{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T15:25:34Z","timestamp":1759073134462,"version":"3.37.3"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004257","name":"Helse Vest","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>When considering malaria disease severity, estimation of parasitemia in erythrocytes is important, but sometimes misleading, since the infected erythrocytes may be sequestered in peripheral capillaries. In African children and Asian adults with falciparum malaria, parasitemia as assessed by quantitative PCR (qPCR) in plasma seems to be a valuable indicator of disease severity, but data on African adults as well as the impact of co-infection with HIV is lacking.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In 131 patients with falciparum malaria in a public tertiary teaching hospital in Mozambique, plasma malaria parasitemia as assessed by qPCR, compared to qualitative malaria PCR in blood cell fraction, was related to malaria disease severity and HIV co-infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 131 patients with falciparum malaria, based on positive qualitative PCR in the blood cell fraction, 93 patients (72%) had positive malaria qPCR in plasma. Patients with severe malaria as defined by the WHO criteria had higher malaria quantitative plasma parasitemia (median 143 genomes\/\u00b5L) compared to those with uncomplicated malaria (median 55 genomes\/\u00b5L, <jats:italic>p<\/jats:italic>\u2009=\u20090.037) in univariate analysis, but this difference was attenuated after adjusting for age, sex and HIV co-infection (<jats:italic>p<\/jats:italic>\u2009=\u20090.055). A quarter of the patients with severe malaria had negative qPCR in plasma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study of adult African in-patients with falciparum malaria with and without HIV co-infection, neither confirms nor rejects previous studies of malaria qPCR in plasma as an indicator of disease severity in patients with falciparum malaria. There is a need for further and larger studies to clarify if parasitemia as assessed malaria qPCR in plasma could be a surrogate marker of disease severity in falciparum malaria.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-020-01399-3","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T18:13:56Z","timestamp":1582136036000},"page":"367-373","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Plasma parasitemia as assessed by quantitative PCR in relation to clinical disease severity in African adults with falciparum malaria with and without HIV co-infection"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6937-3580","authenticated-orcid":false,"given":"Aase","family":"Berg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marit G.","family":"Tellevik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel G.","family":"Haanshuus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingvild","family":"Dalen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Otterdal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thor","family":"Ueland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina J.","family":"Moyo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e5l","family":"Aukrust","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Langeland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"1399_CR1","unstructured":"WHO. Malaria fact sheet. 2018. https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/malaria. Accessed 21 Mar 2019."},{"key":"1399_CR2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12936-017-1731-1","volume":"16","author":"NJ White","year":"2017","unstructured":"White NJ. Malaria parasite clearance. Malar J. 2017;16:88.","journal-title":"Malar J"},{"key":"1399_CR3","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1186\/1475-2875-7-252","volume":"7","author":"A Berg","year":"2008","unstructured":"Berg A, Patel S, Langeland N, Blomberg B. Falciparum malaria and HIV-1 in hospitalized adults in Maputo, Mozambique: does HIV-infection obscure the malaria diagnosis? Malar J. 2008;7:252.","journal-title":"Malar J"},{"key":"1399_CR4","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1093\/infdis\/jis675","volume":"207","author":"IC Hendriksen","year":"2013","unstructured":"Hendriksen IC, White LJ, Veenemans J, Mtove G, Woodrow C, Amos B, et al. Defining falciparum-malaria-attributable severe febrile illness in moderate-to-high transmission settings on the basis of plasma PfHRP2 concentration. J Infect Dis. 2013;207:351\u201361.","journal-title":"J Infect Dis"},{"key":"1399_CR5","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1093\/infdis\/jiu590","volume":"211","author":"M Imwong","year":"2015","unstructured":"Imwong M, Woodrow CJ, Hendriksen IC, Veenemans J, Verhoef H, Faiz MA, et al. Plasma concentration of parasite DNA as a measure of disease severity in falciparum malaria. J Infect Dis. 2015;211:1128\u201333.","journal-title":"J Infect Dis"},{"key":"1399_CR6","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/S0020-7519(02)00111-X","volume":"32","author":"O Mercereau-Puijalon","year":"2002","unstructured":"Mercereau-Puijalon O, Barale JC, Bischoff E. Three multigene families in Plasmodium parasites: facts and questions. Int J Parasitol. 2002;32:1323\u201344.","journal-title":"Int J Parasitol"},{"key":"1399_CR7","doi-asserted-by":"publisher","first-page":"e1001788","DOI":"10.1371\/journal.pmed.1001788","volume":"12","author":"N Hofmann","year":"2015","unstructured":"Hofmann N, Mwingira F, Shekalaghe S, Robinson LJ, Mueller I, Felger I. Ultra-sensitive detection of Plasmodium falciparum by amplification of multi-copy subtelomeric targets. PLoS Med. 2015;12:e1001788.","journal-title":"PLoS Med"},{"key":"1399_CR8","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1017\/S0031182004005888","volume":"129","author":"J Krungkrai","year":"2004","unstructured":"Krungkrai J. The multiple roles of the mitochondrion of the malarial parasite. Parasitology. 