Zaw Myo Thiha, Thant Myo, Hlaing Tin Maung, Aung Naing Zin, Thu Min, Phumchuea Kanit, Phusri Kanokwan, Saeseu Teerawat, Yorsaeng Ritthideach, Nguitragool Wang, Felger Ingrid, Kaewkungwal Jaranit, Cui Liwang, Sattabongkot Jetsumon
Defence Services Medical Research Centre (DSMRC), Nay Pyi Taw, Myanmar.
Mahidol Vivax Research Unit (MVRU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Malar J. 2017 Apr 4;16(1):138. doi: 10.1186/s12936-017-1789-9.
Myanmar has the heaviest burden of malaria in the Greater Mekong Sub-region. Asymptomatic Plasmodium spp. infections are common in this region and may represent an important reservoir of transmission that must be targeted for malaria elimination.
A mass blood survey was conducted among 485 individuals from six villages in Kayah State, an area of endemic but low transmission malaria in eastern Myanmar. Malaria infection was screened by rapid diagnostic test (RDT), light microscopy and real-time polymerase chain reaction (PCR), and its association with demographic factors was explored.
The prevalence of asymptomatic Plasmodium spp. infection was 2.3% (11/485) by real-time PCR. Plasmodium vivax accounted for 72.7% (8/11) and Plasmodium falciparum for 27.3% (3/11) of infections. Men were at greater risk of infection by Plasmodium spp. than women. Individuals who worked as farmers or wood and bamboo cutters had an increased risk of infection.
A combination of RDT, light microscopy and PCR diagnostics were used to identify asymptomatic malaria infection, providing additional information on asymptomatic cases in addition to the routine statistics on symptomatic cases, so as to determine the true burden of disease in the area. Such information and risk factors can improve malaria risk stratification and guide decision-makers towards better design and delivery of targeted interventions in small villages, representative of Kayah State.
缅甸在大湄公河次区域承担着最重的疟疾负担。无症状疟原虫感染在该地区很常见，可能是一个重要的传播源，必须作为疟疾消除的目标。
对缅甸东部克耶邦六个村庄的485人进行了大规模血液调查，该地区是疟疾流行但传播率较低的地区。通过快速诊断测试（RDT）、光学显微镜检查和实时聚合酶链反应（PCR）筛查疟疾感染，并探讨其与人口统计学因素的关联。
通过实时PCR检测，无症状疟原虫感染率为2.3%（11/485）。间日疟原虫占感染病例的72.7%（8/11），恶性疟原虫占27.3%（3/11）。男性感染疟原虫的风险高于女性。从事农民或木材及竹子砍伐工作的人感染风险增加。
采用RDT、光学显微镜检查和PCR诊断相结合的方法来识别无症状疟疾感染，除了有症状病例的常规统计数据外，还提供了无症状病例的额外信息，从而确定该地区疾病的真实负担。这些信息和风险因素可以改善疟疾风险分层，并指导决策者更好地设计和实施针对克耶邦代表性小村庄的靶向干预措施。
