刚果民主共和国金沙萨城乡地区无症状和有症状学龄儿童感染疟原虫的种系组成。
Malaria parasite species composition of Plasmodium infections among asymptomatic and symptomatic school-age children in rural and urban areas of Kinshasa, Democratic Republic of Congo.
机构信息
Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
出版信息
Malar J. 2021 Oct 2;20(1):389. doi: 10.1186/s12936-021-03919-4.
BACKGROUND
Malaria remains a major public health concern in the Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC.
METHODS
A total of 634 (427 asymptomatic and 207 symptomatic) blood samples collected from school-age children aged 6 to 14 years were analysed by microscopy, RDT and Nested-PCR.
RESULTS
The overall prevalence of Plasmodium spp. by microscopy, RDT and PCR was 33%, 42% and 62% among asymptomatic children and 59%, 64% and 95% in symptomatic children, respectively. The prevalence of Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale spp. by PCR was 58%, 20% and 11% among asymptomatic and 93%, 13% and 16% in symptomatic children, respectively. Among P. ovale spp., P. ovale curtisi, P. ovale wallikeri and mixed P. ovale curtisi + P. ovale wallikeri accounted for 75%, 24% and 1% of infections, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p < 0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p < 0.001). Amongst asymptomatic malaria parasite carriers, 43% and 16% of children harboured mixed Plasmodium with P. falciparum infections in the rural and the urban areas, respectively, whereas in symptomatic malaria infections, it was 22% and 26%, respectively. Few children carried single infections of P. malariae (2.2%) and P. ovale spp. (1.9%).
CONCLUSION
School-age children are at significant risk from both asymptomatic and symptomatic malaria infections. Continuous systematic screening and treatment of school-age children in high-transmission settings is needed.
背景
疟疾仍然是刚果民主共和国（DRC）的一个主要公共卫生问题，学龄儿童在疟疾患病率调查中相对被忽视，可能构成重要的传播源。本研究旨在了解金沙萨/DRC 学龄儿童的疟疾感染负担。
方法
共分析了 634 份（427 份无症状和 207 份有症状）来自 6 至 14 岁学龄儿童的血液样本，采用显微镜检查、RDT 和巢式 PCR 进行分析。
结果
显微镜检查、RDT 和 PCR 检测的总疟原虫感染率在无症状儿童中分别为 33%、42%和 62%，在有症状儿童中分别为 59%、64%和 95%。PCR 检测的间日疟原虫、恶性疟原虫和卵形疟原虫感染率在无症状儿童中分别为 58%、20%和 11%，在有症状儿童中分别为 93%、13%和 16%。卵形疟原虫感染中，卵形疟原虫 curtisi、卵形疟原虫 wallikeri 和混合卵形疟原虫 curtisi+卵形疟原虫 wallikeri 分别占 75%、24%和 1%。所有疟原虫感染在无症状感染中均显著更常见于农村地区，而不是城市地区（p<0.001）。与居住在城市地区相比，居住在农村地区与无症状疟原虫携带的风险增加五倍相关（p<0.001）。在无症状疟原虫携带者中，农村地区和城市地区分别有 43%和 16%的儿童携带恶性疟原虫混合感染，而在有症状疟疾感染中，这一比例分别为 22%和 26%。少数儿童携带单一感染的间日疟原虫（2.2%）和卵形疟原虫（1.9%）。
结论
学龄儿童面临着严重的无症状和有症状疟疾感染风险。在高传播地区，需要持续系统地筛查和治疗学龄儿童。
Zotero 插件