Vannier E, Krause PJ, 2012. Human babesiosis. N Engl J Med 366: 2397–2407.
Moritz ED, Winton CS, Tonnetti L, Townsend RL, Berardi VP, Hewins ME, Weeks KE, Dodd RY, Stramer SL, 2016. Screening for Babesia microti in the U.S. blood supply. N Engl J Med 375: 2236–2245.
Herwaldt BL, Linden JV, Bosserman E, Young C, Olkowska D, Wilson M, 2011. Transfusion-associated babesiosis in the United States: a description of cases. Ann Intern Med 155: 509–519.
Conrad PA, Kjemtrup AM, Carreno RA, Thomford J, Wainwright K, Eberhard M, Quick R, Telford SR 3rd, Herwaldt BL, 2006. Description of Babesia duncani n.sp. (Apicomplexa: Babesiidae) from humans and its differentiation from other piroplasms. Int J Parasitol 36: 779–789.
Telford SRI, Gorenflot A, Brasseur P, Spielman A, 1993. Babesial infections in humans and wildlife. Kreier JP, ed. Parasitic Protozoa: Babesia and Plasmodia. San Diego, CA: Academic Press, 1–47.
Homer MJ, Aguilar-Delfin I, Telford SR 3rd, Krause PJ, Persing DH, 2000. Babesiosis. Clin Microbiol Rev 13: 451–469.
Gabrielli S, Totino V, Macchioni F, Zuniga F, Rojas P, Lara Y, Roselli M, Bartoloni A, Cancrini G, 2016. Human babesiosis, Bolivia, 2013. Emerg Infect Dis 22: 1445–1447.
Welc-Faleciak R, Pawelczyk A, Radkowski M, Pancewicz SA, Zajkowska J, Sinski E, 2015. First report of two asymptomatic cases of human infection with Babesia microti (Franca, 1910) in Poland. Ann Agric Environ Med 22: 51–54.
Rigaud E, Jaulhac B, Garcia-Bonnet N, Hunfeld KP, Femenia F, Huet D, Goulvestre C, Vaillant V, Deffontaines G, Abadia-Benoist G, 2016. Seroprevalence of seven pathogens transmitted by the Ixodes ricinus tick in forestry workers in France. Clin Microbiol Infect 22: 735.e1–735.e9.
Lempereur L, Shiels B, Heyman P, Moreau E, Saegerman C, Losson B, Malandrin L, 2015. A retrospective serological survey on human babesiosis in Belgium. Clin Microbiol Infect 21: 96.e1–96.e7.
Zhou X, Xia S, Huang JL, Tambo E, Zhuge HX, Zhou XN, 2014. Human babesiosis, an emerging tick-borne disease in the People’s Republic of China. Parasit Vectors 7: 509.
Zhou X, Li SG, Wang JZ, Huang JL, Zhou HJ, Chen JH, Zhou XN, 2014. Emergence of human babesiosis along the border of China with Myanmar: detection by PCR and confirmation by sequencing. Emerg Microbes Infect 3: e55.
Hong SH, Anu D, Jeong YI, Abmed D, Cho SH, Lee WJ, Lee SE, 2014. Molecular detection and seroprevalence of Babesia microti among stock farmers in Khutul city, Selenge Province, Mongolia. Korean J Parasitol 52: 443–447.
Paparini A, Senanayake SN, Ryan UM, Irwin PJ, 2014. Molecular confirmation of the first autochthonous case of human babesiosis in Australia using a novel primer set for the beta-tubulin gene. Exp Parasitol 141: 93–97.
Ogo NI et al. 2012. Molecular identification of tick-borne pathogens in Nigerian ticks. Vet Parasitol 187: 572–577.
Lolli C, Marenzoni ML, Strona P, Lappo PG, Etiang P, Diverio S, 2016. Infections and risk factors for livestock with species of Anaplasma, Babesia and Brucella under semi-nomadic rearing in Karamoja region, Uganda. Trop Anim Health Prod 48: 603–611.
Mtshali PS, Tsotetsi AM, Thekisoe MM, Mtshali MS, 2014. Nested PCR detection and phylogenetic analysis of Babesia bovis and Babesia bigemina in cattle from peri-urban localities in Gauteng province, South Africa. J Vet Med Sci 76: 145–150.
Maamun JM, Suleman MA, Akinyi M, Ozwara H, Kariuki T, Carlsson HE, 2011. Prevalence of Babesia microti in free-ranging baboons and African green monkeys. J Parasitol 97: 63–67.
Swai ES, Karimuribo ED, French NP, Fitzpatrick JL, Bryant MJ, Kambarage DM, Ogden NH, 2007. Seroprevalence of Babesia bigemina in smallholder dairy cattle in Tanzania and associated risk factors. J S Afr Vet Assoc 78: 15–20.
Swai ES, French NP, Karimuribo ED, Fitzpatrick JL, Bryant MJ, Brown PE, Ogden NH, 2005. Spatial and management factors associated with exposure of smallholder dairy cattle in Tanzania to tick-borne pathogens. Int J Parasitol 35: 1085–1096.
