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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/40822
Title: History of malaria treatment as a predictor of subsequent subclinical parasitaemia: A cross-sectional survey and malaria case records from three villages in Pailin, western Cambodia
Authors: Thomas J. Peto
Sabine E. Kloprogge
Rupam Tripura
Chea Nguon
Nou Sanann
Sovann Yok
Chhouen Heng
Cholrawee Promnarate
Jeremy Chalk
Ngak Song
Sue J. Lee
Yoel Lubell
Mehul Dhorda
Mallika Imwong
Nicholas J. White
Lorenz Von Seidlein
Arjen Dondorp
Mahidol University
Erasmus University Rotterdam
Nuffield Department of Clinical Medicine
National Center for Parasitology, Entomology and Malaria Control
Family Health International
Provincial Health Department
Churchill Hospital
Keywords: Immunology and Microbiology
Issue Date: 26-Apr-2016
Citation: Malaria Journal. Vol.15, No.1 (2016)
Abstract: © 2016 Peto et al. Background: Treatment of the sub-clinical reservoir of malaria, which may maintain transmission, could be an important component of elimination strategies. The reliable detection of asymptomatic infections with low levels of parasitaemia requires high-volume quantitative polymerase chain reaction (uPCR), which is impractical to conduct on a large scale. It is unknown to what extent sub-clinical parasitaemias originate from recent or older clinical episodes. This study explored the association between clinical history of malaria and subsequent sub-clinical parasitaemia. Methods: In June 2013 a cross-sectional survey was conducted in three villages in Pailin, western Cambodia. Demographic and epidemiological data and blood samples were collected. Blood was tested for malaria by high-volume qPCR. Positive samples were analysed by nested PCR to determine the Plasmodium species. To identify previous episodes of malaria, case records were collected from village malaria workers and local health facilities and linked to study participants. Results: Among 1343 participants, 40/122 (32.8 %) with a history of clinical malaria were parasitaemic during the cross-sectional survey, compared to 172/1221 (14.1 %) without this history (p < 0.001). Among the 212 parasitaemic participants in the survey, 40 (18.9 %) had a history of clinical malaria, compared to 87 out of 1131 (7.7 %) parasite-negative participants; p < 0.001, adjusted OR 3.3 (95 % CI; 2.1-5.1). A history of Plasmodium vivax was associated with sub-clinical P. vivax parasitaemia in the survey (p < 0.001), but this association was not seen with Plasmodium falciparum (p = 0.253); only three participants had both P. falciparum parasites in the survey and a clinical history of P. falciparum. Conclusions: A clinical episode of vivax malaria was associated with subsequent sub-clinical parasitaemia. Treatment of P. vivax with artemisinin-based combination therapy without primaquine often resulted in recurrent episodes. Targeting individuals with a history of clinical malaria will be insufficient to eliminate the sub-clinical reservoir as they constitute a minority of parasitaemias.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84964645605&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/40822
ISSN: 14752875
Appears in Collections:Scopus 2016-2017

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