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Total parasite biomass can be estimated using plasma HRP-2 [39], and Yeo et al. [33] have recently reported that ANG-2 levels were positively correlated with this marker of parasite burden.
The method used for genotyping is well established in molecular epidemiological studies and the msp2 gene has proven to be the most informative marker of parasite population diversity [29].
We explored this further with another plasma marker, PfHRP2 (thought to be a marker of parasite burden within the host [ 40]).
Therefore the surrogate marker of parasite clearance used in this analysis is likely to remain the best available evidence on which to base comparisons of treatment efficacy for the rectal artemisinins.
Recently, levels of plasma PfHRP2 (thought to represent parasite load [ 40, 52], though found not useful as a marker of parasite load in a study in Kilifi [ 53]), was found to differentiate between retinopathy positive CM from retinopathy negative CM [ 41].
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This case study demonstrates the feasibility of using molecular tools to better understand therapeutic responses to PQ. Genetic analysis of SNVs in putative resistance genes may identify molecular markers of parasite resistance or correlate with known variations in PQ sensitivity of strains from different geographic areas.
Cysteine proteases, which are strongly immunogenic, are potential as vaccine candidates, therapeutic targets, and also serodiagnostic markers of parasites [ 55, 56].
The SRA gene, first isolated from a Ugandan strain of T. b. rhodesiense, has been shown to be a marker of the parasite invasiveness for humans.
This has direct implications for drug resistance studies that measure pfmdr1 copy number as a marker of decreased parasite susceptibility to antimalarial drugs [ 67] by implying an previously unrecognized role for accompanying changes in pfcrt.
A venous blood sample was taken for peripheral blood parasite counts, hematocrit (Hct), quantitative assessment of plasma PfHRP2 (a marker of total body parasite burden) [ 24, 25], biochemistry and acid base parameters (EC8+ cartridge for i-STAT handheld analyzer), as well as HIV testing and CD4+ lymphocyte count.
In the field, and in the absence of genetic markers for parasite traits such as virulence and fecundity, the impact of mass chemotherapy on general parasite life-history traits could potentially be monitored through the integration of clinical measures and prevalence data with population genetic analyses using microsatellite markers.
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