Departmento de Entomología Médica del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá.
Departmento de Parasitología del Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá.
PLoS One. 2024 Jul 24;19(7):e0305558. doi: 10.1371/journal.pone.0305558. eCollection 2024.
Plasmodium vivax is the main causative agent of malaria in Panama. However, the prevalence of asymptomatic infections in the different endemic regions remains unknown. Understanding the epidemiological behavior of asymptomatic infections is essential for the elimination of malaria. This study aimed to determine the prevalence of asymptomatic malarial infections in one of the main endemic regions of Panama using multiplex real-time reverse transcription RT-MqPCR.
A cross-sectional study was conducted in three communities in the Guna Yala Comarca. A total of 551 thick blood smears and their respective samples on filter paper were collected from volunteers of different ages and sexes from June 20 to 25, 2016. Infections by the Plasmodium spp. were diagnosed using microscopy and RT-MqPCR. All statistical analyses were performed using the R software.
The average prevalence of asymptomatic infections by P. vivax in the three communities detected by RT-MqPCR was 9.3%, with Ukupa having the highest prevalence (13.4%), followed by Aidirgandi (11.1%) and Irgandi (3.3%). A total of 74 samples were diagnosed as asymptomatic infections using RT-MqPCR. Light microscopy (LM) detected that 17.6% (13/74) of the asymptomatic samples and 82.4% (61/74) were diagnosed as false negatives. A 100% correlation was observed between samples diagnosed using LM and RT-MqPCR. A total of 52.7% (39/74) of the asymptomatic patients were female and 85.1% (63/74) were registered between the ages of 1 and 21 years. Factors associated with asymptomatic infection were community (aOR = 0.38 (95% CI 0.17-0.83), p < 0.001) and age aOR = 0.98 (95% CI 0.97-1.00), p < 0.05); F = 5.38; p < 0.05).
This study provides novel evidence of the considerable prevalence of asymptomatic P. vivax infections in the endemic region of Kuna Yala, representing a new challenge that requires immediate attention from the National Malaria Program. The results of this study provide essential information for the health authorities responsible for developing new policies. Furthermore, it will allow program administrators to reorient and design effective malaria control strategies that consider asymptomatic infections as a fundamental part of malaria control and move towards fulfilling their commitment to eliminate it.
间日疟原虫是巴拿马疟疾的主要病原体。然而，不同流行地区无症状感染的流行率仍不清楚。了解无症状感染的流行病学行为对于消除疟疾至关重要。本研究旨在使用多重实时逆转录 RT-MqPCR 确定巴拿马一个主要流行地区的无症状疟原虫感染的流行率。
在 Guna Yala 地区的三个社区进行了一项横断面研究。2016 年 6 月 20 日至 25 日，从不同年龄和性别的志愿者中采集了 551 张厚血涂片及其相应的滤纸样本。使用显微镜和 RT-MqPCR 诊断疟原虫属感染。所有统计分析均使用 R 软件进行。
通过 RT-MqPCR 检测，三个社区间日疟原虫无症状感染的平均流行率为 9.3%，其中 Ukupa 最高（13.4%），其次是 Aidirgandi（11.1%）和 Irgandi（3.3%）。共有 74 份样本通过 RT-MqPCR 诊断为无症状感染。光镜（LM）检测发现，17.6%（13/74）的无症状样本和 82.4%（61/74）被诊断为假阴性。LM 和 RT-MqPCR 诊断的样本之间存在 100%的相关性。52.7%（39/74）的无症状患者为女性，85.1%（63/74）的年龄在 1 至 21 岁之间。与无症状感染相关的因素是社区（aOR = 0.38（95%CI 0.17-0.83），p < 0.001）和年龄 aOR = 0.98（95%CI 0.97-1.00），p < 0.05）；F = 5.38；p < 0.05）。
本研究提供了间日疟原虫在 Kuna Yala 流行地区无症状感染高流行率的新证据，这是国家疟疾规划需要立即关注的新挑战。本研究结果为负责制定新政策的卫生当局提供了重要信息。此外，它将使项目管理者能够重新定位和设计有效的疟疾控制策略，将无症状感染视为疟疾控制的一个基本组成部分，并朝着实现消除疟疾的承诺迈进。
