The temporal dynamics and infectiousness of subpatent Plasmodium falciparum infections in relation to parasite density
The temporal dynamics and infectiousness of subpatent Plasmodium falciparum infections in relation to parasite density
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DOI：
10.1038/s41467-019-09441-1
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发表时间：
2019-03-29
影响因子：
16.6
通讯作者：
Okell, Lucy C.
中科院分区：
文献类型：
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作者：
Slater, Hannah C.;Ross, Amanda;Okell, Lucy C.
在所有地方流行的环境中，低于标准诊断检测限度的疟疾感染是常见的。然而，关键问题仍然围绕着它们对维持传播的贡献以及是否需要发现和针对它们以实现消灭疟疾。在这项研究中，我们分析了一系列疟疾数据集，以量化隐性感染的密度，可检测性，感染过程和传染性。与高传播环境中的个体相比，低传播环境中的无菌感染个体的平均寄生虫密度较低。在队列研究中，亚专利感染被认为是预测未来时期的专利感染，并在膜喂养的研究，个人感染亚专利无性寄生虫密度被认为是约三分之一的传染性蚊子的个人专利（无性寄生虫）感染。这些结果表明，亚专利感染有助于传染性水库，可能是持久的，并需要更敏感的诊断，以检测他们在较低的传输设置。
Malaria infections occurring below the limit of detection of standard diagnostics are common in all endemic settings. However, key questions remain surrounding their contribution to sustaining transmission and whether they need to be detected and targeted to achieve malaria elimination. In this study we analyse a range of malaria datasets to quantify the density, detectability, course of infection and infectiousness of subpatent infections. Asymptomatically infected individuals have lower parasite densities on average in low transmission settings compared to individuals in higher transmission settings. In cohort studies, subpatent infections are found to be predictive of future periods of patent infection and in membrane feeding studies, individuals infected with subpatent asexual parasite densities are found to be approximately a third as infectious to mosquitoes as individuals with patent (asexual parasite) infection. These results indicate that subpatent infections contribute to the infectious reservoir, may be long lasting, and require more sensitive diagnostics to detect them in lower transmission settings.