Banegas Sharon, Escobar Denis, Pinto Alejandra, Moncada Marcela, Matamoros Gabriela, Valdivia Hugo O, Reyes Allan, Fontecha Gustavo
Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras.
Department of Parasitology, U.S. Naval Medical Research Unit South (NAMRU SOUTH), Lima 07006, Peru.
Pathogens. 2024 Jun 27;13(7):541. doi: 10.3390/pathogens13070541.
Efforts on a global scale for combating malaria have achieved substantial progress over the past twenty years. Two Central American nations have accomplished their goal of eliminating malaria: El Salvador and Belize. Honduras has decreased the incidence of malaria and now reports fewer than 4000 malaria cases annually, aspiring to reach elimination by 2030. To accomplish this goal, it is essential to assess the existing strategies employed for malaria control and to address the task of incorporating novel intervention strategies to identify asymptomatic reservoirs.
A survey for detecting asymptomatic cases was carried out in the community of Kaukira, in Gracias a Dios, Honduras, focusing on malaria transmission during 2023. Asymptomatic community members were recruited as participants, malaria screening was performed through a rapid diagnostic test in situ, and a blood sample was collected on filter paper. Highly sensitive molecular assays based on photo-induced electron transfer PCR (PET-PCR) were performed to detect the two species of circulating in Honduras: and . In addition, the identification of the parasite species was verified by amplifying three genetic markers (, , and ).
A total of 138 participants were recruited, mostly adult women. All individuals tested negative on the rapid diagnostic test. Positive results for malaria were detected by PET-PCR in 17 samples (12.3%). Most samples (12 out of 17) were amplified with a Ct value between 37 and 42, indicating very low parasitemias. Out of the 17 samples, 16 of them also showed amplification in the species assays. There were nine cases of infections and seven cases of infections that were further confirmed by nested PCR (nPCR) of and . Parasitemias ranged from 100 p/μL to less than 0.25 p/μL. One sample showed mixed infection.
The existence of asymptomatic malaria reservoirs in Honduras can contribute to disease transmission and pose a challenge that may hinder elimination efforts, requiring public health authorities to modify surveillance strategies to identify the disease and treat this population accordingly.
在过去二十年里，全球范围内抗击疟疾的努力取得了重大进展。中美洲的两个国家已实现消除疟疾的目标：萨尔瓦多和伯利兹。洪都拉斯降低了疟疾发病率，目前每年报告的疟疾病例少于4000例，力争到2030年实现消除疟疾目标。为实现这一目标，评估现有的疟疾控制策略并完成纳入新的干预策略以识别无症状感染者的任务至关重要。
在洪都拉斯格拉西亚斯-阿迪奥斯省的考基拉社区开展了一项检测无症状病例的调查，重点关注2023年期间的疟疾传播情况。招募无症状社区成员作为参与者，通过现场快速诊断检测进行疟疾筛查，并在滤纸上采集血样。基于光诱导电子转移PCR（PET-PCR）的高灵敏度分子检测用于检测在洪都拉斯传播的两种疟原虫：恶性疟原虫和间日疟原虫。此外，通过扩增三个基因标记（18S rRNA、cytochrome b和DHFR）来验证寄生虫种类的鉴定。
共招募了138名参与者，大多数为成年女性。所有个体的快速诊断检测结果均为阴性。通过PET-PCR在17个样本（12.3%）中检测到疟疾阳性结果。大多数样本（17个中的12个）的Ct值在37至42之间扩增，表明疟原虫血症水平非常低。在这17个样本中，有16个在疟原虫种类检测中也显示出扩增。通过恶性疟原虫和间日疟原虫的巢式PCR（nPCR）进一步确认了9例恶性疟原虫感染和7例间日疟原虫感染。疟原虫血症范围从100个/微升至小于0.25个/微升。一个样本显示混合感染。
洪都拉斯无症状疟疾感染者的存在可能导致疾病传播，并构成可能阻碍消除努力的挑战，这就要求公共卫生当局修改监测策略以识别该疾病并相应地治疗这部分人群。
