Patterns of mixed Plasmodium species infections among children six years and under in selected malaria hyper-endemic communities of Zambia: population-based survey observations.
Patterns of mixed Plasmodium species infections among children six years and under in selected malaria hyper-endemic communities of Zambia: population-based survey observations.
复制标题
DOI：
10.1186/s12879-015-0935-7
复制
发表时间：
2015-05-02
影响因子：
3.7
通讯作者：
Michelo C
中科院分区：
文献类型：
--
作者：
Sitali L;Chipeta J;Miller JM;Moonga HB;Kumar N;Moss WJ;Michelo C
虽然疟疾是可以预防和治疗的，但全球每年仍有66万人死于疟疾，其中5岁以下儿童的负担最重。在赞比亚，在大多数没有显微镜服务的卫生设施中，仅检测恶性疟原虫的疟疾快速诊断测试是疟疾诊断的主要确证手段。由于这种恶性疟原虫物种诊断方法，非恶性疟原虫疟疾不仅诊断不足，而且完全被遗漏，从而使确切的疾病负担未知。因此，我们调查了各种疟原虫的患病率。和相关的感染负担。使用了2012年4月至5月进行的2012年全国疟疾指标调查中两个疟疾高度流行省（东部省和卢阿普拉省）的数据。疟疾调查是一项具有全国代表性的两阶段类集调查，在疟疾传播季节结束时进行。作为调查的一部分，从家庭收集了社会、行为和背景资料。厚血涂片，RDT和干血斑（DBS）从6岁以下的儿童收集。使用Giemsa染色载玻片并通过显微镜检查，同时使用聚合酶链反应（PCR）分析疟疾疟原虫属的DBS。采用多因素Logistic回归分析背景因素与疟疾的关系。总共有873名6岁以下的儿童接受了调查。疟原虫属的总体患病率。PCR检测的阳性率为54.3%（95%CI 51-57.6%）。恶性疟原虫占88%，混合感染占10.6%，非恶性疟原虫单一感染占1.4%。在混合感染中，大多数是恶性疟原虫和三日疟原虫的混合感染（占所有混合感染的6.5%）。2岁及2岁以上（2-5岁）儿童混合疟疾感染的风险（aOR 2.8 CI 1.31-5.69）比2岁以下儿童高3倍。混合疟原虫的高流行率。这一人群中的疟疾感染强调审查目前的疟疾RDT诊断方法。据观察，两岁以下儿童混合感染的发生率低于两岁至五岁的儿童，这可能是由于这一年龄组的母亲被动免疫保护等因素。
Although malaria is preventable and treatable, it still claims 660,000 lives every year globally with children under five years of age having the highest burden. In Zambia, malaria rapid diagnostic tests (RDTs) that only detect Plasmodium falciparum are the main confirmatory means for malaria diagnosis in most health facilities without microscopy services. As a consequence of this P. falciparum species diagnostic approach, non-falciparum malaria is not only under-diagnosed but entirely missed, thereby making the exact disease burden unknown. We thus investigated the prevalence of various Plasmodium spp. and associated burden of infection in selected communities in Zambia. Data from two malaria hyper-endemic provinces (Eastern and Luapula) of the 2012 National Malaria Indicator Survey (MIS), conducted between April and May 2012, were used. The MIS is a nationally representative, two-stage cluster survey conducted to coincide with the end of the malaria transmission season. Social, behavioural and background information were collected from households as part of the survey. Thick blood smears, RDTs and dried blood spots (DBS) were collected from children below six years of age. Slides were stained using Giemsa and examined by microscopy while polymerase chain reaction (PCR) was used to analyse the DBS for malaria Plasmodium spp. Multivariate logistic regression was employed to examine the association between background factors and malaria. Overall, 873 children younger than six years of age were surveyed. The overall prevalence of Plasmodium spp. by PCR was 54.3% (95% CI 51–57.6%). Of the total Plasmodium isolates, 88% were P. falciparum, 10.6% were mixed infections and 1.4% were non-falciparum mono infections. Among the mixed infections, the majority were a combination of P. falciparum and P. malariae (6.5% of all mixed infections). Children two years and older (2–5 years) had three-fold higher risk of mixed malaria infections (aOR 2.8 CI 1.31–5.69) than children younger than two years of age. The high prevalence of mixed Plasmodium spp. infections in this population stresses review of the current malaria RDT diagnostic approaches. The observed less incidence of mixed infections in children under two years of age compared to their older two-to-five-year-old counterparts is probably due to the protective maternal passive immunity, among other factors, in that age group.
登录
查看更多内容
影响因子：
4.9
作者：
Guerra-Neira A;Rubio JM;Royo JR;Ortega JC;Auñón AS;Diaz PB;Llanes AB
通讯作者：
Llanes AB
抗疟疾药物在消除疟疾中的作用。
影响因子：
3
作者：
White NJ
通讯作者：
White NJ
影响因子：
1.8
作者：
Carvalho, T. L.;Ribolla, P. E. M.;Mota, L. S. L. S.
通讯作者：
Mota, L. S. L. S.
影响因子：
3.8
作者：
Mendes, Cristina;Dias, Fernanda;Arez, Ana Paula
通讯作者：
Arez, Ana Paula
影响因子：
3.4
作者：
Mbakilwa, Hilda;Manga, Chacha;Reyburn, Hugh
通讯作者：
Reyburn, Hugh