Contribution of Asymptomatic Plasmodium Infections to the Transmission of Malaria in Kayin State, Myanmar.
Plasmodium falciparum
Plasmodium vivax
Mass drug administration
Southeast Asia
artemisinin resistance
elimination
entomological inoculation rate
malaria
primaquine
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
16 04 2019
16 04 2019
Historique:
received:
19
09
2018
accepted:
27
11
2018
pubmed:
1
12
2018
medline:
10
1
2020
entrez:
1
12
2018
Statut:
ppublish
Résumé
The objective of mass antimalarial drug administration (MDA) is to eliminate malaria rapidly by eliminating the asymptomatic malaria parasite reservoirs and interrupting transmission. In the Greater Mekong Subregion, where artemisinin-resistant Plasmodium falciparum is now widespread, MDA has been proposed as an elimination accelerator, but the contribution of asymptomatic infections to malaria transmission has been questioned. The impact of MDA on entomological indices has not been characterized previously. MDA was conducted in 4 villages in Kayin State (Myanmar). Malaria mosquito vectors were captured 3 months before, during, and 3 months after MDA, and their Plasmodium infections were detected by polymerase chain reaction (PCR) analysis. The relationship between the entomological inoculation rate, the malaria prevalence in humans determined by ultrasensitive PCR, and MDA was characterized by generalized estimating equation regression. Asymptomatic P. falciparum and Plasmodium vivax infections were cleared by MDA. The P. vivax entomological inoculation rate was reduced by 12.5-fold (95% confidence interval [CI], 1.6-100-fold), but the reservoir of asymptomatic P. vivax infections was reconstituted within 3 months, presumably because of relapses. This was coincident with a 5.3-fold (95% CI, 4.8-6.0-fold) increase in the vector infection rate. Asymptomatic infections are a major source of malaria transmission in Southeast Asia.
Sections du résumé
BACKGROUND
The objective of mass antimalarial drug administration (MDA) is to eliminate malaria rapidly by eliminating the asymptomatic malaria parasite reservoirs and interrupting transmission. In the Greater Mekong Subregion, where artemisinin-resistant Plasmodium falciparum is now widespread, MDA has been proposed as an elimination accelerator, but the contribution of asymptomatic infections to malaria transmission has been questioned. The impact of MDA on entomological indices has not been characterized previously.
METHODS
MDA was conducted in 4 villages in Kayin State (Myanmar). Malaria mosquito vectors were captured 3 months before, during, and 3 months after MDA, and their Plasmodium infections were detected by polymerase chain reaction (PCR) analysis. The relationship between the entomological inoculation rate, the malaria prevalence in humans determined by ultrasensitive PCR, and MDA was characterized by generalized estimating equation regression.
RESULTS
Asymptomatic P. falciparum and Plasmodium vivax infections were cleared by MDA. The P. vivax entomological inoculation rate was reduced by 12.5-fold (95% confidence interval [CI], 1.6-100-fold), but the reservoir of asymptomatic P. vivax infections was reconstituted within 3 months, presumably because of relapses. This was coincident with a 5.3-fold (95% CI, 4.8-6.0-fold) increase in the vector infection rate.
CONCLUSION
Asymptomatic infections are a major source of malaria transmission in Southeast Asia.
Identifiants
pubmed: 30500927
pii: 5219030
doi: 10.1093/infdis/jiy686
pmc: PMC6467188
doi:
Substances chimiques
Antimalarials
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1499-1509Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 101148
Pays : United Kingdom
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
Southeast Asian J Trop Med Public Health. 1988 Jun;19(2):283-9
pubmed: 3227405
Lancet Infect Dis. 2018 May;18(5):565-572
pubmed: 29398388
Lancet. 2014 Sep 13;384(9947):1005-70
pubmed: 25059949
PLoS Med. 2006 Jun;3(6):e183
pubmed: 16719547
Malar J. 2015 Sep 30;14:381
pubmed: 26424000
PLoS One. 2016 Jul 21;11(7):e0159160
pubmed: 27441839
J Clin Microbiol. 2014 Sep;52(9):3303-9
pubmed: 24989601
Trans R Soc Trop Med Hyg. 1996 Mar-Apr;90(2):105-11
pubmed: 8761562
Lancet Infect Dis. 2013 Feb;13(2):175-81
pubmed: 23182932
Am J Trop Med Hyg. 1982 Mar;31(2):183-91
pubmed: 7072883
Southeast Asian J Trop Med Public Health. 1998 Mar;29(1):3-9
pubmed: 9740259
Trans R Soc Trop Med Hyg. 1995 May-Jun;89(3):248-54
pubmed: 7660424
Wellcome Open Res. 2019 Jun 17;3:109
pubmed: 31206035
J Med Entomol. 2004 Mar;41(2):201-8
pubmed: 15061279
Trop Med Int Health. 1999 Feb;4(2):131-8
pubmed: 10206267
Acta Trop. 2005 Jun;94(3):230-40
pubmed: 15878154
Am J Trop Med Hyg. 1952 Jul;1(4):612-7
pubmed: 14943909
PLoS Med. 2017 Jan 10;14(1):e1002212
pubmed: 28072872
J Infect Dis. 2018 Apr 23;217(10):1561-1568
pubmed: 29394367
Clin Infect Dis. 2016 Sep 15;63(6):784-791
pubmed: 27313266
J Med Entomol. 2005 Sep;42(5):777-9
pubmed: 16363160
Clin Infect Dis. 2018 Nov 13;67(11):1670-1676
pubmed: 29846536
Lancet Infect Dis. 2018 Mar;18(3):337-345
pubmed: 29398391
J Infect Dis. 2016 May 1;213(9):1491-4
pubmed: 26667316
Malar J. 2014 Dec 16;13:500
pubmed: 25515943
Int J Parasitol. 2017 Feb;47(2-3):163-170
pubmed: 28043858
J Infect Dis. 2019 Feb 15;219(5):695-702
pubmed: 30295822
Parasit Vectors. 2016 Jan 13;9:17
pubmed: 26762512
Parasit Vectors. 2011 May 25;4:89
pubmed: 21612587
Lancet. 2018 May 12;391(10133):1916-1926
pubmed: 29703425
Lancet Infect Dis. 2017 May;17(5):491-497
pubmed: 28161569
J Infect Dis. 2016 Apr 15;213(8):1322-9
pubmed: 26681777
Trop Med Int Health. 2003 Sep;8(9):767-74
pubmed: 12950662
Am J Trop Med Hyg. 1955 Sep;4(5):781-9
pubmed: 13259002
Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):181-92
pubmed: 18165491
Lancet Infect Dis. 2016 Jun;16(6):674-684
pubmed: 26906747
Bull World Health Organ. 1960;22:605-19
pubmed: 13812457
Wellcome Open Res. 2017 Sep 6;2:81
pubmed: 29062913
Southeast Asian J Trop Med Public Health. 1988 Jun;19(2):259-69
pubmed: 3227404