Persistent Plasmodium falciparum and Plasmodium vivax infections in a western Cambodian population: implications for prevention, treatment and elimination strategies

Malaria Journal

Research

Jeremy Chalk¹  Pasathorn Sirithiranont¹  Rupam Tripura¹  Arjen M. Dondorp²  Thomas J. Peto²  Nicholas J. White²  Nicholas P. J. Day²  Sue J. Lee²  Lorenz von Seidlein³  Richard J. Maude³  Mallika Imwong⁴  Chea Nguon⁵  Mehul Dhorda⁶ 

[1] Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;Department of Epidemiology, Harvard T. H. Chan School of Public Health, 02115, Boston, MA, USA;Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;National Centre for Parasitology, Entomology, and Malaria Control (CNM), Trapeng Svay Village, Sangkat Phnom Penh Thmei, Khan Sen Sok, Phnom Penh, Cambodia;WorldWide Antimalarial Resistance Network, Asia Regional Centre, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;

关键词: Malaria;    Persistence;    Cohort;    Plasmodium;    Falciparum;    Vivax;    Clearance;    Artemisinins;    Resistance;    Pailin;    Cambodia;    PCR;   

DOI  :  10.1186/s12936-016-1224-7

 received in 2015-11-11, accepted in 2016-03-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSubclinical Plasmodium parasitaemia is an important reservoir for the transmission and persistence of malaria, particularly in low transmission areas.MethodsUsing ultrasensitive quantitative PCR (uPCR) for the detection of parasitaemia, the entire population of three Cambodian villages in Pailin province were followed for 1 year at three-monthly intervals. A cohort of adult participants found initially to have asymptomatic malaria parasitaemia was followed monthly over the same period.ResultsThe initial cross sectional survey in June 2013 (M0) of 1447 asymptomatic residents found that 32 (2.2 %) had Plasmodium falciparum, 48 (3.3 %) had P. vivax, 4 (0.3 %) had mixed infections and in 142/1447 (9.8 %) malaria was detected but there was insufficient DNA to identify the species (Plasmodium. species). Polymorphisms in the ‘K13-propeller’ associated with reduced susceptibility to artemisinin derivatives (C580Y) were found in 17/32 (51 %) P. falciparum strains. Monthly follow-up without treatment of 24 adult participants with asymptomatic mono or mixed P. falciparum infections found that 3/24 (13 %) remained parasitaemic for 2–4 months, whereas the remaining 21/24 (87 %) participants had cleared their parasitaemia after 1 month. In contrast, 12/34 (35 %) adult participants with P. vivax mono-infection at M0 had malaria parasites (P. vivax or P. sp.) during four or more of the following 11 monthly surveys.ConclusionsThis longitudinal survey in a low transmission setting shows limited duration of P. falciparum carriage, but prolonged carriage of P. vivax infections. Radical treatment of P. vivax infections by 8-aminoquinoline regimens may be required to eliminate all malaria from Cambodia.Trial registration ClinicalTrials.gov NCT01872702

【 授权许可】

CC BY   
© Tripura et al. 2016