Gametocytaemia in senegalese children with uncomplicated Falciparum malaria treated with chloroquine, amodiaquine or sulfadoxine plus pyrimethamine
Gametocytaemia in senegalese children with uncomplicated Falciparum malaria treated with chloroquine, amodiaquine or sulfadoxine plus pyrimethamine
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DOI：
10.1051/parasite/2001083243
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发表时间：
2001-09-01
期刊：
影响因子：
2.9
通讯作者：
Robert, V
中科院分区：
文献类型：
--
作者：
Sokhna, CS;Trape, JF;Robert, V
对266名塞内加尔儿童（中位年龄4岁，范围0.5-16岁）用氯喹（CQ）、阿莫地喹（AQ）或磺胺嘧啶+乙胺嘧啶（SP）治疗的无并发症疟疾进行了恶性疟原虫配子体血症研究。体内耐药率分别为44%、16%和7%。用药后0、4、7和14天厚涂片镜检，配子体计数，用药后1周出现配子体血症高峰;在第0、7和14天，配子体的出现率分别为35%、73%和63%，配子体密度的几何平均值分别为1.3、12.5和5.6/穆尔血。治疗、治疗功效和治疗前症状的持续时间。SP组的配子体患病率和密度明显高于CQ组，CQ组高于AQ组。耐药感染者的配子体患病率和密度高于敏感感染者。首次临床症状出现与治疗之间的时间与第0天和第4天的配子体患病率和密度呈正相关且显著相关。早期用AQ治疗，对抗敏感性感染，其次是最低的配子体细胞血症，相反，用SP治疗对抗抗性感染，其次是最高的配子体细胞血症。在第0天的无性阶段的密度和第0天和第14天之间的任何一天的配子血之间没有观察到明确的关系。强调了治疗后配子体血症的流行病学意义及其在耐药寄生虫传播中的可能作用，提出了避免或减少这种配子体血症的解决方案。
Plasmodium falciparum gametocytaemia was studied in 266 Senegalese children (median 4 years, range 0.5-16) with uncomplicated malaria treated with chloroquine (CQ), amodiaquine (AQ) or sulfadoxine+pyrimethamine (SP). The proportion of resistant infections in vivo to these drugs was 44 %, 16 % and 7 %, respectively, Gametocytes were counted by microscopy in thick smears on days 0, 4, 7 and 14 after treatment, There was a peak of gametocytaemia one week after treatment; on days 0, 7 and 14 the gametocyte prevalences were 35 %, 73 % and 63 %, and the geometric means of gametocyte densities were 1.3, 12.5 and 5.6/mul of blood, Three factors were found to influence gametocytaemia: treatment, efficacy of treatment, and duration of symptoms before treatment. Gametocyte prevalence and density significantly appeared higher in children treated with SP than with CQ, and higher with CQ than with AQ. Gametocyte prevalence and density were higher in resistant than in sensitive infections. The period between the appearance of the first clinical symptoms and treatment was positively and significantly linked to gametocyte prevalence and density on days 0 and 4. Early treatment with AQ, against sensitive infection, was followed by the lowest gametocytaemia, By contrast, treatment with SP against resistant infection was followed by the highest gametocytaemia. No clear relationship was observed between the density of asexual stages on day 0 and the gametocytaemia of any day between days 0 and 14. The epidemiological significance of post-therapeutic gametocytaemia and its possible role in the spread of resistant parasites are underlined, Solutions are proposed in order to avoid or reduce this gametocytaemia.