Nakayima J et al. 2014. Detection and characterization of zoonotic pathogens of free-ranging non-human primates from Zambia. Parasit Vectors 7: 490.
Levin AE et al. 2016. Serologic screening of United States blood donors for Babesia microti using an investigational enzyme immunoassay. Transfusion 56: 1866–1874.
Houghton RL, Homer MJ, Reynolds LD, Sleath PR, Lodes MJ, Berardi V, Leiby DA, Persing DH, 2002. Identification of Babesia microti-specific immunodominant epitopes and development of a peptide EIA for detection of antibodies in serum. Transfusion 42: 1488–1496.
Fesel C, Goulart LF, Silva Neto A, Coelho A, Fontes CJ, Braga EM, Vaz NM, 2005. Increased polyclonal immunoglobulin reactivity toward human and bacterial proteins is associated with clinical protection in human Plasmodium infection. Malar J 4: 5.
Donati D, Zhang LP, Chene A, Chen Q, Flick K, Nystrom M, Wahlgren M, Bejarano MT, 2004. Identification of a polyclonal B-cell activator in Plasmodium falciparum. Infect Immun 72: 5412–5418.
Bronsdon MA, Homer MJ, Magera JM, Harrison C, Andrews RG, Bielitzki JT, Emerson CL, Persing DH, Fritsche TR, 1999. Detection of enzootic babesiosis in baboons (Papio cynocephalus) and phylogenetic evidence supporting synonymy of the genera Entopolypoides and Babesia. J Clin Microbiol 37: 1548–1553.
Thomford JW, Conrad PA, Telford SR 3rd, Mathiesen D, Bowman BH, Spielman A, Eberhard ML, Herwaldt BL, Quick RE, Persing DH, 1994. Cultivation and phylogenetic characterization of a newly recognized human pathogenic protozoan. J Infect Dis 169: 1050–1056.
Baldwin CL et al. 1988. Bovine T cells, B cells, and null cells are transformed by the protozoan parasite Theileria parva. Infect Immun 56: 462–467.
Mungai M, Tegtmeier G, Chamberland M, Parise M, 2001. Transfusion-transmitted malaria in the United States from 1963 through 1999. N Engl J Med 344: 1973–1978.
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Babesia is a tick-borne intraerythrocytic parasite that is clinically and diagnostically similar to malaria parasite, conferring risk of misdiagnosis in areas where both parasites are endemic. Data on Babesia in humans in Africa are lacking, despite evidence that it is present in regional animal populations. Samples that were collected in November 2014 to July 2015 in Kilosa district, Tanzania, were evaluated for evidence of malaria and Babesia infection. Clinical data and laboratory samples (i.e., hemoglobin, rapid diagnostic testing [RDT] for malaria, peripheral blood smear, and dried blood spots) from a routine survey were available for analysis. Dried blood spots were tested using an investigational enzyme linked immunosorbent assay (ELISA) against Babesia microti. A total of 1,030 children aged 1 month to < 5 years were evaluated; 186 (18.1%) were malaria RDT positive, 180 (96.8%) of whom had peripheral smears reviewed; 70/180 (38.9%) were smear positive for parasites. The median (inter quartile range) and range of B. microti ELISA signal to cutoff (S/C) ratio was 0.10 (0.06–0.15) and 0.01–1.65, respectively; the S/C ratios were significantly higher in subjects ≥ 1 year as compared with those < 1 year old (P < 0.001). There was also a statistically significant association between a positive RDT for malaria and the Babesia S/C (median 0.09 versus 0.13 in RDT negative versus RDT positive, respectively; P < 0.001). The highest S/C ratios were disproportionately clustered in a few hamlets. The findings suggest that Babesia may be present in Kilosa district, Tanzania. However, serological cross-reactivity and false positivity, notably between Babesia and Plasmodium spp., cannot be definitively excluded and have implications for testing in other settings.
Financial support: This study was made possible by a grant from the Bill & Melinda Gates Foundation (OPP1032340).
Disclosure: A. L. was President and Chief Scientific Officer of Immunetics, Inc. at the time this study was conducted. E. M. B. was a coinvestigator on a previous study funded by a grant to Immunetics from the National Heart, Lung, and Blood Institute.
Authors’ addresses: Evan M. Bloch, Department of Pathology, Johns Hopkins Medicine, Baltimore, MD, E-mail: firstname.lastname@example.org. Kasubi Mabula, Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, E-mail: email@example.com. Andrew Levin, Kephera Diagnostics, LLC, Boston, MA, E-mail: firstname.lastname@example.org. Zakayo Mrango, National Institute for Medical Research, Kilosa, Tanzania, E-mail: email@example.com. Jerusha Weaver, Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, E-mail: firstname.lastname@example.org. Beatriz Munoz and Sheila K. West, Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, E-mail: email@example.com and firstname.lastname@example.org.