IMPACT OF TRANSMISSION INTENSITY AND AGE ON PLASMODIUM-FALCIPARUM DENSITY AND ASSOCIATED FEVER - IMPLICATIONS FOR MALARIA VACCINE TRIAL DESIGN
IMPACT OF TRANSMISSION INTENSITY AND AGE ON PLASMODIUM-FALCIPARUM DENSITY AND ASSOCIATED FEVER - IMPLICATIONS FOR MALARIA VACCINE TRIAL DESIGN
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DOI：
10.1093/infdis/172.4.1047
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发表时间：
1995-10-01
影响因子：
6.4
通讯作者：
HOFFMAN, SL
中科院分区：
文献类型：
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作者：
BEADLE, C;MCELROY, PD;HOFFMAN, SL
为了便于疫苗试验的设计，在高强度（HI）和低强度传播季节期间，在6个月至6岁的肯尼亚人中研究疟疾。在治愈后的84天期间，HI组中暴露于受感染的蚊子是9倍，而恶性疟原虫感染的发病率仅增加2倍，没有年龄效应。HI组复发恶性疟原虫的密度高14倍，年龄与寄生虫血症大于或等于5000/μ L之间存在显著关联。发热是寄生虫血症的唯一临床表现，且仅当寄生虫密度大于或等于5000/μ L时。当寄生虫血症时，64%的大于或等于20，000个寄生虫/μ L的儿童与10%的1-4999个寄生虫/μ L的儿童发热。复发性恶性疟原虫感染作为疫苗试验终点，可在肯尼亚西部大于或等于6岁的儿童中进行全年研究。然而，在儿童中的高传播季节，将最佳地研究伴有或不伴有升高温度的高度寄生虫血症（大于或等于5000或20，000/mu L
To facilitate design of vaccine trials, malaria was studied in 6-month- to 6-year-oId Kenyans during high (HI) and low intensity transmission seasons, During 84 days after cure, exposure to infected mosquitoes was 9-fold greater in the HI group, yet incidence of P. falciparum infection was increased only 2-fold, with no age effect. The density of recurrent P. falciparum was 14-fold greater in the HI group, and there was a striking association between age and parasitemia greater than or equal to 5000/mu L. Fever was the only clinical manifestation attributable to parasitemia and only when the parasite density was greater than or equal to 5000/mu L. Sixty-four percent of children with greater than or equal to 20,000 parasites/mu L versus 10% with 1-4999/mu L were febrile when parasitemic. Recurrent P. falciparum infection as a vaccine trial end point can be studied year-round among children greater than or equal to 6 years in western Kenya. However, high-grade parasitemia (greater than or equal to 5000 or 20,000/mu L) with or without elevated temperature will be optimally studied in the high transmission season among children