2004;129:511\u201324.","journal-title":"Parasitology"},{"key":"1399_CR9","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0166-6851(99)00199-1","volume":"106","author":"LM Figueiredo","year":"2000","unstructured":"Figueiredo LM, Pirrit LA, Scherf A. Genomic organisation and chromatin structure of Plasmodium falciparum chromosome ends. Mol Biochem Parasitol. 2000;106:169\u201374.","journal-title":"Mol Biochem Parasitol"},{"key":"1399_CR10","doi-asserted-by":"publisher","first-page":"e0218982","DOI":"10.1371\/journal.pone.0218982","volume":"14","author":"CG Haanshuus","year":"2019","unstructured":"Haanshuus CG, M\u00f8rch K, Blomberg B, et al. Assessment of malaria real-time PCR methods and application with focus on low-level parasitaemia. PLoS ONE. 2019;14:e0218982.","journal-title":"PLoS ONE"},{"key":"1399_CR11","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1093\/cid\/cis590","volume":"55","author":"IC Hendriksen","year":"2012","unstructured":"Hendriksen IC, Ferro J, Montoya P, Chhaganlal KD, Seni A, Gomes E, et al. Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique. Clin Infect Dis. 2012;55:1144\u201353.","journal-title":"Clin Infect Dis"},{"key":"1399_CR12","doi-asserted-by":"publisher","first-page":"e88257","DOI":"10.1371\/journal.pone.0088257","volume":"9","author":"A Berg","year":"2014","unstructured":"Berg A, Patel S, Aukrust P, David C, Gonca M, Berg ES, et al. Increased severity and mortality in adults co-infected with malaria and HIV in maputo, mozambique: a prospective cross-sectional study. PLoS ONE. 2014;9:e88257.","journal-title":"PLoS ONE"},{"key":"1399_CR13","doi-asserted-by":"publisher","first-page":"749","DOI":"10.3201\/eid1505.081009","volume":"15","author":"V Chalwe","year":"2009","unstructured":"Chalwe V, Van Geertruyden JP, Mukwamataba D, Menten J, Kamalamba J, Mulenga M, et al. Increased risk for severe malaria in HIV-1-infected adults, Zambia. Emerg Infect Dis. 2009;15:749 (quiz 858).","journal-title":"Emerg Infect Dis."},{"key":"1399_CR14","doi-asserted-by":"publisher","first-page":"e114480","DOI":"10.1371\/journal.pone.0114480","volume":"9","author":"A Berg","year":"2014","unstructured":"Berg A, Patel S, Gonca M, David C, Otterdal K, Ueland T, et al. Cytokine network in adults with falciparum malaria and HIV-1: increased IL-8 and IP-10 levels are associated with disease severity. PLoS ONE. 2014;9:e114480.","journal-title":"PLoS ONE"},{"issue":"Suppl","key":"1399_CR15","first-page":"11","volume":"19","author":"WHO","year":"2014","unstructured":"WHO. Severe malaria. Trop Med Int Health. 2014;19(Suppl):11.","journal-title":"Trop Med Int Health"},{"key":"1399_CR16","doi-asserted-by":"publisher","first-page":"3303","DOI":"10.1128\/JCM.01057-14","volume":"52","author":"M Imwong","year":"2014","unstructured":"Imwong M, Hanchana S, Malleret B, Renia L, Day NP, Dondorp A, et al. High-throughput ultrasensitive molecular techniques for quantifying low-density malaria parasitemias. J Clin Microbiol. 2014;52:3303\u20139.","journal-title":"J Clin Microbiol"},{"key":"1399_CR17","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/S0140-6736(00)02727-6","volume":"356","author":"J Whitworth","year":"2000","unstructured":"Whitworth J, Morgan D, Quigley M, Smith A, Mayanja B, Eotu H, et al. Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study. Lancet. 2000;356:1051\u20136.","journal-title":"Lancet"},{"key":"1399_CR18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.nmni.2015.02.004","volume":"5","author":"L Dormond","year":"2015","unstructured":"Dormond L, Jaton K, de Valliere S, Genton B, Greub G. Malaria real-time PCR: correlation with clinical presentation. New Microbes New Infect. 2015;5:10\u20132.","journal-title":"New Microbes New Infect"},{"key":"1399_CR19","doi-asserted-by":"publisher","first-page":"ofw028","DOI":"10.1093\/ofid\/ofw028","volume":"3","author":"PP Nyein","year":"2016","unstructured":"Nyein PP, Aung NM, Kyi TT, Htet ZW, Anstey NM, Kyi MM, et al. High Frequency of Clinically Significant Bacteremia in Adults Hospitalized With Falciparum Malaria. Open Forum Infect Dis. 2016;3:ofw028.","journal-title":"Open Forum Infect Dis."},{"key":"1399_CR20","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1186\/1475-2875-11-201","volume":"11","author":"AA Lamikanra","year":"2012","unstructured":"Lamikanra AA, Dobano C, Jimenez A, Nhabomba A, Tsang HP, Guinovart C, et al. A direct comparison of real time PCR on plasma and blood to detect Plasmodium falciparum infection in children. Malar J. 2012;11:201.","journal-title":"Malar J"},{"key":"1399_CR21","doi-asserted-by":"publisher","first-page":"191","DOI":"10.4269\/ajtmh.2005.73.191","volume":"73","author":"L Andrews","year":"2005","unstructured":"Andrews L, Andersen RF, Webster D, Dunachie S, Walther RM, Bejon P, et al. Quantitative real-time polymerase chain reaction for malaria diagnosis and its use in malaria vaccine clinical trials. Am J Trop Med Hyg. 2005;73:191\u20138.","journal-title":"Am J Trop Med Hyg"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-020-01399-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s15010-020-01399-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-020-01399-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T07:37:48Z","timestamp":1613720268000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s15010-020-01399-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,19]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["1399"],"URL":"https:\/\/doi.org\/10.1007\/s15010-020-01399-3","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"type":"print","value":"0300-8126"},{"type":"electronic","value":"1439-0973"}],"subject":[],"published":{"date-parts":[[2020,2,19]]},"assertion":[{"value":"29 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}