Global & Temporal Patterns of Submicroscopic Plasmodium falciparum Malaria Infection
Global & Temporal Patterns of Submicroscopic Plasmodium falciparum Malaria Infection
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全球的
DOI：
10.1101/554311
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Whittaker C
中科院分区：
文献类型：
--
作者：
Whittaker C
恶性疟原虫感染的分子检测揭示了大量的个体具有显微镜无法检测到的低密度（但可传播）感染。在这里，我们对横断面疟疾调查进行了最新的系统回顾，以探索这些亚微观感染的患病率和驱动因素，并确定它们可能与疟疾控制工作相关的地方。我们的研究结果表明，亚显微感染在低传播环境中占主导地位，但也揭示了其流行率的明显地理差异，在南美调查中最高，在西非研究中最低。虽然目前的传输水平部分解释了这些结果，我们发现，历史传输强度也代表了一个至关重要的决定因素的亚微观水库的大小。亚显微镜下感染更可能在成人比儿童，虽然我们没有观察到一个统计学上的显着影响的季节性。我们的研究结果表明，亚显微感染对传播的贡献可能在不同环境中有很大差异，可能会在消除方法中采用不同的方法来靶向它们。
Molecular detection of Plasmodium falciparum infection has revealed large numbers of individuals with low-density (yet transmissible) infections undetectable by microscopy. Here we present an updated systematic review of cross-sectional malaria surveys to explore the prevalence and drivers of these submicroscopic infections and define where they are likely to be relevant to malaria control efforts. Our results show that submicroscopic infections predominate in low transmission settings, but also reveal marked geographical variation in their prevalence, being highest in South American surveys and lowest in West African studies. Whilst current transmission levels partly explain these results, we find that historical transmission intensity also represents a crucial determinant of the size of the submicroscopic reservoir. Submicroscopic infection was more likely in adults than children, although we did not observe a statistically significant influence of seasonality. Our results suggest that the contribution of submicroscopic infections to transmission likely varies substantially across settings, potentially warranting different approaches to their targeting in the approach to elimination.