Plasmodium falciparum gametocyte carriage in asymptomatic children in western Kenya -: art. no. 18
Plasmodium falciparum gametocyte carriage in asymptomatic children in western Kenya -: art. no. 18
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DOI：
10.1186/1475-2875-3-18
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发表时间：
2004-06-01
期刊：
影响因子：
3
通讯作者：
Sauerwein, RW
中科院分区：
文献类型：
--
作者：
Bousema, JT;Gouagna, LC;Sauerwein, RW
背景：关于恶性疟原虫配子细胞发育和动力学的研究几乎全部集中在接受抗疟药物治疗的患者身上，而在流行地区，大多数疟原虫携带者是无症状的。本研究确定了在乙胺磺胺（SP）抗疟疾治疗缺失和存在的情况下，影响无症状儿童配子体贫血的因素。方法：对来自肯尼亚西部的526名儿童（6个月至16岁）进行无性寄生虫和配子体筛查，每周随访4周。根据国家指南，估计寄生虫血症大于或等于1000个寄生虫/例的儿童接受SP治疗。在未治疗和sp治疗的单一恶性疟原虫感染儿童中测定配子体发育和持久性相关因素。结果：5岁以下儿童配子细胞患病率为33.8%，随年龄增长而下降。在没有治疗的情况下，18.6%的儿童在随访期间出现配子体贫血；在sp治疗的儿童中，这一比例为29.8%。年龄，高无性寄生虫密度和登记时配子细胞存在是配子细胞血症的预测因素。5岁以下儿童、5 - 9岁儿童和10岁及以上儿童配子细胞血症的估计平均持续时间分别为9.4天、7.8天和4.1天。结论：本研究表明，很大一部分无症状的儿童未经治疗后发生配子细胞血症。配子体贫血症在五岁以下儿童中尤为常见，他们体内配子体的时间较长。配子体贫血的年龄依赖性持续时间以前没有显示，这可能增加了这一年龄组对感染性水库的重要性。
Background: Studies on Plasmodium falciparum gametocyte development and dynamics have almost exclusively focused on patients treated with antimalarial drugs, while the majority of parasite carriers in endemic areas are asymptomatic. This study identified factors that influence gametocytaemia in asymptomatic children in the absence and presence of pyrimethamine-sulphadoxine (SP) antimalarial treatment.Methods: A cohort of 526 children (6 months-16 years) from western Kenya was screened for asexual parasites and gametocytes and followed weekly up to four weeks. Children with an estimated parasitaemia of greater than or equal to1,000 parasites/mul were treated with SP according to national guidelines. Factors associated with gametocyte development and persistence were determined in untreated and SP-treated children with P. falciparum mono-infection.Results: Gametocyte prevalence at enrolment was 33.8% in children below five years of age and decreased with age. In the absence of treatment 18.6% of the children developed gametocytaemia during follow-up; in SP-treated children this proportion was 29.8%. Age, high asexual parasite density and gametocyte presence at enrolment were predictive factors for gametocytaemia. The estimated mean duration of gametocytaemia for children below five, children from five to nine and children ten years and above was 9.4, 7.8 and 4.1 days, respectively.Conclusion: This study shows that a large proportion of asymptomatic untreated children develop gametocytaemia. Gametocytaemia was particularly common in children below five years who harbor gametocytes for a longer period of time. The age-dependent duration of gametocytaemia has not been previously shown and could increase the importance of this age group for the infectious reservoir.