Relapses Contribute Significantly to the Risk of Plasmodium vivax Infection and Disease in Papua New Guinean Children 1-5 Years of Age
Relapses Contribute Significantly to the Risk of Plasmodium vivax Infection and Disease in Papua New Guinean Children 1-5 Years of Age
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DOI：
10.1093/infdis/jis580
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发表时间：
2012-12-01
影响因子：
6.4
通讯作者：
Mueller, Ivo
中科院分区：
文献类型：
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作者：
Betuela, Inoni;Rosanas-Urgell, Anna;Mueller, Ivo
背景资料。间日疟原虫在肝脏中形成持久的催眠体。他们对生活在高度流行地区的儿童的间日疟负担有多大还不得而知。在这项研究中，433名1-5岁的巴布亚新几内亚儿童被随机分为青蒿琥酯(7天)+伯氨喹(14天)、青蒿琥酯单独治疗或不治疗，并积极跟踪观察复发的疟原虫感染和疾病40周。青蒿琥酯-伯氨喹治疗组与青蒿琥酯组和对照组相比，间日疟原虫发作的风险分别降低了28%(P=0.042)和33%(P=0.015)。仅在随访的前3个月观察到显著下降(青蒿琥酯-伯氨喹与对照组相比，-58%[P=.004]；青蒿琥酯-伯氨喹与青蒿琥酯相比，-49%[P=.031])，此后差异不大。伯氨喹治疗还将定量实时聚合酶链式反应和光镜阳性间日疟原虫再感染的风险降低了44%(P
Background. Plasmodium vivax forms long-lasting hypnozoites in the liver. How much they contribute to the burden of P. vivax malaria in children living in highly endemic areas is unknown.Methods. In this study, 433 Papua New Guinean children aged 1-5 years were Randomized to receive artesunate (7 days) plus primaquine (14 days), artesunate alone or no treatment and followed up actively for recurrent Plasmodium infections and disease for 40 weeks.Results. Treatment with artesunate-primaquine reduced the risk of P. vivax episodes by 28% (P=.042) and 33% (P=.015) compared with the artesunate and control arms, respectively. A significant reduction was observed only in the first 3 months of follow-up (artesunate-primaquine vs control, -58% [P=.004]; artesunate-primaquine vs artesunate, -49% [P=.031]) with little difference thereafter. Primaquine treatment also reduced the risk of quantitative real-time polymerase chain reaction-and light microscopy-positive P. vivax reinfections by 44% (P