Department of Immunology & Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Clin Microbiol Rev. 2011 Apr;24(2):377-410. doi: 10.1128/CMR.00051-10.
Malaria remains a major cause of morbidity and mortality in the tropics, with Plasmodium falciparum responsible for the majority of the disease burden and P. vivax being the geographically most widely distributed cause of malaria. Gametocytes are the sexual-stage parasites that infect Anopheles mosquitoes and mediate the onward transmission of the disease. Gametocytes are poorly studied despite this crucial role, but with a recent resurgence of interest in malaria elimination, the study of gametocytes is in vogue. This review highlights the current state of knowledge with regard to the development and longevity of P. falciparum and P. vivax gametocytes in the human host and the factors influencing their distribution within endemic populations. The evidence for immune responses, antimalarial drugs, and drug resistance influencing infectiousness to mosquitoes is reviewed. We discuss how the application of molecular techniques has led to the identification of submicroscopic gametocyte carriage and to a reassessment of the human infectious reservoir. These components are drawn together to show how control measures that aim to reduce malaria transmission, such as mass drug administration and a transmission-blocking vaccine, might better be deployed.
疟疾仍然是热带地区发病率和死亡率的主要原因，恶性疟原虫是大多数疾病负担的罪魁祸首，间日疟原虫是疟疾在地理上分布最广泛的原因。配子体是感染按蚊并介导疾病传播的有性阶段寄生虫。尽管配子体具有这一关键作用，但对其研究仍很不完善，但随着人们对消除疟疾的兴趣最近重新兴起，对配子体的研究正在流行。本文综述了目前对人体中恶性疟原虫和间日疟原虫配子体的发育和寿命以及影响其在流行人群中分布的因素的了解。还回顾了影响对蚊子传染性的免疫反应、抗疟药物和耐药性的证据。我们讨论了分子技术的应用如何导致了亚微观配子体携带的鉴定，并重新评估了人类感染库。这些组成部分结合在一起，展示了旨在减少疟疾传播的控制措施（如大规模药物治疗和传播阻断疫苗）如何更好地部署。
