School of Veterinary Medicine, University of Surrey, Guildford.
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
J Infect Dis. 2018 Mar 13;217(7):1099-1109. doi: 10.1093/infdis/jix686.
As part of a longitudinal cohort investigation of intestinal schistosomiasis and malaria in Ugandan children and their mothers on the shorelines of Lakes Victoria and Albert, we documented risk factors and morbidity associated with nonfalciparum Plasmodium infections and the longitudinal dynamics of Plasmodium species in children. Host age, household location, and Plasmodium falciparum infection were strongly associated with nonfalciparum Plasmodium infections, and Plasmodium malariae infection was associated with splenomegaly. Despite regular artemisinin combination therapy treatment, there was a 3-fold rise in P. malariae prevalence, which was not accountable for by increasing age of the child. Worryingly, our findings reveal the consistent emergence of nonfalciparum infections in children, highlighting the complex dynamics underlying multispecies infections here. Given the growing body of evidence that nonfalciparum malaria infections cause significant morbidity, we encourage better surveillance for nonfalciparum Plasmodium infections, particularly in children, with more sensitive DNA detection methods and improved field-based diagnostics.
作为对乌干达维多利亚湖和阿尔伯特湖湖滨地区儿童及其母亲肠道血吸虫病和疟疾的纵向队列研究的一部分，我们记录了与非恶性疟原虫感染相关的风险因素和发病率，以及儿童中疟原虫物种的纵向动态。宿主年龄、家庭位置和恶性疟原虫感染与非恶性疟原虫感染强烈相关，间日疟原虫感染与脾肿大有关。尽管定期进行青蒿素联合疗法治疗，但恶性疟原虫感染的患病率上升了 3 倍，这不能归因于儿童年龄的增长。令人担忧的是，我们的研究结果揭示了儿童中非恶性疟原虫感染的持续出现，突出了这里多种感染背后的复杂动态。鉴于越来越多的证据表明非恶性疟原虫感染会导致严重的发病率，我们鼓励更好地监测非恶性疟原虫感染，特别是在儿童中，使用更敏感的 DNA 检测方法和改进的现场诊断方法。
