Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan
Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan
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DOI：
10.4269/ajtmh.1996.54.325
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发表时间：
1996-04-01
影响因子：
3.3
通讯作者：
Arnot, DE
中科院分区：
文献类型：
--
作者：
Roper, C;Elhassan, IM;Arnot, DE
我们使用巢式聚合酶链反应（PCR）检测低水平恶性疟原虫感染低于血膜检查的检测阈值。这揭示了大量的无症状，亚显微镜下的专利感染的人口中的苏丹村庄目前全年，虽然临床疟疾发作几乎完全局限于传播季节。在我们9月、1月、4月和6月的调查中，PCR检测的患病率分别为13%、19%、24%和19%。这些数字表明，旱季感染的流行率比以前的显微镜调查所显示的要高得多。此外，在整个9月至11月的传播季节，79人的队列中有20%是健康的，但在随后几个月的一系列样本中，至少有一个样本的PCR结果为恶性疟原虫阳性。因此，该地区感染恶性疟原虫的程度高于以前的估计，突出表明许多人感染了疟原虫，但在一年的大部分时间里都是健康的。因此，水库寄生虫种群比以前认为的更大，更稳定，这一发现与该地区恶性疟原虫寄生虫分析报告的多态位点的高水平遗传变异一致。
We have used the nested polymerase chain reaction (PCR) to assay for low level Plasmodium falciparum infections that were below the threshold of detection of blood film examination. This revealed a substantial group of asymptomatic, submicroscopically patent infections within the population of a Sudanese village present throughout the year although clinical malaria episodes were almost entirely confined to the transmission season. In our September, January, April, and June surveys, the PCR-detected prevalences were 13%, 19%, 24%, and 19%, respectively. These figures reveal a much higher prevalence of dry season infection than previous microscopic surveys have indicated. Furthermore, 20% of a cohort of 79 individuals were healthy throughout the September to November transmission season but were PCR-positive for P. falciparum in a least one of a series of samples taken in the ensuing months. Levels of exposure to P. falciparum infection were therefore higher than was previously believed in this region, highlighting the fact that many individuals were infected but healthy for most of the year. The reservoir parasite population was thus larger and more stable than previously thought, a finding that is consistent with the high levels of genetic variation at polymorphic loci reported from analysis of P. falciparum parasites in this area.