疟原虫 curtisi 和疟原虫 wallikeri 感染的比较:荟萃分析方法。

Comparison of Plasmodium ovale curtisi and Plasmodium ovale wallikeri infections by a meta-analysis approach.

机构信息

Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines.

出版信息

Sci Rep. 2021 Mar 19;11(1):6409. doi: 10.1038/s41598-021-85398-w.

Abstract

Malaria caused by Plasmodium ovale species is considered a neglected tropical disease with limited information about its characteristics. It also remains unclear whether the two distinct species P. ovale curtisi and P. ovale wallikeri exhibit differences in their prevalence, geographic distribution, clinical characteristics, or laboratory parameters. Therefore, this study was conducted to clarify these differences to support global malaria control and eradication programs. Studies reporting the occurrence of P. ovale curtisi and P. ovale wallikeri were explored in databases. Differences in proportion, clinical data, and laboratory parameters between the two species were estimated using a random-effects model and expressed as pooled odds ratios (ORs), mean difference (MD), or standardized MD depending on the types of extracted data. The difference in geographical distribution was visualized by mapping the origin of the two species. A total of 1453 P. ovale cases extracted from 35 studies were included in the meta-analysis. The p-value in the meta-analyses provided evidence favoring a real difference between P. ovale curtisi malaria cases (809/1453, 55.7%) and P. ovale wallikeri malaria cases (644/1453, 44.3%) (p: 0.01, OR 1.61, 95% CI 0.71-3.63, I: 77%). Subgroup analyses established evidence favoring a real difference between P. ovale curtisi and P. ovale wallikeri malaria cases among the imported cases (p: 0.02, 1135 cases). The p value in the meta-analyses provided evidence favoring a real difference in the mean latency period between P. ovale curtisi (289 cases) and P. ovale wallikeri malaria (266 cases) (p: 0.03, MD: 27.59, 95% CI 1.99-53.2, I: 94%), total leukocyte count (p < 0.0001, MD: 840, 95% CI 610-1070, I: 0%, two studies) and platelet count (p < 0.0001, MD: 44,750, 95% CI 2900-60,500, I: 32%, three studies). Four continents were found to have reports of P. ovale spp., among which Africa had the highest number of reports for both P. ovale spp. in its 37 countries, with a global proportion of 94.46%, and an almost equal distribution of both P. ovale spp., where P. ovale curtisi and P. ovale wallikeri reflected 53.09% and 46.90% of the continent's proportion, respectively. This is the first systematic review and meta-analysis to demonstrate the differences in the characteristics of the two distinct P. ovale species. Malaria caused by P. ovale curtisi was found in higher proportions among imported cases and had longer latency periods, higher platelet counts, and higher total leukocyte counts than malaria caused by P. ovale wallikeri. Further studies with a larger sample size are required to confirm the differences or similarities between these two species to promote malaria control and effective eradication programs.

摘要

卵形疟原虫引起的疟疾被认为是一种被忽视的热带病,关于其特征的信息有限。目前尚不清楚两种不同的卵形疟原虫种——卵形疟原虫 curtisi 和卵形疟原虫 wallikeri 在流行率、地理分布、临床特征或实验室参数方面是否存在差异。因此,本研究旨在阐明这些差异,以支持全球疟疾控制和消除计划。在数据库中探索了报告卵形疟原虫 curtisi 和卵形疟原虫 wallikeri 发生情况的研究。使用随机效应模型估计两种物种之间比例、临床数据和实验室参数的差异,并根据提取数据的类型表示为汇总优势比(OR)、均值差(MD)或标准化 MD。通过绘制两种物种的起源图来可视化地理分布的差异。共有 35 项研究中的 1453 例卵形疟原虫病例纳入荟萃分析。荟萃分析中的 p 值提供了支持卵形疟原虫 curtisi 疟病例(809/1453,55.7%)和卵形疟原虫 wallikeri 疟病例(644/1453,44.3%)之间存在真实差异的证据(p:0.01,OR 1.61,95% CI 0.71-3.63,I:77%)。亚组分析证实了在输入病例中卵形疟原虫 curtisi 和卵形疟原虫 wallikeri 疟之间存在真实差异(p:0.02,1135 例)。荟萃分析中的 p 值提供了支持卵形疟原虫 curtisi(289 例)和卵形疟原虫 wallikeri(266 例)之间潜伏期平均差异的证据(p:0.03,MD:27.59,95% CI 1.99-53.2,I:94%)、总白细胞计数(p<0.0001,MD:840,95% CI 610-1070,I:0%,两项研究)和血小板计数(p<0.0001,MD:44750,95% CI 2900-60500,I:32%,三项研究)之间存在真实差异。发现有 4 个大洲有卵形疟原虫 spp. 的报告,其中非洲在其 37 个国家中报告了最多的卵形疟原虫 spp.,占全球的 94.46%,并且两种卵形疟原虫 spp. 的分布几乎相等,卵形疟原虫 curtisi 和卵形疟原虫 wallikeri 分别反映了该大陆比例的 53.09%和 46.90%。这是首次系统评价和荟萃分析,证明了两种不同卵形疟原虫种的特征存在差异。在输入病例中发现卵形疟原虫 curtisi 引起的疟疾比例较高,潜伏期较长,血小板计数较高,总白细胞计数较高。需要进一步开展更大样本量的研究,以确认这两种物种之间的差异或相似性,从而促进疟疾控制和有效的消除计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c329/7979700/21fad6c69159/41598_2021_85398_Fig1_HTML.jpg

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