Temporal Dynamics of Subclinical Malaria in Different Transmission Zones of Myanmar.

Autor:	Egger JR; Duke Global Health Institute, Duke University, Durham, North Carolina., Han KT; Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar., Fang H; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China., Zhou XN; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.; Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China., Hlaing TM; Defense Services Medical Research Center, Nay Pyi Taw, Myanmar., Thant M; Defense Services Medical Research Center, Nay Pyi Taw, Myanmar., Han ZY; Duke Global Health Institute, Duke University, Durham, North Carolina.; Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar., Wang XX; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China., Hong T; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China., Platt A; Duke Global Health Institute, Duke University, Durham, North Carolina., Simmons R; Duke Global Health Institute, Duke University, Durham, North Carolina.; PPD, Morrisville, North Carolina., Thane TK; Duke Global Health Institute, Duke University, Durham, North Carolina., Meng M; Duke Global Health Institute, Duke University, Durham, North Carolina., Hogue J; Duke Global Health Institute, Duke University, Durham, North Carolina., Markwalter CF; Duke Global Health Institute, Duke University, Durham, North Carolina., Thi A; National Malaria Control Program, Myanmar Ministry of Health and Sports, Nay Pyi Taw, Myanmar., Htay T; Duke Global Health Institute, Duke University, Durham, North Carolina., Thein ZW; Duke Global Health Institute, Duke University, Durham, North Carolina., Paing AK; Duke Global Health Institute, Duke University, Durham, North Carolina., Tun ZM; Duke Global Health Institute, Duke University, Durham, North Carolina., Oo SM; Duke Global Health Institute, Duke University, Durham, North Carolina., Aung PP; Duke Global Health Institute, Duke University, Durham, North Carolina., Nyunt MM; University of Maryland School of Medicine, Baltimore, Maryland., Plowe CV; University of Maryland School of Medicine, Baltimore, Maryland.
Jazyk:	angličtina
Zdroj:	The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2022 Jul 25. Date of Electronic Publication: 2022 Jul 25.
DOI:	10.4269/ajtmh.22-0027
Abstrakt:	Countries in the Greater Mekong Subregion have committed to eliminate Plasmodium falciparum malaria by 2025. Subclinical malaria infections that can be detected by highly sensitive polymerase chain reaction (PCR) testing in asymptomatic individuals represent a potential impediment to this goal, although the extent to which these low-density infections contribute to transmission is unclear. To understand the temporal dynamics of subclinical malaria in this setting, a cohort of 2,705 participants from three epidemiologically distinct regions of Myanmar was screened for subclinical P. falciparum and P. vivax infection using ultrasensitive PCR (usPCR). Standard rapid diagnostic tests (RDTs) for P. falciparum were also performed. Individuals who tested positive for malaria by usPCR were followed for up to 12 weeks. Regression analysis was performed to estimate whether the baseline prevalence of infection and the count of repeated positive tests were associated with demographic, behavioral, and clinical factors. At enrollment, the prevalence of subclinical malaria infection measured by usPCR was 7.7% (1.5% P. falciparum monoinfection, 0.3% mixed P. falciparum and P. vivax, and 6.0% P. vivax monoinfection), while P. falciparum prevalence measured by RDT was just 0.2%. Prevalence varied by geography and was higher among older people and in those with outdoor exposure and travel. No difference was observed in either the prevalence or count of subclinical infection by time of year, indicating that even in low-endemicity areas, a reservoir of subclinical infection persists year-round. If low-density infections are shown to represent a significant source of transmission, identification of high-risk groups and locations may aid elimination efforts.
Databáze:	MEDLINE
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