Risk factors for Plasmodium vivax gametocyte carriage in Thailand

Abstract

To study the risk factors for Plasmodium vivax gametocyte carriage, the presence or absence of gametocytes was determined in 2,125 patients with P. vivax malaria participating in clinical trials at the Hospital for Tropical Diseases in Bangkok, Thailand. Stepwise logistic regression models were used to determine which variables were significantly related to gametocyte carriage. On admission, 615 patients (29%) had detectable gametocytes (before treatment). After treatment had started, an additional 245 patients (11%) developed patent gametocytemia. The variables retained by multivariate analysis were highest observed temperature (adjusted odds ratio [AOR] per °C increase = 0.82, 95% confidence interval [CI] = 0.71-0.94, P = 0.006), asexual parasitemia > 9,200/μL (AOR = 2.8, 95% CI = 1.9-4.2, P < 0.0001), erythrocyte counts (AOR = 0.8/million/μL increase, 95% CI = 0.67-0.95, P = 0.01), monocyte percentage (AOR = 0.93 per % increase, 95% CI = 0.89-0.96, P < 0.0001), lymphocyte percentage (AOR = 0.98 per % increase, 95% CI = 0.97-0.99, P = 0.006), albumin (AOR = 0.67 per 10 g/mL increase, 95% CI = 0.5-0.9, P = 0.007), and anion gap (AOR = 1.1 per unit increase, 95% CI = 1.02-1.14, P = 0.009). The possible significance of these observations is discussed.