Details

Autor(en) / Beteiligte

• Douglas, Nicholas M.
• Simpson, Julie A.
• Phyo, Aung Pyae
• Siswantoro, Hadjar
• Hasugian, Armedy R.
• Kenangalem, Enny
• Poespoprodjo, Jeanne Rini
• Singhasivanon, Pratap
• Anstey, Nicholas M.
• White, Nicholas J.
• Tjitra, Emiliana
• Nosten, Francois
• Price, Rie N.

Titel

Gametocyte Dynamics and the Role of Drugs in Reducing the Transmission Potential of Plasmodium vivax

Ist Teil von

• The Journal of infectious diseases, 2013-09, Vol.208 (5), p.801-812

Ort / Verlag

Oxford: Oxford University Press

Erscheinungsjahr

2013

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Designing interventions that will reduce transmission of vivax malaria requires knowledge of Plasmodium vivax gametocyte dynamics. Methods. We analyzed data from a randomized controlled trial in northwestern Thailand and 2 trials in Papua, Indonesia, to identify and compare risk factors for vivax gametocytemia at enrollment and following treatment. Results. A total of 492 patients with P. vivax infections from Thailand and 476 patients (162 with concurrent falciparum parasitemia) from Indonesia were evaluable. Also, 84.3% (415/492) and 66.6% (209/314) of patients with monoinfection were gametocytemic at enrollment, respectively. The ratio of gametocytemia to asexual parasitemia did not differ between acute and recurrent infections (P= .48 in Thailand, P = .08 in Indonesia). High asexual parasitemia was associated with an increased risk of gametocytemia during follow-up in both locations. In Thailand, the cumulative incidence of gametocytemia between day 7 and day 42 following dihydroartemisinin + piperaquine (DHA + PIP) was 6.92% vs 29.1% following chloroquine (P<.001). In Indonesia, the incidence of gametocytemia was 33.6% following artesunate + amodiaquine (AS + AQ), 7.42% following artemether + lumefantrine, and 6.80% following DHA + PIP (P<.001 for DHA + PIP vs AS + AQ). Conclusions. P. vivax gametocyte carriage mirrors asexual-stage infection. Prevention of relapses, particularly in those with high asexual parasitemia, is likely the most important strategy for interrupting P. vivax transmission.