巴布亚新几内亚新感染和临床疟疾发病率之间复杂的关系。

The complex relationship of exposure to new infections and incidence of clinical malaria in Papua New Guinea.

机构信息

Swiss Tropical and Public Health Institute, Basel, Switzerland.

University of Basel, Basel, Switzerland.

出版信息

Elife. 2017 Sep 1;6:e23708. doi: 10.7554/eLife.23708.

UNLABELLED

The molecular force of blood-stage infection (FOB) is a quantitative surrogate metric for malaria transmission at population level and for exposure at individual level. Relationships between FOB, parasite prevalence and clinical incidence were assessed in a treatment-to-reinfection cohort, where () hypnozoites were eliminated in half the children by primaquine (PQ). Discounting relapses, children acquired equal numbers of new () and blood-stage infections/year (FOB = 0-18, FOB = 0-23) resulting in comparable spatial and temporal patterns in incidence and prevalence of infections. Including relapses, FOB increased >3 fold (relative to PQ-treated children) showing greater heterogeneity at individual (FOB = 0-36) and village levels. and FOB were strongly associated with clinical episode risk. Yearly clinical incidence rate (IR = 0.28) was higher than for (IR = 0.12) despite lower FOB. These relationships between FOB, clinical incidence and parasite prevalence reveal a comparable decline in and transmission that is normally hidden by the high burden of relapses.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov NCT02143934.

未标注

血液阶段感染的分子力（FOB）是衡量人群疟疾传播水平和个体暴露水平的定量替代指标。在一个治疗-再感染队列中评估了 FOB、寄生虫流行率和临床发病率之间的关系，其中一半儿童通过伯氨喹（PQ）消除了休眠疟原虫。不计复发，儿童每年获得相同数量的新（）和血液阶段感染/年（FOB = 0-18，FOB = 0-23），导致感染的发病率和流行率具有相似的空间和时间模式。包括复发在内，FOB 增加了 >3 倍（与 PQ 治疗的儿童相比），显示出个体（FOB = 0-36）和村庄水平的更大异质性。和 FOB 与临床发作风险密切相关。每年的临床发病率（IR = 0.28）高于（IR = 0.12），尽管 FOB 较低。FOB、临床发病率和寄生虫流行率之间的这些关系揭示了和的传播呈可比下降趋势，而复发的高负担通常掩盖了这种下降趋势。