Demographical, hematological and serological risk factors for Plasmodium falciparum gametocyte carriage in a high stable transmission zone in Cameroon
Demographical, hematological and serological risk factors for Plasmodium falciparum gametocyte carriage in a high stable transmission zone in Cameroon
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DOI：
10.1371/journal.pone.0216133
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发表时间：
2019-04-25
期刊：
影响因子：
3.7
通讯作者：
Ayong, Lawrence
中科院分区：
文献类型：
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作者：
Essangui, Estelle;Eboumbou Moukoko, Carole Else;Ayong, Lawrence
外周血中存在成熟配子体形式的疟原虫是疟疾传播的关键条件。然而，在大多数疟疾传播区进行的研究报告说，大多数病人没有配子母细胞。因此，我们试图确定的风险因素，所有阶段和成熟的配子母细胞携带在喀麦隆的恶性疟原虫高稳定传播的地区。使用三种互补的方法确定配子阳性：厚血涂片显微镜，RT-PCR和RT-LAMP，而暴露于感染进行了评估，通过酶联免疫吸附试验。在随机纳入的361名疟疾流行居民中（平均年龄：28 ± 23岁，年龄范围：2-100岁，男女性别比：1.1），87.8%被诊断为恶性疟原虫感染，其中45.7%表现为发热（腋温≥ 37.5 ℃）。通过厚血涂片显微镜和RT-PCR靶向成熟配子体转录本Pfs 25的成熟配子体阳性率分别为1.9%和8.9%。以性期标记Pfs 16为靶点，RT-PCR和RT-LAMP检测配子体的阳性率分别为24.1%和36.3%。多变量分析显示贫血是成熟和所有阶段配子体携带的共同独立危险因素，而发热和低抗配子体抗体水平仅与所有阶段配子体携带独立相关。两者合计，数据表明，重要的差异，配子体运输的风险因素取决于阶段分析，贫血，发热和抗疟原虫血浆抗体水平低的主要贡献的风险因素。
Presence of mature gametocyte forms of malaria parasites in peripheral blood is a key requirement for malaria transmission. Yet, studies conducted in most malaria transmission zones report the absence of gametocyte in the majority of patients. We therefore sought to determine the risk factors of both all-stage and mature gametocyte carriage in an area with high stable transmission of Plasmodium falciparum in Cameroon. Gametocyte positivity was determined using three complementary methods: thick blood smear microscopy, RT-PCR and RT-LAMP, whereas exposure to the infection was assessed by enzyme-linked immunosorbent assay. Of 361 malaria endemic residents randomly included in the study (mean age: 28 +/- 23 years, age range: 2-100 years, male/female sex ratio: 1.1), 87.8% were diagnosed with P. falciparum infection, of whom 45.7% presented with fever (axillary body temperatur >= 37.5 degrees C). Mature gametocyte positivity was 1.9% by thick blood smear microscopy and 8.9% by RT-PCR targeting the mature gametocyte transcript, Pfs25. The gametocyte positivity rate was 24.1% and 36.3% by RT-PCR or RT-LAMP, respectively, when targeting the sexual stage marker, Pfs16. Multivariate analyses revealed anemia as a common independent risk factor for both mature and all-stage gametocyte carriage, whereas fever and low anti-gametocyte antibody levels were independently associated with all-stage gametocyte carriage only. Taken together, the data suggest important differences in risk factors of gametocyte carriage depending on stage analyzed, with anemia, fever and low antiplasmodial plasma antibody levels representing the major contributing risk factors.