|
|
|
|
Effects of liver-stage clearance by Primaquine on gametocyte carriage of Plasmodium vivax and P. falciparum
|
|
|
|
|
|
|
|
نویسنده
|
wampfler r. ,hofmann n.e. ,karl s. ,betuela i. ,kinboro b. ,lorry l. ,silkey m. ,robinson l.j. ,mueller i. ,felger i.
|
|
منبع
|
plos neglected tropical diseases - 2017 - دوره : 11 - شماره : 7
|
|
چکیده
|
Background: primaquine (pq) is the only currently licensed antimalarial that prevents plasmodium vivax (pv) relapses. it also clears mature p. falciparum (pf) gametocytes,thereby reducing post-treatment transmission. randomized pq treatment in a treatment-to-reinfection cohort in papua new guinean children permitted the study of pv and pf gametocyte carriage after radical cure and to investigate the contribution of pv relapses. methods: children received radical cure with chloroquine,artemether-lumefantrine plus either pq or placebo. blood samples were subsequently collected in 2-to 4-weekly intervals over 8 months. gametocytes were detected by quantitative reverse transcription-pcr targeting pvs25 and pfs25. results: pq treatment reduced the incidence of pv gametocytes by 73%,which was comparable to the effect of pq on incidence of blood-stage infections. 92% of pv and 79% of pf gametocyte-positive infections were asymptomatic. pv and to a lesser extent pf gametocyte positivity and density were associated with high blood-stage parasite densities. multivariate analysis revealed that the odds of gametocytes were significantly reduced in mixed-species infections compared to single-species infections for both species (orpv= 0.39 [95% ci 0.25–0.62],orpf= 0.33 [95% ci 0.18–0.60],p<0.001). no difference between the pq and placebo treatment arms was observed in density of pv gametocytes or in the proportion of pv infections that carried gametocytes. first infections after blood-stage and placebo treatment,likely caused by a relapsing hypnozoite,were equally likely to carry gametocytes than first infections after pq treatment,likely caused by an infective mosquito bite. conclusion: pv relapses and new infections are associated with similar levels of gametocytaemia. relapses thus contribute considerably to the pv reservoir highlighting the importance of effective anti-hypnozoite treatment for efficient control of pv. © 2017 wampfler et al.
|
|
|
|
|
آدرس
|
swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, divison of population health and immunity,the walter and eliza hall institute of medical research,parkville,australia,department of medical biology,university of melbournevic, Australia, vector borne diseases unit,png institute of medical research,goroka, Papua New Guinea, vector borne diseases unit,png institute of medical research,goroka, Papua New Guinea, vector borne diseases unit,png institute of medical research,goroka, Papua New Guinea, swiss tropical and public health institute,basel, Switzerland, divison of population health and immunity,the walter and eliza hall institute of medical research,parkville,australia,department of medical biology,university of melbournevic,australia,vector borne diseases unit,png institute of medical research,goroka,papua new guinea,centre for biomedical research,burnet institute,melbourne, Australia, divison of population health and immunity,the walter and eliza hall institute of medical research,parkville,australia,department of medical biology,university of melbournevic,australia,malaria parasites & hosts unit,institut pasteur,paris, France, swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Authors
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|