Assessing the burden of submicroscopic Plasmodium infections in a pre-elimination malaria setting in sub-Saharan Africa, Guinea-Bissau.

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES
Ronise Silva, Luis Filipe Lopes, Amabelia Rodrigues, Ana Paula Arez, Márcia M Medeiros
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引用次数: 0

Abstract

Background: Submicroscopic Plasmodium infections can be a source of persistent malaria transmission. The aim of this study was to assess their frequency, distribution, morbidity and associated factors in a pre-elimination malaria setting in sub-Saharan Africa, Guinea-Bissau, where the Plasmodium falciparum is the predominant Plasmodium species.

Methods: Dried fingerprick whole blood samples from 601 participants in the 2017 national, household-based, cross-sectional survey to estimate malaria prevalence were subjected to DNA extraction. The DNA was used in nested end-point PCR assays targeting genus- and species-specific regions of the Plasmodium 18S rRNA genes. Statistical analysis of socio-demographic, clinical and molecular data was carried out using the Statistical Package for the Social Sciences, version 29. Factors associated with submicroscopic P. falciparum infections and their magnitude were sought using Chi-square test and multiple logistic regression models, respectively. Statistically significant level was considered at P-value < 0.05.

Results: Nested PCR assays detected submicroscopic P. falciparum infections in 20.3% (95% CI = 16.8-23.8) of individuals microscopically negative for Plasmodium species in the general population and in 21.4% (95% CI = 9.9-36.5) of microscopically negative pregnant women. Submicroscopic Plasmodium malariae infections were also detected as co-infections in 3.0% individuals who were microscopically positive only for P. falciparum. Infections with other Plasmodium species were not detected. Submicroscopic P. falciparum infections were not associated with age, sex, or the presence of fever. A logistic regression model adjusted for ethnicity and health region showed that individuals from the Balanta and Bijagos ethnic groups, most of whom live in the low malaria-transmission areas of Quinara and Bissau, and the Bijagos archipelago, respectively, were less likely to have submicroscopic P. falciparum infections than individuals from the large Fula ethnic group, most of whom live in the high malaria-transmission area of Gabu. Submicroscopic P. falciparum infections were not associated with anaemia in children under 5 years of age.

Conclusion: The results obtained highlight the contribution of asymptomatic and submicroscopic P. falciparum infections to malaria transmission in high malaria-transmission areas and the need for molecular-based tools to detect submicroscopic Plasmodium species.

在撒哈拉以南非洲几内亚比绍疟疾消灭前的环境中评估亚显微疟原虫感染的负担。
背景:亚显微疟原虫感染可能是疟疾持续传播的源头。在撒哈拉以南非洲的几内亚比绍,恶性疟原虫是主要的疟原虫种类,本研究旨在评估恶性疟原虫感染的频率、分布、发病率和相关因素:对参加 2017 年全国家庭横断面调查以估计疟疾流行率的 601 名参与者的干燥指刺全血样本进行了 DNA 提取。DNA 被用于针对疟原虫 18S rRNA 基因属种特异性区域的巢式终点 PCR 检测。社会人口学、临床和分子数据的统计分析采用社会科学统计软件包第 29 版进行。分别使用卡方检验(Chi-square test)和多元逻辑回归模型(multiple logistic regression models)寻找与镜下恶性疟原虫感染相关的因素及其严重程度。统计意义以 P 值为标准:巢式 PCR 检测发现,在显微镜下疟原虫阴性的普通人群中,有 20.3%(95% CI = 16.8-23.8)的人感染了镜下恶性疟原虫,在显微镜下疟原虫阴性的孕妇中,有 21.4%(95% CI = 9.9-36.5)的人感染了镜下恶性疟原虫。在显微镜下对恶性疟原虫检测呈阳性的人群中,有 3.0% 的人同时感染了亚显微疟原虫。未检测到其他疟原虫感染。镜下恶性疟原虫感染与年龄、性别或是否发烧无关。根据种族和卫生区域调整后的逻辑回归模型显示,巴兰塔族和比热戈斯族群(大部分分别生活在基纳拉和比绍的疟疾低传播地区以及比热戈斯群岛)感染显微镜下恶性疟原虫的几率低于富拉族群(大部分生活在加布的疟疾高传播地区)。显微镜下恶性疟原虫感染与 5 岁以下儿童贫血无关:结论:研究结果表明,无症状和亚显微镜下恶性疟原虫感染对疟疾高传播地区的疟疾传播起着重要作用,因此需要使用分子工具来检测亚显微镜下的疟原虫种类。
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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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