Molecular incidence and clearance of Plasmodium falciparum infection

Malaria Journal

Research

Donald J. Krogstad¹  Ousmane A. Koita²  John L. Gerone³  Belco Poudiougou⁴  Mahamadou Diakité⁴  Yéya T. Touré⁴  Mouctar Diallo⁴ 

[1] Center for Infectious Diseases, Tulane University School of Public Health and Tropical Medicine, #8317, J. Bennett Johnston Building, Room 510, 1324 Tulane Avenue, 70112, New Orleans, LA, USA;Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA;Faculty of Medicine, Pharmacy and Odontostomatology, Mali-Tulane Tropical Medicine Research Center, University of Bamako, Bamako, Mali;Center for Infectious Diseases, Tulane University School of Public Health and Tropical Medicine, #8317, J. Bennett Johnston Building, Room 510, 1324 Tulane Avenue, 70112, New Orleans, LA, USA;Faculty of Medicine, Pharmacy and Odontostomatology, Mali-Tulane Tropical Medicine Research Center, University of Bamako, Bamako, Mali;Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA;Faculty of Medicine, Pharmacy and Odontostomatology, Mali-Tulane Tropical Medicine Research Center, University of Bamako, Bamako, Mali;

关键词: Clearance;    Diagnosis;    Epidemiology;    Incidence;    Malaria;    Microscopy;    Molecular methods;    Prevalence;    Plasmodium falciparum;   

DOI  :  10.1186/s12936-015-0941-7

 received in 2015-01-04, accepted in 2015-10-11,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAlthough the epidemiology of malaria has been based primarily on microscopy and rapid diagnostic tests, molecular methods are necessary to understand the complexity of natural infection in regions where transmission is intense and simultaneous infection with multiple parasite genotypes is common such as sub-Saharan Africa.MethodsTo compare microscopic and molecular estimates of the incidence and clearance of Plasmodium falciparum infection, we followed 80 children monthly for 1 year in the village of Bancoumana in Mali.Results and discussionSimilar seasonal patterns were observed with both methods (rainy season peak, dry season nadir), although molecular methods detected more infections than microscopy (571 vs 331 in 906 specimens), more new infections (311 vs 104 during 829 person-months) and spontaneous clearance events (317 vs 116) and found higher incidence (0.38 vs 0.13 new genotypes/person/month, p < 0.001) and spontaneous clearance rates (0.38 vs 0.14 genotypes cleared/person/month, p < 0.001). These differences were greatest for persistently-infected subjects in whom neither new infections nor the clearance of old infections could be detected by microscopy (0.71 new infections and 0.73 cleared infections per month using molecular methods vs 0.000 by microscopy, p < 0.001).ConclusionsMolecular methods provide information about genetic diversity, the intensity of transmission and spontaneous clearance in the absence of drug treatment that cannot be obtained by microscopy. They will be necessary to evaluate the efficacy of vaccines, drugs and other control strategies for diseases such as malaria in which simultaneous infection with more than one organism (genotype) is common.

【 授权许可】

CC BY   
© Krogstad et al. 2015