Jorel Franco Antone N.

Tangpuz

9/7/16
Plasmodium Ovale

Plasmodium ovale is one of the five

described Plasmodium species that
cause malaria in humans (with
Plasmodium falciparum generally
causing the most severe disease and
most of the mortality from the
disease).
Plasmodium ovale is generally
thought of as having a relatively
limited distribution, with endemic transmission traditionally described as being limited to
areas of tropical Africa, New Guinea, the eastern parts of Indonesia, and the Philippines.
However, P. ovale infections have also been reported from the Middle East, the Indian
subcontinent, and parts of Southeast Asia. In West Africa (and to a lesser extent Central
Africa), age specific prevalence (based on light microscopy, LM) of >10% has been
observed. However, in most places where P. ovaleis observed, it is relatively uncommon and
its prevalence (as detected by LM) rarely exceeds 35%. As is the case for P. malariae and P.
falciparum, P. ovale infections in West African populations tend to be most common in
children under ten years of age. Little is known about the potential for interaction between P.
ovale and other malaria infections. However, the fact that P. ovale has been found to be
most prevalent in areas of West Africa where P. vivax is nearly absent because of the virtual
absence of the Duffy blood-group-antigen, which P. vivaxrequires to invade red blood cells,
might indicate a negative interaction between these two species. (Mueller et al. 2007 and
references therein) Recent work indicates that there are likely two
distinct Plasmodium species that have both been referred to as P. ovale (Sutherland et al.
2010; Oguike et al. 2011)
Like P. vivax, P. ovale has long been thought to have a dormant stage "hypnozoite" stage
that can persist in the liver and cause relapses by invading the bloodstream weeks (or even
years) later, but Richter et al. (2010) have questioned whether such a stage actually exists
for P. ovale.
The human malaria parasite life cycle involves two hosts, a mosquito and a human. The life
cycle is very complex, including both sexual and asexual phases and involves a stage in the
liver as well as the blood stage, the latter being responsible for the clinical manifestations of
the disease.
Distribution

Plasmodium ovale is generally thought of as having a relatively limited distribution, with

endemic transmission traditionally described as being limited to areas of tropical Africa, New
Guinea, the eastern parts of Indonesia, and the Philippines. However, P. ovale infections
have also been reported from the Middle East, the Indian subcontinent, and parts of
Southeast Asia.
Life Cycle
The human malaria parasite life cycle involves two hosts, a mosquito and a human. The life
cycle is very complex, including both sexual and asexual phases (see life cycle diagram) and
involves a stage in the liver as well as the blood stage, the latter being responsible for the
clinical manifestations of the disease.

EVOLUTION AND SYSTEMATICS

Evolution
Systematics and Taxonomy
There are more than 150 named species of Plasmodium that infect various species of
vertebrates. Four species are well known as true parasites of humans, utilizing humans
almost exclusively as a natural intermediate host: P. falciparum, P. vivax, P. ovale and P.
malariae. In recent years it has become apparent that the simian malaria parasite P.
knowlesi also regularly infects humans, as well as its natural monkey intermediate hosts.
(Centers for Disease Control Parasites and Health website) Furthermore, it is now apparent
that there are likely two distinct Plasmodium species that have both been referred to as P.
ovale.
MOLECULAR BIOLOGY AND GENETICS
Genetics
What has until recently referred to as simply Plasmodium ovale is now believed to be two
distinct taxa (Sutherland et al. 2010; Caldero et al. 2012 and references therein). Calderaro
et al. (2012) developed an assay using real-time PCR to distinguish these two forms that will
facilitate future epidemiological and other research.
RELEVANCE TO HUMANS AND ECOSYSTEMS
Risks
Plasmodium ovale is one of the five described Plasmodium species that cause malaria in
humans (with Plasmodium falciparum generally causing the most severe disease and most
of the mortality from the disease).

