The burden of Plasmodium vivax relapses in an Amerindian village in French Guiana

Malaria Journal

Opinion

Celia Basurko¹  Mathieu Nacher¹  Paul Brousse²  Muriel Ville²  Aurelia Stefani³  Bernard Carme⁴  Delphine Lemonnier⁵  Narcisse Elenga⁶  Félix Djossou⁷  Magalie Demar⁷ 

[1] Centre d’Investigation Clinique Epidémiologie clinique Antilles Guyane (Inserm / DGOS CIE 802), Centre Hospitalier de Cayenne, Cayenne, French Guiana;Epidemiologie Parasitoses et Mycoses Tropicales, Université Antilles Guyane, EA 3593, Cayenne, French Guiana;Département des Centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana;Epidemiologie Parasitoses et Mycoses Tropicales, Université Antilles Guyane, EA 3593, Cayenne, French Guiana;Epidemiologie Parasitoses et Mycoses Tropicales, Université Antilles Guyane, EA 3593, Cayenne, French Guiana;Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana;Pharmacie Centrale, Centre Hospitalier de Cayenne, Cayenne, French Guiana;Service de Pédiatrie, Centre Hospitalier de Cayenne, Cayenne, French Guiana;Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana;

关键词: Malaria;    Vivax Malaria;    G6PD Deficiency;    Primaquine;    Vivax Case;   

DOI  :  10.1186/1475-2875-12-367

 received in 2013-06-24, accepted in 2013-10-22,  发布年份 2013

来源: Springer

【 摘 要 】

Malaria is a public health problem in French Guiana. Plasmodium vivax is the most frequent parasite. The objective of this analysis was to estimate the proportion of relapses in the burden of vivax malaria using the statistical rule stating that any case of vivax malaria occurring less than 90 days following a first episode is a relapse.A total of 622 subjects were followed for 2,9 years with 336 first single episodes of P. vivax malaria, and a total of 1,226 episodes of vivax malaria among which 559 were relapses (45.5%). For 194 patients having had falciparum malaria followed by vivax malaria it was estimated that 19% of the vivax episodes occurred less than 90 days following the falciparum episode and thus were possibly relapses due to the activation of latent hypnozoites. Despite the number of vivax cases and the number of relapses, there were only 28 recorded primaquine prescriptions (3.4% of vivax episodes, 4.5% of subjects).The present study points out that despite the fact that nearly half of the P. vivax cases, many of which in children, are caused by latent hypnozoites, only a minority of them benefit from primaquine radical cure. The obstacles to this are discussed and suggestions are made to reduce the burden of vivax malaria in Camopi and other remote health centres in French Guiana.

【 授权许可】

CC BY   
© Nacher et al.; licensee BioMed Central Ltd. 2013