Prevalence of Plasmodium falciparum gametocytaemia in asymptomatic school children before and after treatment with dihydroartemisinin-piperaquine (DP).
Prevalence of Plasmodium falciparum gametocytaemia in asymptomatic school children before and after treatment with dihydroartemisinin-piperaquine (DP).
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DOI：
10.1016/j.parepi.2023.e00292
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发表时间：
2023-05
影响因子：
3.2
通讯作者：
Sutherland, Colin J.
中科院分区：
文献类型：
--
作者：
Dinko, Bismarck;Awuah, Dennis;Boampong, Kwadwo;Larbi, John A.;Bousema, Teun;Sutherland, Colin J.
在大多数疟疾流行地区，无症状的疟原虫携带者构成了大多数疟疾感染者。这些无症状感染的个体中有一部分携带配子体，这是疟疾寄生虫的可传播阶段，维持人与蚊子的传播。很少有研究检查无症状的学龄儿童中的配子细胞血症，这些儿童可能是传播的重要宿主。我们评估了抗疟治疗前配子体血症的患病率，并监测了无症状疟疾儿童治疗后配子体的清除情况。共274名小学生进行了恶性疟原虫寄生虫病的显微镜检查。155名寄生虫阳性儿童在直接观察下接受了双氢青蒿素-哌喹（DP）治疗。在给药前7天、给药前第0天以及给药开始后第7、14和21天，通过显微镜检查确定配子细胞携带情况。筛选（第-7天）和入组（第0天）时显微镜可检测到配子母细胞的患病率分别为9%（25/274）和13.6%（21/155）。DP处理后，配子体携带率在第7、14和21天分别降至4%（6/135）、3%（5/135）和6%（10/151）。少数接受治疗的儿童中存在无性寄生虫，导致在第7天（9%，12/135）、第14天（4%，5/135）和第21天（7%，10/151）显微镜下可检出寄生虫。配子携带与参与者的年龄（p = 0.05）和无性寄生虫密度（p = 0.08）呈负相关。在变量分析中，治疗后持续7天或更长时间的配子体血症与治疗后第7天的无性寄生虫血症（P = 0.027）和治疗当天的配子体存在（P < 0.001）显著相关。虽然DP为临床疟疾提供了极好的治愈率和较长的预防半衰期，但我们的研究结果表明，在治疗无症状感染后，无性寄生虫和配子体可能在治疗后的前3周内持续存在于少数个体中。这表明DP可能不适合用于在非洲消除疟疾的大规模药物管理战略。
Asymptomatic Plasmodium carriers form the majority of malaria-infected individuals in most endemic areas. A proportion of these asymptomatically infected individuals carry gametocytes, the transmissible stages of malaria parasites, that sustain human to mosquito transmission. Few studies examine gametocytaemia in asymptomatic school children who may form an important reservoir for transmission. We assessed the prevalence of gametocytaemia before antimalarial treatment and monitored clearance of gametocytes after treatment in asymptomatic malaria children. A total of 274 primary school children were screened for P. falciparum parasitaemia by microscopy. One hundred and fifty-five (155) parasite positive children were treated under direct observation with dihydroartemisinin-piperaquine (DP). Gametocyte carriage was determined by microscopy seven days prior to treatment, day 0 before treatment, and on days 7, 14 and 21 post initiation of treatment. The prevalence of microscopically-detectable gametocytes at screening (day −7) and enrolment (day 0) were 9% (25/274) and 13.6% (21/155) respectively. Following DP treatment, gametocyte carriage dropped to 4% (6/135), 3% (5/135) and 6% (10/151) on days 7, 14 and 21 respectively. Asexual parasites persisted in a minority of treated children, resulting in microscopically detectable parasites on days 7 (9%, 12/135), 14 (4%, 5/135) and 21 (7%, 10/151). Gametocyte carriage was inversely correlated with the age of the participants (p = 0.05) and asexual parasite density (p = 0.08). In a variate analysis, persistent gametocytaemia 7 or more days after treatment was significantly associated with post-treatment asexual parasitaemia at day 7 (P = 0.027) and presence of gametocytes on the day of treatment (P < 0.001). Though DP provides both excellent cure rates for clinical malaria and a long prophylactic half-life, our findings suggest that after treatment of asymptomatic infections, both asexual parasites and gametocytes may persist in a minority of individuals during the first 3 weeks after treatment. This indicates DP may be unsuitable for use in mass drug administration strategies towards malaria elimination in Africa.
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影响因子：
3
作者：
Davlantes E;Dimbu PR;Ferreira CM;Florinda Joao M;Pode D;Félix J;Sanhangala E;Andrade BN;Dos Santos Souza S;Talundzic E;Udhayakumar V;Owens C;Mbounga E;Wiesner L;Halsey ES;Martins JF;Fortes F;Plucinski MM
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影响因子：
3.7
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通讯作者：
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3
作者：
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通讯作者：
Gyapong, Margaret