Plasmodium ovale
Plasmodium ovale is a species of parasitic protozoa that causes tertian malaria in humans.
It is one of several species of Plasmodium parasites that infect humans
including Plasmodium falciparum and Plasmodium vivaxwhich are responsible for most
malarial infection. It is rare compared to these two parasites, and substantially less
dangerous than P. falciparum.
P. ovale has recently been shown by genetic methods to consist of two subspecies, P. ovale
curtisi and P. ovale wallikeri.
History
This species was first described by Stephens in a patient from East Africa in 1922. [2]
Epidemiology
While it is frequently said that P. ovale is very limited in its range being limited to West
Africa, the Philippines, eastern Indonesia, and Papua New Guinea, it has been reported
from Bangladesh ,Cambodia, India,Thailand and Vietnam. /The reported prevalence is low
(<5%) with the exception of West Africa, where prevalences above 10% have been
observed.[citation needed]
The epidemiology of this parasite is in need of updating because the most recent global map
of its distribution was produced in 1969.
It has been estimated that there are about 15 million cases of infection each year with this
parasite.
Clinical features
The prepatent period in the human ranges from 12 to 20 days. Some forms in the liver have
delayed development and relapse may occur after periods of up to 4 years after infection.
The developmental cycle in the blood lasts approximately 49 h. An examination of records
from induced infections indicated that there were an average of 10.3 fever episodes of > or
= 101 F (38,3 C) and 4.5 fever episodes of > or = 104 F (40,0 C). Mean maximum
parasite levels were 6,944/microl for sporozoite-induced infections and 7,310/microl for
trophozoite-induced infections.
Diagnosis

The microscopic appearance of P. ovale is very similar to that of P. vivax and if there are only
a small number of parasites seen, it may be impossible to distinguish the two species on
morphological grounds alone. There is no difference between the medical treatment of P.
ovale and P. vivax, and therefore some laboratory diagnoses report "P. vivax/ovale", which is
perfectly acceptable as treatment for the two are very similar. Schffner's dots are seen on
the surface of the parasitised red blood cell, but these are larger and darker than in P.
vivax and are sometimes called James' dots or James' stippling. About twenty percent of the
parasitised cells are oval in shape (hence the species name) and some of the oval cells also
have fimbriated edges (the so-called "comet cell"). The matureschizonts of P. ovale never
have more than twelve nuclei within them and this is the only reliable way of distinguishing
between the two species.
P. vivax and P. ovale that has been sitting in EDTA for more than half-an-hour before the
blood film is made will look very similar in appearance to P. malariae, which is an important
reason to warn the laboratory immediately when the blood sample is drawn so they can
process the sample as soon as it arrives.
Molecular tests (tests that look for DNA material from P. ovale in blood) must take into
account the fact that there are two subspecies of ovale and tests designed for one
subspecies may not necessarily detect the other.
Treatment
Standard treatment is concurrent treatment with chloroquine and primaquine. The
combination atovaquone-proguanil may be used in those patients who are unable to
take chloroquine for whatever reason.
Phylogenetics
Among the species infecting the great apes, Plasmodium schwetzi morphologically appears
to be the closest relation to P.ovale. As of 2013 this had not been confirmed by DNA studies.
The original species has been shown to be two morphologically identical forms - Plasmodium
ovale curtisi andPlasmodium ovale wallikeri - which can be differentiated only by genetic
means. Both species have been identified in Ghana, Myanmar, Nigeria, So Tom, Sierra
Leone and Uganda. The separation of the lineages is estimated to have occurred between
1.0 and 3.5 million years ago in hominid hosts. A second analysis suggests that these
species separated 4.5 million years ago (95% confidence interval 0.5 7.7 Mya).
These species appear to be more closely related to Plasmodium malariae than
to Plasmodium vivax.

The two species appear to differ in their biology with P. ovale wallikeri having a shorter
latency period than P. ovale ovale.
Life Cycle
Human Infection
Liver Stage
The P. ovale sporozoite enters a hepatocyte and begins its exoerythrocytic schizogony stage.
This is characterized by multiple rounds of nuclear division without cellular segmentation.
After a certain number of nuclear divisions, the parasite cell will segment and merozoites are
formed.
There are situations where some of the sporozoites do not immediately start to grow and
divide after entering the hepatocyte, but remain in a dormant, hypnozoite stage for weeks or
months. The duration of latency is variable from one hypnozoite to another and the factors
that will eventually trigger growth are not known; this explains how a single infection can be
responsible for a series of waves of parasitaemia or "relapses".
Erythrocytic Cycle
While similar to P. vivax, P. ovale is able to infect individuals who are negative for the
Duffy blood group, which is the case for many residents of sub Saharan Africa. This explains
the greater prevalence of P. ovale (rather than P. vivax) in most of Africa.
Sexual Stage
Mosquito Stage
Vectors

Anopheles albimanus

Anopheles atroparvus

Anopheles dirus

Anopheles farauti

Anopheles freeborni

Anopheles gambiae

Anopheles maculatus

Anopheles quadrimaculatus

Anopheles stephensi

[18]

Anopheles subpictus

Other hosts
Chimpanzees and Saimiri monkeys can be infected with this parasite.

Sources:
http://eol.org/pages/10408875/details
http://www.scientistsagainstmalaria.net/parasite/plasmodium-ovale