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Open Access Research Article

Co-infections with Babesia microti and Plasmodium parasites along the China-Myanmar border

Xia Zhou12, Sheng-Guo Li3, Shen-Bo Chen1, Jia-Zhi Wang3, Bin Xu1, He-Jun Zhou1, Hong-Xiang Zhu Ge2, Jun-Hu Chen1 and Wei Hu14*

Author Affiliations

1 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite & Vector Biology Ministry of Health, Shanghai 200025, China

2 Department of Parasitology, Medical College of Soochow University, No.199 Renai Road, Suzhou 215123, China

3 Tengchong Center for Disease Control and prevention, Yunnan province 679100, China

4 Department of Microbiology and Microbial Engineering, School of Life Science, Fudan University, Shanghai 200433, China

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Infectious Diseases of Poverty 2013, 2:24  doi:10.1186/2049-9957-2-24

Published: 3 October 2013

Abstract

Background

Babesiosis is an emerging health risk in several parts of the world. However, little is known about the prevalence of Babesia in malaria-endemic countries. The area along the China-Myanmar border in Yunnan is a main endemic area of malaria in P.R. China, however, human infection with Babesia microti (B. microti) is not recognized in this region, and its profile of co-infection is not yet clear.

Methods

To understand its profile of co-infections with B. microti, our investigation was undertaken in the malaria-endemic area along the China-Myanmar border in Yunnan between April 2012 and June 2013. Four parasite species, including B. microti, Plasmodium falciparum (P. falciparum), P. vivax, and P. malariae, were identified among 449 suspected febrile persons detected by nested polymerase chain reaction (PCR) assay based on small subunit ribosomal ribonucleic acid (RNA) genes of B. microti and Plasmodium spp.

Results

Of all the collected samples from febrile patients, mono-infection with B. microti, P. vivax, P. falciparum, and P. malariae accounted for 1.8% (8/449), 9.8% (44/449), 2.9% (13/449), and 0.2% (1/449), respectively. The rate of mixed infections of B. microti with P. falciparum or P. vivax are both 0.2% (1/449), and mixed infections of P. falciparum and P. vivax accounted for 1.1% (5/449).

Conclusions

This report supports the hypothesis that babesiosis caused by B. microti is emerging along the China-Myanmar border in the Yunnan province, P.R. China, but it was ignored because of low parasitemia or mixed infection with Plasmodium spp. More sensitive and specific diagnosis methods are needed to find the rapid response mechanism of emergency for babesiosis and malaria co-prevalence areas.

Keywords:
Babesia; Plasmodium; Co-infection; China-Myanmar border