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赞比亚南部消除前低疟疾传播环境中葡萄糖-6-磷酸脱氢酶缺乏症和配子体血症的流行情况。

Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency and Gametocytemia in a Pre-Elimination, Low Malaria Transmission Setting in Southern Zambia.

机构信息

1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

2Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.

出版信息

Am J Trop Med Hyg. 2021 Jan 4;104(3):1000-1002. doi: 10.4269/ajtmh.20-1187.

DOI:10.4269/ajtmh.20-1187
PMID:33399042
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7941823/
Abstract

The WHO recommends single low-dose (SLD) primaquine as a gametocytocide to reduce Plasmodium falciparum transmission in areas of low transmission. Despite this recommendation, uptake of SLD primaquine has been low because of concerns of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Individuals with G6PD deficiency can experience hemolysis when exposed to primaquine. In Southern Province, Zambia, malaria transmission has declined significantly over the past decade. Single low-dose primaquine may be an effective tool, but there is limited information on G6PD deficiency. We screened 137 residents in Macha, Southern Province, Zambia, and the prevalence of G6PD (A-) was 15%. We also revisited data collected from 2008 to 2013 in the same area and found the highest gametocyte burden among those aged 5-15 years. The findings from this study suggest that SLD primaquine targeted to school-aged children may be an effective tool to help achieve malaria elimination in southern Zambia.

摘要

世界卫生组织推荐使用单一低剂量（SLD）伯氨喹啉作为配子体杀灭剂，以减少低传播地区的恶性疟原虫传播。尽管有此推荐，但由于担心葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症，SLD 伯氨喹啉的使用率一直很低。G6PD 缺乏症患者在接触伯氨喹啉时可能会发生溶血。在赞比亚南部省，疟疾传播在过去十年中显著下降。单一低剂量伯氨喹啉可能是一种有效的工具，但关于 G6PD 缺乏症的信息有限。我们对赞比亚南部马查的 137 名居民进行了筛查，发现 G6PD（A-）的患病率为 15%。我们还重新审视了 2008 年至 2013 年在同一地区收集的数据，发现 5-15 岁年龄组的配子体负担最高。这项研究的结果表明，针对学龄儿童的 SLD 伯氨喹啉可能是在赞比亚南部实现消除疟疾的有效工具。