Subclinical Plasmodium falciparum infections act as year-round reservoir for malaria in the hypoendemic Chittagong Hill districts of Bangladesh
Subclinical Plasmodium falciparum infections act as year-round reservoir for malaria in the hypoendemic Chittagong Hill districts of Bangladesh
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DOI：
10.1016/j.ijid.2016.06.019
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发表时间：
2016-08-01
影响因子：
8.4
通讯作者：
Sullivan, David J., Jr.
中科院分区：
文献类型：
--
作者：
Shannon, Kerry L.;Khan, Wasif A.;Sullivan, David J., Jr.
目的：分析了低流行孟加拉国亚临床疟疾患者的危险因素以及季节和空间分布。方法：2009年至2012年，对随机样本进行了不考虑症状的主动疟疾监测（n = 3971）和孕妇（n = 589）。结果：总体亚临床恶性疟原虫疟疾点患病率为1.0%（n = 35），但孕妇为3.2%（n = 18）。总人群的估计发病率为39.9/1000人-年。与有症状的疟疾不同，亚临床感染有明显的季节性，在雨季没有季节性增加。69%的亚临床恶性疟原虫感染者报告了通常与疟疾相关的症状，而没有感染的人只有18%。男性，孕妇，jhum种植者，和那些生活在更接近森林和海拔较高的亚临床infection.Conclusions：亚地方性亚临床疟疾感染与一些家庭和人口因素，类似症状的情况下，有较高的患病率。与季节性很强的临床症状疟疾不同，这些主动发现的感染全年都存在，在任何特定时间都占感染的绝大多数，并可能成为继续传播的水库。(C)2016作者由Elsevier Ltd代表国际传染病学会出版。
Objectives: An analysis of the risk factors and seasonal and spatial distribution of individuals with subclinical malaria in hypoendemic Bangladesh was performed.Methods: From 2009 to 2012, active malaria surveillance without regard to symptoms was conducted on a random sample (n = 3971) and pregnant women (n = 589) during a cohort malaria study in a population of 24 000.Results: The overall subclinical Plasmodium falciparum malaria point prevalence was 1.0% (n = 35), but was 3.2% (n = 18) for pregnant women. The estimated incidence was 39.9 per 1000 person-years for the overall population. Unlike symptomatic malaria, with a marked seasonal pattern, subclinical infections did not show a seasonal increase during the rainy season. Sixty-nine percent of those with subclinical P. falciparum infections reported symptoms commonly associated with malaria compared to 18% without infection. Males, pregnant women, jhum cultivators, and those living closer to forests and at higher elevations had a higher prevalence of subclinical infection.Conclusions: Hypoendemic subclinical malaria infections were associated with a number of household and demographic factors, similar to symptomatic cases. Unlike clinical symptomatic malaria, which is highly seasonal, these actively detected infections were present year-round, made up the vast majority of infections at any given time, and likely acted as reservoirs for continued transmission. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.