Plasmodium interspecies interactions during a period of increasing prevalence of Plasmodium ovale in symptomatic individuals seeking treatment: an observational study.
Plasmodium interspecies interactions during a period of increasing prevalence of Plasmodium ovale in symptomatic individuals seeking treatment: an observational study.
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DOI：
10.1016/s2666-5247(21)00009-4
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Kamau E
中科院分区：
文献类型：
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作者：
Akala HM;Watson OJ;Mitei KK;Juma DW;Verity R;Ingasia LA;Opot BH;Okoth RO;Chemwor GC;Juma JA;Mwakio EW;Brazeau N;Cheruiyot AC;Yeda RA;Maraka MN;Okello CO;Kateete DP;Managbanag JR;Andagalu B;Ogutu BR;Kamau E
非恶性疟疾在地方性环境中的流行病学和严重程度引起的关注有限。我们的目的是描述肯尼亚地方病环境中有症状的个体中非恶性疟原虫的流行率、相互作用、临床风险因素和时间趋势。我们通过PCR对2008年至2016年收集的2027份临床样本进行了诊断和分析。描述性统计用于描述疟原虫种的患病率和分布。设计了一个统计模型，用于估计疟原虫种的频率和评估种间相互作用。采用混合效应线性回归模型，对每个地点进行随机截距，以检验患病率随时间的变化。恶性疟原虫单种感染占72.5%，混合感染占25.8%，非恶性疟原虫单种感染仅占1.7%。23.1%为含有卵圆假单胞菌的混合感染。一个基于似然模型计算的人口频率的每个物种估计一个显着的宿主内干扰之间的恶性疟原虫和卵形疟原虫curtisi。混合效应逻辑回归模型确定卵圆疟原虫和卵圆疟原虫种随时间显著增加，恶性疟原虫单一种和三日疟原虫相互减少。如果同时感染三日疟原虫，则恶性疟原虫感染出现发热的风险降低0.43倍。调查结果显示，非恶性疟原虫物种的流行率高于预期。在研究期间，观察到卵形沃里克疟原虫和卵形柯蒂斯疟原虫感染阳性的感染比例显著增加，这可能是由于这些物种对疟疾药物治疗的反应性减弱。在肯尼亚，卵形疟原虫的出现频率增加可能会威胁到肯尼亚的疟疾控制工作，并增加旅行者患疟疾的风险。AFHSB及其GEIS科
The epidemiology and severity of non-falciparum malaria in endemic settings has garnered limited attention. We aimed to characterize the prevalence, interaction, clinical risk factors and temporal trends of nonfalciparum species among symptomatic individuals in endemic settings of Kenya. We diagnosed and analyzed infecting malaria species via PCR in 2027 clinical samples collected between 2008 and 2016. Descriptive statistics were used to describe the prevalence and distribution of Plasmodium species. A statistical model was designed and used for estimating the frequency of Plasmodium species and assessing interspecies interactions. Mixed effect linear regression models with random intercepts for each location was used to test for change in prevalence over time. 72•5% of the samples were P. falciparum single species infections, 25•8% were mixed infections and only l•7% occurred as single non-falciparum species infections. 23•l% were mixed infections containing P. ovale. A likelihood-based model calculation of the population frequency of each species estimated a significant within-host interference between P. falciparum and P. ovale curtisi. Mixed-effect logistic regression models identified a significant increase of P. ovale wallikeri and P. ovale curtisi species over time with reciprocal decrease in P. falciparum single species and P. malariae. The risk of P. falciparum infections presenting with fever was 0•43 times less likely if co-infected with P. malariae. Findings show higher prevalence of non-falciparum species than expected. The proportion of infections that were positive for infection by P. ovale wallikeri and P. ovale curtisi was observed to significantly increase over the period of study which could be due to attenuated responsiveness to malaria drug treatment on these species. The increase in frequency of P. ovale species in Kenya could threaten malaria control effort in Kenya and pose increased risk of malaria to travelers. AFHSB and its GEIS Section