Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment.
Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment.
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DOI：
10.1017/s003118201400033x
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发表时间：
2014-12
期刊：
影响因子：
2.4
通讯作者：
Stothard JR
中科院分区：
文献类型：
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作者：
Betson M;Sousa-Figueiredo JC;Atuhaire A;Arinaitwe M;Adriko M;Mwesigwa G;Nabonge J;Kabatereine NB;Sutherland CJ;Stothard JR
在一项调查乌干达湖滨社区疟疾动态的纵向研究中，尽管定期治疗，但在幼儿中观察到疟疾流行率一直很高。为了探索蒿甲醚-苯芴醇（AL）的短期效果，在Bukoba村进行了治疗后寄生虫携带情况的试点调查。共有163名血膜和快速抗原试验阳性的儿童（2-7岁）接受AL治疗，其中只有8.7%的人出现腋温升高。在第7天和第17天，分别有40名儿童（26.3%）和33名儿童（22.3%）通过显微镜检查呈阳性。实时PCR分析表明，基线时多种疟原虫感染很常见，41.1%的儿童对恶性疟原虫/三日疟原虫呈阳性，9.2%的儿童对恶性疟原虫/卵形疟原虫呈阳性。3种均为8.0%。此外，在第17天，在基线时感染恶性疟疾的儿童中有39.9%再次对同一物种呈阳性，在基线时感染三日疟原虫的儿童中有9.2%对三日疟原虫呈阳性。在这里，慢性多物种疟疾感染在AL治疗后的儿童中持续存在。需要对非恶性疟原虫感染进行更好的床旁诊断，以及进一步调查无症状个体的AL表现。
During a longitudinal study investigating the dynamics of malaria in Ugandan lakeshore communities, a consistently high malaria prevalence was observed in young children despite regular treatment. To explore the short-term performance of artemether-lumefantrine (AL), a pilot investigation into parasite carriage after treatment(s) was conducted in Bukoba village. A total of 163 children (aged 2–7 years) with a positive blood film and rapid antigen test were treated with AL; only 8·7% of these had elevated axillary temperatures. On day 7 and then on day 17, 40 children (26·3%) and 33 (22·3%) were positive by microscopy, respectively. Real-time PCR analysis demonstrated that multi-species Plasmodium infections were common at baseline, with 41·1% of children positive for Plasmodium falciparum/Plasmodium malariae, 9·2% for P. falciparum/ Plasmodium ovale spp. and 8·0% for all three species. Moreover, on day 17, 39·9% of children infected with falciparum malaria at baseline were again positive for the same species, and 9·2% of those infected with P. malariae at baseline were positive for P. malariae. Here, chronic multi-species malaria infections persisted in children after AL treatment(s). Better point-of-care diagnostics for non-falciparum infections are needed, as well as further investigation of AL performance in asymptomatic individuals.