Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Apartado 0816-02593, República de Panamá.
Departamento de Análisis Epidemiológico y Bioestadísticas, Instituto Conmemorativo Gorgas de Estudios de la Salud, Apartado 0816-02593, República de Panamá.
Infect Genet Evol. 2019 Apr;69:216-223. doi: 10.1016/j.meegid.2019.02.003. Epub 2019 Feb 4.
The Panamá Canal construction encompassed one of the first examples of malaria elimination. Nevertheless, malaria has uninterruptedly persisted in Native American populations living within a few kilometers of the Panamá Canal. Here, we present results from a monthly longitudinal study (May 2016 to March 2018), whose goal was to quantitatively describe seasonal patterns of Plasmodium spp. infection in Anopheles albimanus Wiedemann, and its association with environmental covariates, at Ipetí-Guna, a village within a region targeted for malaria elimination in Panamá. To detect Plasmodium spp. infections we employed a standard nested PCR on DNA extracts from mosquito pools of varying size, which were then used to estimate monthly infection rates using a maximum likelihood method. The infection rate estimates (IR) were analyzed using time series analysis methods to study their association with changes in rainfall, temperature, NDVI (a satellite derived vegetation index), malaria cases and human biting rates (HBR). We found that mosquitoes were infected by Plasmodium vivax mainly from September to December, reaching a peak in December. Time series modeling showed malaria IR in An albimanus increased, simultaneously with HBR, and IR in the previous month. These results suggest that elimination interventions, such as mass drug administration, are likely to be more effective if deployed from the middle to the end of the dry season (March and April at Ipetí-Guna), when the likelihood of malaria infection in mosquitoes is very low and when curtailing human infections driving infections in mosquitoes can reduce malaria transmission, and increase the chance for elimination.
巴拿马运河的建设是消灭疟疾的首例范例之一。然而,在距离巴拿马运河几公里范围内的美洲原住民中,疟疾仍在持续存在。在这里,我们展示了一项月度纵向研究(2016 年 5 月至 2018 年 3 月)的结果,该研究的目的是定量描述在巴拿马一个旨在消除疟疾的地区的伊佩蒂-瓜纳(Ipetí-Guna),按蚊(Anopheles albimanus Wiedemann)季节性疟原虫感染的模式及其与环境协变量的关系。为了检测疟原虫感染,我们采用了标准的巢式 PCR 对不同大小的蚊子池的 DNA 提取物进行检测,然后使用最大似然法来估算每月的感染率。使用时间序列分析方法分析感染率估计值(IR),以研究其与降雨量、温度、NDVI(卫星衍生的植被指数)、疟疾病例和人类叮咬率(HBR)变化的关系。我们发现,按蚊主要在 9 月至 12 月期间感染间日疟原虫(Plasmodium vivax),12 月达到高峰。时间序列模型显示,按蚊疟原虫感染率(IR)与 HBR 和上月的 IR 同时增加。这些结果表明,如果在旱季(伊佩蒂-瓜纳的 3 月和 4 月)中到后期(即 3 月和 4 月)部署大规模药物治疗等消除干预措施,可能会更有效,因为此时蚊子感染疟疾的可能性非常低,并且可以减少人类感染来降低蚊子感染,增加消除疟疾的机会。