High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations
High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations
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DOI：
10.4269/ajtmh.2002.66.641
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发表时间：
2002-06-01
影响因子：
3.3
通讯作者：
Camargo, EP
中科院分区：
文献类型：
--
作者：
Alves, FP;Durlacher, RR;Camargo, EP
在巴西亚马逊河流域西部的Rondonia，2个沿河地区的疟疾流行病学进行了评估，在Portuchuelo进行了为期1年的研究，并在Rio马查多（= Ji-Parana）的riverinc社区进行了横断面调查。疟原虫属通过光学显微镜和核糖体DNA的聚合酶链反应（PCR）扩增诊断感染。PCR检测疟原虫感染的效率是显微镜的6-7倍。间日疟原虫和恶性疟原虫感染均以无症状和有症状的形式发生。有症状和无症状的临床形式之间的关系是大致相似的两种疟原虫。无症状患者监测2个月。无症状感染的患病率比有症状感染的患病率高4-5倍，分别为20%和4.6%，葡萄牙和49.5%和10%，Ji-Parana。症状性疟疾主要发生在年轻年龄组的患者中。相比之下，无症状疟疾与年龄较大的人群有显著关联（葡萄牙丘埃洛和吉巴拉那的中位数分别为26.5岁和21岁），而两个地区有症状疟疾的中位数分别为14岁和8岁。在亚马逊河流域，在生活时间较短的群体中，症状性疟疾也更为普遍（葡萄牙丘埃洛和吉巴拉那分别为13年和4年），而无症状性疟疾在该地区生活时间较长的群体中更为普遍（葡萄牙丘埃洛和吉巴拉那的中位数分别为25.5年和18年）。无症状疟疾的高流行率可能给目前在亚马逊地区采取的控制疟疾战略带来新的问题，该战略基本上是以治疗有症状的病人为基础的。
The epidemiology of malaria in 2 riverine localities in Rondonia, Brazilian western Amazonia, was assessed by a 1-year study at Portuchuelo, and a cross-sectional survey at riverinc communities at Rio Machado (= Ji-Parana). Plasmodium spp. infections were diagnosed by light microscopy and by polymerase chain reaction (PCR) amplification of ribosomal DNA. PCR was 6-7 times more efficient than microscopy for detecting plasmodial infections. Both Plasmodium vivax and Plasmodium falciparum infections occurred as asymptomatic and symptomatic forms of the disease. The relation between symptomatic and asymptomatic clinical forms was roughly similar for both species of Plasmodium. Symptomless patients were monitored for 2 months. The prevalence of symptomless infections was 4-5 times higher than the symptomatic ones-respectively, 20% and 4.6% for Portuchuelo and 49.5% and 10% for Ji-Parana. Symptomatic malaria occurred mostly in patients in younger age groups. In contrast, there was a significant association of symptomless malaria with older age groups (medians of 26.5 and 21 years, respectively, for Portuchuelo and Ji-Parana), whereas the age medians for symptomatic malaria were 14 and 8 years, respectively, in the 2 regions. Symptomatic malaria also was more prevalent in groups living for shorter times in Amazonia (13 and 4 years, respectively, for Portuchuelo and Ji-Parana) as compared with symptomless malaria, which was more prevalent in groups living for longer periods in the region (medians of 25.5 and 18 years, respectively, for Portuchuelo and Ji-Parana). The high prevalence of symptomless malaria may pose new problems for the currently adopted strategy for the control of malaria in the Amazonian region, which is essentially based on the treatment of symptomatic patients.