Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment

被引:47
|
作者
Betson, Martha [1 ]
Sousa-Figueiredo, Jose C. [2 ]
Atuhaire, Aaron [3 ]
Arinaitwe, Moses [3 ]
Adriko, Moses [3 ]
Mwesigwa, Gerald [3 ]
Nabonge, Juma [4 ]
Kabatereine, Narcis B. [3 ]
Sutherland, Colin J. [2 ]
Stothard, J. Russell [5 ]
机构
[1] Royal Vet Coll, Dept Prod & Populat Hlth, Hatfield, Herts, England
[2] London Sch Hyg & Trop Med, Fac Infect & Trop Dis, London WC1, England
[3] Minist Hlth, Vector Control Div, Kampala, Uganda
[4] Vector Control Div, Mayuge Dist, Uganda
[5] Univ Liverpool, Liverpool Sch Trop Med, Dept Parasitol, Liverpool L3 5QA, Merseyside, England
基金
英国惠康基金;
关键词
artemisinin combination therapy; malaria; rapid diagnostic test; Uganda; Plasmodium falciparum; Plasmodium malariae; Plasmodium ovale; UNCOMPLICATED FALCIPARUM-MALARIA; RAPID DIAGNOSTIC-TESTS; DIHYDROARTEMISININ-PIPERAQUINE; COMBINATION THERAPY; RANDOMIZED-TRIAL; PARASITE; TRANSMISSION; OVALE; SCHISTOSOMIASIS; POLYMORPHISMS;
D O I
10.1017/S003118201400033X
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
During a longitudinal study investigating the dynamics of malaria in Ugandan lakeshore communities, a consistently high malaria prevalence was observed in young children despite regular treatment. To explore the short-term performance of artemether-lumefantrine (AL), a pilot investigation into parasite carriage after treatment(s) was conducted in Bukoba village. A total of 163 children (aged 2-7 years) with a positive blood film and rapid antigen test were treated with AL; only 8.7% of these had elevated axillary temperatures. On day 7 and then on day 17, 40 children (26.3%) and 33 (22.3%) were positive by microscopy, respectively. Real-time PCR analysis demonstrated that multi-species Plasmodium infections were common at baseline, with 41.1% of children positive for Plasmodium falciparum/Plasmodium malariae, 9.2% for P. falciparum/Plasmodium ovale spp. and 8.0% for all three species. Moreover, on day 17, 39.9% of children infected with falciparum malaria at baseline were again positive for the same species, and 9.2% of those infected with P. malariae at baseline were positive for P. malariae. Here, chronic multi-species malaria infections persisted in children after AL treatment(s). Better point-of-care diagnostics for non-falciparum infections are needed, as well as further investigation of AL performance in asymptomatic individuals.
引用
收藏
页码:1880 / 1890
页数:11
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