual vivax-falciparum antigens and the other two for vivax antigen. All positive results were internally validated with PCR using two species-specific forward primers which showed three cases positive for vivax and one positive for both vivax and falciparum. Among 205 controls selected from healthy voluntary blood donors, three had vivax infections, three had falciparum infections and four were found to have infections with both parasites. The prevalence of malarial infections in cases and controls were found to be 2.05% and 4.87% respectively while falciparum parasitemia in cases and controls were found to be 0.51% and 3.41% respectively. When analysed, the difference was found to be statistically significant.
Conclusion
In a malaria endemic region where asymptomatic parasitemia rates are high, imatinib mesylate given as a fixed daily dose provided protection to patients of CML-CP from falciparum malaria. However the association between the occurrence of vivax malaria and exposure to Imatinib was not statistically significant. The internal validation of positive samples by PCR showed a high, acceptable correlation.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): malaria, Tyrosine kinase inhibitor
Abstract: PB2041
Type: Publication Only
Background
Rising evidence of artemisin resistant malaria in Indian subcontinent and South America has prompted researchers to search for alternative antimalarials. In the last few decades, few reports and subsequent in vitro results have emerged showing dependence of malarial parasites, particularly Pl. falciparum on RBC tyrosine kinases for its maturation and egress. As there were no clinical data to support the hypothesis, we conducted a case control study with patients of CML-CP on fixed dose Imatinib as cases and a representative healthy population as control
Aims
- To find the prevalence of asymptomatic malarial parasitemia in patients of CML-CP on Imatinib and compare with the prevalence in healthy blood donors
- To internally validate the results of positive RDT samples with PCR in both cases and controls
Methods
A standard questionnaire and Rapid Diagnostic Test (RDT) for plasmodium antigens from the blood of cases attending CML clinic were used as study tools. 191 CML patients on Imatinib 400mg/d for a minimum period of 1 year were analysed
Results
Out of 54 febrile episodes during the study period, one patient had vivax malaria. RDT testing on non-febrile participants revealed two samples positive for dual vivax-falciparum antigens and the other two for vivax antigen. All positive results were internally validated with PCR using two species-specific forward primers which showed three cases positive for vivax and one positive for both vivax and falciparum. Among 205 controls selected from healthy voluntary blood donors, three had vivax infections, three had falciparum infections and four were found to have infections with both parasites. The prevalence of malarial infections in cases and controls were found to be 2.05% and 4.87% respectively while falciparum parasitemia in cases and controls were found to be 0.51% and 3.41% respectively. When analysed, the difference was found to be statistically significant.
Conclusion
In a malaria endemic region where asymptomatic parasitemia rates are high, imatinib mesylate given as a fixed daily dose provided protection to patients of CML-CP from falciparum malaria. However the association between the occurrence of vivax malaria and exposure to Imatinib was not statistically significant. The internal validation of positive samples by PCR showed a high, acceptable correlation.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): malaria, Tyrosine kinase inhibitor